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Feasibility, Acceptability, and Preliminary Efficacy of WECARE: a WeChat-based Intervention for Chinese American Dementia Caregivers
ABSTRACT
Background:
Chinese American family caregivers of persons with dementia (PWD) experience high rates of psychosocial distress and adverse health outcomes. They face substantial obstacles to what? Accessing care? associated with their minority and immigrant status, including stigma and misperception of dementia, limited knowledge and use of welfare and services, and poor social support. Few interventions have been developed or tested for this vulnerable population.
Objective:
This study aims to pilot test the first culturally tailored intervention called Wellness Enhancement for Caregivers (WECARE) delivered via WeChat, a social media app highly popular in Chinese population. WECARE was designed specifically for Chinese American dementia caregivers to improve their caregiving skills, reduce stress, and enhance psychosocial wellbeing. Feasibility, acceptability, and preliminary efficacy of the WECARE were assessed in this pilot.
Methods:
Twenty-four Chinese American family caregivers of PWD were recruited for a pre-post one-arm trial of the WECARE. Most of them (83%) are older than 50 years and a majority (73%) are female. Through subscribing to the WECARE official account, participants received interactive multimedia programs on their WeChat account multiple times a week for 7 weeks. A backend database automatically delivered program components and tracked user activities. Three online group meetings were organized to facilitate social networking. Participants also completed baseline and follow-up surveys. Feasibility was assessed by the follow-up rate and curriculum completion rate; acceptability was assessed by user satisfaction and perceived usefulness of the program; efficacy was assessed with pre-post differences in two primary outcomes of depressive symptoms and caregiving burden.
Results:
Twenty-three participants completed the intervention and follow-up survey with a retention rate of 96%. The backend database revealed that the mean curriculum completion rate was 67%. Participants also reported high rates of user satisfaction and perceived usefulness of the intervention and high ratings of weekly programs. There was a significant improvement in participants’ primary psychosocial health outcomes; their depressive symptoms reduced from 5.74 to 3.35 with an effect size of .41 and caregiving burden decreased from 25.78 to 21.96 with an effect size of .27.
Conclusions:
This pilot study suggests that WECARE was feasible and acceptable; it also demonstrated initial efficacy in improving psychosocial wellbeing in Chinese American dementia caregivers. A larger study with a control group is needed to assess its efficacy and effectiveness. We call for more culturally appropriate mHealth interventions for Chinese American family caregivers of PWD.
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