Pilot Randomized Controlled Trial of the Feasibility of a Mobile App-Delivered Mindfulness-Based Intervention for Caregiver Stress.
Evan Plys, Morgan Seward, Elizabeth M Allen, Raquel G Tatar, Jennifer Huberty, Ana-maria Vranceanu
The Gerontologist May 10, 2025 DOI: 10.1093/geront/gnaf047
Summary
A free mobile app designed for mindfulness significantly engaged dementia caregivers, with 90% of eligible participants enrolling and 95% completing the program. In a pilot trial with 47 caregivers using the Healthy Minds Program for Caregivers (HMP-C) and 48 in an education podcast control, those using HMP-C reported large improvements in mindfulness and positive caregiving aspects. While clinical outcomes like stress and anxiety did not show significant differences compared to the control group, trends favored HMP-C, suggesting a need for further testing in a larger trial.
Abstract
We tested feasibility and preliminary benefits of a free mobile app-delivered mindfulness-based intervention for stress among dementia caregivers (i.e., Healthy Minds Program for Caregivers [HMP-C]). Single-blind Stage 1b pilot randomized controlled trial compared 12 weeks of HMP-C (n = 47) with a dose-matched education podcast control (n = 48; Wellness App [WA]). T-tests examined between-group differences. Feasibility benchmarks were met for acceptability (90% eligible enrolled), demand (95% completed post-tests), and data collection (100% measures complete). Treatment satisfaction was sufficient for HMP-C. Adherence was slightly lower than benchmarks (>52.5 minutes weekly) for HMP-C (67%) and WA (66%). Mechanistic targets of mindfulness (p < .001; d = -1.21) and positive aspects of caregiving (p < .001; d = -0.92) showed large pre-post improvements in the HMP-C group. Mechanistic validity was established through significant correlations between change in stress and change in mindfulness (r = -0.40, p = .006) and positive aspects of caregiving (r = -.49, p = .001). Pre-post improvements in HMP-C were not statistically significantly compared with WA for stress (p = .097; d = -0.35), depression (p = .110; d = -0.34), or anxiety (p = .237; d = -0.25). The current study demonstrated feasibility and mechanistic target engagement and validity for HMP-C. As expected in an underpowered feasibility trial, clinical outcomes did not improve more than control, but trends favored HMP-C. Together, findings demonstrate that a fully powered Stage 2 trial is warranted to test the efficacy of HMP-C compared with WA.