JMIR Publications

ABSTRACT

Background:

Providing informal care can lead to substantial psychological burden, while time constraints, financial pressures, and limited access to services may hinder caregivers from seeking traditional psychological support. Internet-based interventions (IBIs) may offer a flexible and accessible alternative; however, their successful implementation requires an understanding of stakeholders’ perspectives.

Objective:

This study aimed to assess caregivers’ and clinicians’ awareness, attitudes, acceptability, willingness to use IBIs, and perceived advantages and barriers, with the broader goal of informing the adaptation and implementation of IBIs for informal caregivers in Italy.

Methods:

An online stakeholder survey was conducted in Italy between October 2021 and December 2022. The final sample comprised 133 participants divided into three mutually exclusive groups: 67 caregivers only, 51 clinicians only, and 15 participants who identified as both caregivers and clinicians. Participants were recruited through social media, personal contacts, and snowball sampling. The survey assessed sociodemographic and caregiving or clinical characteristics, knowledge and awareness of IBIs, acceptability and willingness to use them, attitudes, and perceived advantages and barriers.

Results:

Caregivers showed limited prior familiarity with IBIs: 26.9% had previously heard of them and 9.0% had tried one. Nevertheless, 56.7% were willing to try an IBI in their caregiver role, and most considered IBIs potentially useful for other caregivers (76.1%) and for themselves (68.7%). Although 88.1% conceptualized caregiving as a dyadic phenomenon, 82.1% preferred an individual IBI format. Clinicians demonstrated greater familiarity with IBIs (74.5%) and substantial openness toward implementation: 70.6% were willing to use IBIs in clinical practice and 62.7% were interested in receiving IBI-specific training. Across stakeholder groups, improved accessibility emerged as a central perceived benefit. Among clinicians, overcoming geographical distance was the highest-ranked advantage, whereas patients’ attitudes and online security/data privacy were the two highest-ranked barriers. Among caregivers, lack of mental-health-system readiness was the highest-ranked barrier. Findings from the dual-role subgroup were broadly consistent with the importance attributed to accessibility and implementation readiness.

Conclusions:

Stakeholders showed substantial receptiveness toward IBIs for informal caregivers despite differences in previous familiarity and perceived implementation barriers. The findings suggest that successful implementation in Italy may require clear information for caregivers, flexible intervention formats, clinician training, attention to engagement and data privacy, and integration with existing healthcare and caregiver-support services. The discrepancy between caregivers’ predominantly dyadic understanding of caregiving and their preference for individual intervention also supports testing flexible models in which relational or dyadic components can complement, rather than replace, individual caregiver support.