JMIR Publications

ABSTRACT

Background:

TTemporary migrant live–in caregivers constitute a vulnerable stream of temporary foreign workers in Canada. This is because the majority are racialized women from the Global South, the gendered nature of caregiving work has historically been undervalued, and their working and living spheres are intertwined which makes application of labor laws and surveillance almost impossible. Their invisible position in the fabric of Canadian society along with their precarious employment and immigration status place their mental health at jeopardy. Furthermore, they experience multiple barriers in accessing mental health services due to their long work hours, limited knowledge about health resources, stigma, and fear of deportation should their employers suspect or discover that they are experiencing mental health problems. There is a paucity of research about psychological support for this population.

Objective:

Our pilot project aimed to assess the efficacy of a six-week online delivery of a psychological intervention based on Acceptance and Commitment Therapy (ACT).

Methods:

A pilot randomized waitlist control design was used. Participants were recruited by two community peer champions, who collaborated with community health organizations serving migrant live-in caregivers and applied snowball sampling technique. A total of 36 participants who met study inclusion criteria were recruited and randomly assigned to the intervention and waitlist control groups. Standardized self-reported surveys were administered online pre-, post-, and 6-week post-intervention to assess mental distress (DASS 21), psychological flexibility (AAQ-2), mindfulness (CAMS-R) and Multi-System Model of Resilience (MSMR-I). Both independent and dependent t-tests were used to compare study outcomes at pre, post and 6 weeks follow up across and within both arms of the study. Linear mixed-effects models were created for each outcome of interest from baseline to post-intervention among intervention and control participants. Self-reported impact of WE2CARE intervention was examined using independent t-test across the study arms.

Results:

Average age of participants was 38 years. Many participants were born in the Philippines (79%). Sixty percent reported an income of less than $25,000/year after taxes. The pilot data on the impact of the psychological intervention showed an improvement in psychological distress, mindful qualities (CAMS-R), and external resilience (MSMR ER) particularly in the domain of life satisfaction and accessible support among the intervention group compared to control group.

Conclusions:

WE2CARE is among the first studies exploring the efficacy of on-line delivery of ACT in addressing mental health challenges among live-in caregivers. While there are increased web-based ACT interventions, few uses group videoconferencing to promote peer connection and mutual support. WE2CARE showed promising results in reducing psychological distress and promoting mindfulness and resiliency. The intervention highly motivated participants to engage collectively in building social support networks. Clinical Trial: Not Applicable