JMIR Publications

ABSTRACT

Background:

Adult day centers (ADC) are well positioned to address social isolation among the rapidly growing population of people living with dementia (PLWD), but are underutilized relative to other forms of long-term care. Mistrust of these centers among family caregivers remains a barrier to their use. Digital health tools offer a promising approach to enhance transparency, improve communication, and build trust between caregivers and ADCs. As such, we developed, CareMobi a user-centered mobile application that supports care coordination between ADC, care providers, and caregivers.

Objective:

The objective of this study was to evaluate the real-world usability, acceptability, and feasibility of CareMobi among staff in ADCs, and the caregivers of PLWD who attend centers.

Methods:

Guided by the Goal–Question–Metric (GQM/GAQM) framework we conducted a low-burden field usability evaluation of CareMobi in two ADCs. Data included baseline caregiver surveys, application usage logs, administration of the Post-Study System Usability Questionnaire (PSSUQ), and participant interviews. Feasibility benchmarks were established a priori using stop/amend/go criteria for evaluable retention, usability, satisfaction, engagement, and acceptability. Quantitative analyses summarized demographics, caregiver confidence, and app usability (7-point scale, median scores). Qualitative analyses used thematic coding of interviews and written feedback to identify perceived benefits, barriers, and recommendations for implementation.

Results:

Family caregivers (n=15) from two ADCs participated in a mixed-methods pilot. Participants were primarily female (87%), non-Hispanic White (93%), and middle-aged or older (67% aged 30–64). Most were sole caregivers (80%). Baseline confidence in managing dementia-related care was high, particularly in communication with providers. Of 15 enrolled caregivers, 14 (93%) logged into CareMobi at least once, and the majority “agreed/strongly agreed” that the app was easy to use (6/8, 75.0%) and easy to learn (7/8, 87.5%); 6/8 (75.0%) liked the interface and found information well organized. All staff indicated the CareMobi app was easy to use, easy to learn, and well organized (median = 7). Willingness to use the app beyond the study period was high among caregivers (6/8, 75.0%) and staff (3/3, 100%), Open-ended caregiver responses emphasized reassurance from daily updates, user-friendliness, and time savings. Staff reported reduced “phone tag” streamlining coordination, particularly for new ADC enrollees. However, established caregivers tended to use the app passively, defaulting to phone calls. Themes highlighted needs for structured logging guidance, role-specific templates, and integration with existing systems. Caregivers and staff noted that routine updates fostered trust, improved decision-making about attendance, strengthened communication with health care providers, and provided peace of mind.

Conclusions:

CareMobi offers a promising approach to modernizing adult day centers (ADC) in ways that respect resource limitations and caregiver needs, through combining digital transparency with low-burden communication. Future efforts should center on equity and focus on linguistic inclusion, infrastructure support, and engagement in underserved communities.