WECARE: A Behavioral Intervention for Dementia Caregivers (WECARE)

WECARE: A mHealth Intervention to Enhance Caregiving Mastery Among Chinese American Dementia Caregivers

This study aims to pilot test a culturally tailored behavioral intervention called "WECARE" to enhance caregiving mastery and improve psychosocial wellbeing of Chinese American family caregivers of persons with Alzheimer's Disease and related dementia.

Study Overview

• Status: Completed
• Conditions: Caregiver Burden; Caregiver Stress Syndrome
• Intervention / Treatment: Behavioral: Wellness Enhancement for Caregivers (WECARE)

Detailed Description

The investigators propose to test a culturally tailored mHealth behavioral intervention to enhance caregiving mastery and improve psychosocial wellbeing among Chinese American family caregivers of persons living with Alzheimer's Disease and related dementia. This intervention, Wellness Enhancement for Caregivers (WECARE), will be delivered via WeChat, a social media app highly popular among Chinese Americans. About 45 participants will be recruited for the pilot test. Participants will complete a baseline survey, receive 7-week WECARE program on their WeChat accounts, complete a follow-up survey 12 weeks after the baseline, and then a qualitative interview on Zoom.

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Fairfax, Virginia, United States, 22030
      • George Mason University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. 21 years or older,
2. self-identified as Chinese or Chinese American,
3. speak and read Chinese (Mandarin or Cantonese),
4. own a smartphone and use WeChat,
5. living in Washington DC metropolitan, and
6. currently care for a family member with ADRD and provide care for at least 10 hours a week.

Exclusion Criteria:

1. do not read or speak Chinese,
2. care-recipient is in hospice care or have a life expectancy less than 6 months,
3. signs of severe intellectual deficits or psychotic disorders, or
4. unable to provide informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: WECARE; Participants will first complete a baseline survey online, then subscribe to the WECARE official account on their own WeChat accounts and begin receiving the 7-week interactive and personalized program. The program content includes short video clips, pictorial messages, and audio recordings. Each week, the WECARE program is focused on a theme aimed to increase participants' caregiving mastery, enhance self-care, and improve psychosocial wellbeing. Four weeks after the intervention or 11 weeks after the baseline, participants will complete a follow-up survey online.

Behavioral: Wellness Enhancement for Caregivers (WECARE); WECARE behavioral intervention is guided by behavioral theories aimed to increase participants' caregiving mastery, enhance self-care, and improve psychosocial wellbeing. Participants will receive multimedia content on their WeChat account on cellphone or tablet, including short video clips, pictorial messages, short articles, and audio recordings 6 days a week, for 7 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Efficacy of Behavioral Intervention in Change From Baseline in Depressive Symptoms	The baseline and follow-up differences in depressive symptoms will be assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The CES-D is a 20-item survey instrument designed to measure the frequency and severity of depressive symptoms. The total score is calculated by summing the responses to all 20 items. The total scale ranges from 0 to 60, with higher scores indicating more severe depressive symptoms (a worse outcome). The primary analysis will calculate the difference in this total score between baseline and follow-up. adults and dementia caregivers.	Baseline, and Follow-Up at Weeks 11-12 (4 to 5 weeks after completion of the intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Efficacy of Behavioral Intervention in Change From Baseline in Caregiving Burden	The baseline and follow-up differences in caregiving burden will be assessed using the 12-item Zarit Burden Interview (ZBI-12). The ZBI-12 is designed to measure the subjective physical, psychological, and social burden experienced by caregivers. Each item is rated on a 5-point scale from "never" (0) to "nearly always" (4), The total score is calculated by summing the responses to all 12 items. The total scale ranges from 0 to 48, with higher scores indicating greater caregiving burden (a worse outcome). The primary analysis will calculate the difference in this total score between baseline and follow-up.	Baseline, and Follow-Up at Weeks 11-12 (4 to 5 weeks after completion of the intervention)
Efficacy of Behavioral Intervention in Change From Baseline in Life Satisfaction	The baseline and follow-up differences in life satisfaction will be assessed using the Satisfaction with Life Scale (SWLS). The SWLS is a 5-item survey instrument designed to measure a person's global cognitive judgments of satisfaction with their life. The total score is calculated by summing the responses to all 5 items. The total scale ranges from 0 to 30, with higher scores indicating greater life satisfaction (a better outcome). The primary analysis will calculate the difference in this total score between baseline and follow-up.	Baseline, and Follow-Up at Weeks 11-12 (4 to 5 weeks after completion of the intervention)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Efficacy of Behavioral Intervention in Change From Baseline in Caregiving Mastery	The baseline and follow-up differences in caregiving mastery will be assessed using the Caregiving Mastery Scale. This 7-item survey instrument is designed to measure a caregiver's self-perception of their ability to effectively manage caregiving tasks and challenges. The total score is calculated by summing the responses to all 7 items. The total scale ranges from 0 to 28, with higher scores indicating greater caregiving mastery (a better outcome). The primary analysis will calculate the difference in this total score between baseline and follow-up.	Baseline, and Follow-Up at Weeks 11-12 (4 to 5 weeks after completion of the intervention)
Efficacy of Behavioral Intervention in Change in Care-recipient's Problem Behaviors	The baseline and follow-up differences in care-recipient problem behaviors will be assessed using the Revised Memory and Problem Behavior Checklist (RMBPC). The RMBPC is a 24-item survey instrument designed to measure observable behavioral problems in care recipients across three subdomains: memory-related issues, depressive behaviors, and disruptive behaviors. The total score is calculated by summing the Yes (1) or No (0) responses to all 24 items. The total scale ranges from 0 to 24, with higher scores indicating a higher frequency of problem behaviors (a worse outcome). The primary analysis will calculate the difference in this total score between baseline and follow-up.	Baseline, and Follow-Up at Weeks 11-12 (4 to 5 weeks after completion of the intervention)
Efficacy of Behavioral Intervention in Change From Baseline in Positive Aspect of Caregiving	The baseline and follow-up differences in caregivers' positive aspects of caregiving will be measured by Positive Aspects of Caregiving Scale, a 9-item scale 5-point Likert scale from 0 to 4, with total scores ranging from 0 to 36, with higher score indicating more positive perception of caregiving. The baseline and follow-up differences in the scores will be calculated.	Baseline, and Follow-Up at Weeks 11-12 (4 to 5 weeks after completion of the intervention)

Collaborators and Investigators

• Sponsor: George Mason University
• Investigators: Principal Investigator: Alicia Hong, George Mason University

Publications and helpful links

General Publications

• Shen K, Hong YA, Zhang YJ, Han HR, Lin J, Hepburn K. Process evaluation of a digital health intervention for dementia caregivers: Integrating active and passive measurements. Alzheimers Dement. 2025 Sep;21(9):e70663. doi: 10.1002/alz.70663.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2023
• Primary Completion (Actual): August 31, 2024
• Study Completion (Actual): August 31, 2024

Study Registration Dates

• First Submitted: July 6, 2023
• First Submitted That Met QC Criteria: August 7, 2023
• First Posted (Actual): August 15, 2023

Study Record Updates

• Last Update Posted (Actual): June 9, 2026
• Last Update Submitted That Met QC Criteria: June 7, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Behavior; Caregiver Burden; Health Care Facilities Workforce and Services; Health Personnel; Caregivers
• Other Study ID Numbers: George Mason University

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Given the small sample size, we will not make individual participant data available to the public.
• IPD Sharing Time Frame: After the investigators completes primary data collection and the first report from this trial is accepted for publication.
• IPD Sharing Access Criteria: Researchers will submit a request including the purpose of accessing the data and a data user agreement
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No