Feasibility of a Telephone-Delivered Mindfulness Intervention for Informal Caregivers of Rural-Dwelling African Americans With Dementia.

A telephone-delivered mindfulness training program for informal caregivers of African Americans with dementia living in rural North Carolina was feasible and acceptable. Of those screened, 78% enrolled, 86% completed the study, and 88% attended at least six of eight weekly sessions. Caregivers reported reduced perceived burden and increased positive emotions from before to after the intervention. Both inhibitory and prospective intolerance of uncertainty also decreased. Participants valued the program, especially the telephone format. The findings suggest this approach may help reduce caregiver burden in underserved rural populations and warrants testing in a randomized trial.

Study at a glance

Abstract

Mindfulness training has been associated with improved health outcomes among family caregivers of people living with dementia, but access to training is limited, especially in rural areas. Moreover, mindfulness training that addresses the unique perspectives of African American families is needed. The study aimed to test the feasibility and acceptability of a theory-driven, telephone-delivered mindfulness intervention for caregivers of African Americans with moderate-to-severe dementia living in rural eastern North Carolina. In this single-arm, multiple-methods study, pairs of informal caregivers attended an 8-week mindfulness training program involving weekly one-hour telephone-delivered sessions, and an online retreat. Feasibility outcomes included enrollment, retention, attendance, and acceptability. Exploratory pre-post endpoints related to our theoretical model included perceived caregiver burden (Zarit Burden Interview), uncertainty intolerance (Intolerance of Uncertainty Scale), and positive emotions (Meaning and Purpose Scale). Seventy-eight percent of screened individuals enrolled, 86% completed the study, and 88% attended ≥6 sessions. Participants found the program valuable, especially via telephone. Perceived burden decreased from pre-to-post intervention (mean difference [MD] -2.7, (95% CI: -4.5, -1.3; Cohen's d -0.47) and positive emotions increased (MD 2.7, 95% CI 0.81, 4.5; d = 0.37). Both inhibitory (MD -1.0, 95% CI -1.8, -0.09; d = -0.28) and prospective (MD -1.2, 95% CI -2.7, 0.3; d = -0.20) intolerance of uncertainty were lower post-intervention. A telephone-delivered mindfulness training intervention was feasible and shows promise for reducing perceived burden among rural-dwelling informal caregivers of African Americans with dementia. Further testing in a randomized parallel-group trial comparing mindfulness training to a credible control intervention is warranted. ClinicalTrials.gov NCT04058886.