JMIR Publications

ABSTRACT

Background:

Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterised by low levels of psychological wellbeing and consistently report unmet needs for psychological support. Mobile app-based (mHealth) interventions present a novel approach to both reducing stress and improving wellbeing.

Objective:

This study aimed to evaluate the effectiveness of a mobile app-based psychological intervention for people providing care to family or friends with a physical or mental disability.

Methods:

In a randomised single-blind controlled trial, 183 caregivers were randomly allocated to either an intervention (n = 73) or active control (n = 110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness based) cognitive behavioural therapies, while the active control app contained the self-monitoring feature only. Both programs were completed over a 5-week period. It was hypothesised that intervention app exposure would be associated with decreases in depression, anxiety, stress, and increases in wellbeing, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, post-intervention, and 3-to-4 months post-intervention. App quality was also assessed.

Results:

The intervention group experienced reductions in stress (b = -2.07, p = .04) and depressive symptoms (b = -1.36, p = .05) from baseline to post-intervention. These changes were further enhanced from post-intervention to follow-up, with the intervention group continuing to report lower levels of depression (b = -1.82, p = .03) and higher levels of emotional wellbeing (b = 6.13, p < .001), optimism (b = 0.78, p = .007), self-esteem (b = -0.84, p = .005), support from family (b = 2.15, p = .001), support from significant others (b = 2.66, p < .001), and subjective wellbeing (b = 4.82, p < .001). The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5.

Conclusions:

This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customisation in the treatment design. Clinical Trial: Australian New Zealand Clinical Trial Registry Identifier: ACTRN12616000996460 (Registered on 28/07/2016).