Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 28, 2025
Date Accepted: Sep 17, 2025
Acceptance and Commitment Training for Family Caregivers of People with Neurodevelopmental Disabilities: Protocol for a Collaborative Implementation Study
ABSTRACT
Background:
Family caregivers of individuals with neurodevelopmental disabilities (NDDs) experience high levels of stress, anxiety, and depression, yet few interventions are designed to improve their mental well-being. Additionally, most evidence-based interventions do not actively involve caregivers as peer facilitators.
Objective:
To address this gap, we developed an Acceptance and Commitment Training (ACT) group intervention co-facilitated by trained caregivers and clinicians. This study evaluates the real-world implementation of this innovative, evidence-based ACT intervention aimed at enhancing caregiver mental health and resilience.
Methods:
Guided by the RE-AIM implementation science framework, this study examines the intervention’s reach, effectiveness, adoption, implementation, and maintenance. ACT workshops were delivered both virtually and in-person across 12 intervention sites in Canada. Caregivers participated in pre-, post-, and 3-month follow-up assessments measuring stress, resilience, and self-compassion using validated instruments (DASS-21, PSI-4 SF, BFDS, MSMR-I, SCS-SF), alongside ACT process measures (CFQ, VLQ, AAQ-II). Implementation fidelity was assessed through checklists, feedback forms, and reflective memos. Additionally, focus groups with caregiver facilitators, clinician facilitators, workshop participants, and organizational leaders provided qualitative insights into the implementation process and the caregiver-clinician co-facilitation model.
Results:
The ACT intervention has reached (n=195) caregivers of individuals with NDDs. A total of two focus groups have been conducted, including 5 caregivers, 13 facilitators, and 5 organizational leaders. Preliminary qualitative feedback suggests that participants experienced meaningful benefits from the intervention, while facilitators and agencies expressed enthusiasm for its impact, despite implementation challenges. Quantitative and qualitative data analysis is underway.
Conclusions:
Preliminary feedback indicates that this ACT intervention is a promising approach to enhancing the mental well-being and resilience of caregivers of individuals with NDDs. The RE-AIM framework has been instrumental in systematically capturing process data and documenting the balance between fidelity and adaptation. Further analysis will refine implementation strategies and support the broader scalability of the intervention to diverse community settings Clinical Trial: NA
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