JMIR Publications

ABSTRACT

Background:

The responsibilities of being a primary caregiver for a loved one with Alzheimer's disease can produce significant stress for the caregiver, leading to deleterious outcomes for the caregiver’s physical and psychological health. Hence, researchers are developing online interventions to provide support for caregivers. Members of our research team previously developed and tested a positive emotion regulation intervention that we delivered through videoconferencing, where caregiver participants would meet one-on-one with a trained facilitator. While proven effective, such delivery methods have limited scalability as they require significant resources in terms of cost and direct contact hours.

Objective:

The aim of the present study was to conduct a pilot test of a socially enhanced, self-guided version of the positive emotion regulation intervention, SAGE LEAF (Social Augmentation of self-Guided Electronic delivery of the Life Enhancing Activities for Family caregivers). Research has shown that the social presence, or the perception of others in a virtual space, is associated with enhanced learning and user satisfaction. Hence, the intervention leverages various social features (e.g. discussion boards, podcasts, videos, user profiles, social notifications, etc.) to foster a sense of social presence among participants and study team members.

Methods:

Usability, usefulness, feasibility, and acceptability data were collected from a pilot test where participants (N = 15) were given full access to the SAGE LEAF intervention over 6 weeks, and completed pre- and post-intervention assessments (N = 10). Preliminary efficacy measures were also collected.

Results:

The results suggest that SAGE LEAF is feasible, with participants viewing an average of 72% (SD = 42%) of the total available intervention web pages. Additionally, acceptability was found to be good, demonstrated by participants’ willingness to recommend the SAGE LEAF program to a friend or other dementia caregiver. We found a moderate, positive correlation between social presence scores and participants’ willingness to recommend the program to others, r(9) = 0.672, p = 0.033. We also found a positive correlation between social presence scores and participants’ perceptions of the overall usefulness of the intervention, r(9) = 0.773, p = 0.009. This suggests that participants’ sense of social presence may be important for feasibility and acceptability of the program.

Conclusions:

In this pilot study, the SAGE LEAF intervention demonstrates potential for broader dissemination for Alzheimer's caregivers. We aim to incorporate participant feedback about how the social features may be improved in future iterations to enhance usability and to further bolster a sense of social connection amongst participants and study staff members. Next steps include partnering with dementia clinics and other caregiver-serving organizations across the US to conduct a randomized-controlled trial to evaluate the effectiveness of the intervention. Clinical Trial: ClinicalTrials.gov, NCT05562583, https://clinicaltrials.gov/ct2/show/NCT05562583