Development and feasibility of Inlife: A pilot study of an online social support intervention for informal caregivers of people with dementia

Alieske E H Dam, Martin P J van Boxtel, Nico Rozendaal, Frans R J Verhey, Marjolein E de Vugt, Alieske E H Dam, Martin P J van Boxtel, Nico Rozendaal, Frans R J Verhey, Marjolein E de Vugt

Abstract

Background: Informal caregivers of individuals with dementia have an increased risk to face social isolation due to progression of the disease. Online social media interventions might offer a new opportunity to increase access to social support and enhance positive interactions and openness in dementia care networks.

Objective: This explorative pilot study describes (1) the development of an online social support intervention Inlife, and (2) the evaluation of the feasibility of this intervention and the measurements to assess its effectiveness.

Methods: The Medical Research Council (MRC) framework guided the development of the online social support intervention. This is a stepwise approach that integrates potential users' views with the development and validation of the program content. The program was developed by combining (1) individual caregiver interviews (n = 10), (2) focus group sessions with experts and web designers (n = 6), and (3) individual think-aloud tests (n = 2). Subsequently, a pilot study with informal caregivers was conducted (n = 25) to examine the program's feasibility and preliminary effectiveness. Online self-report measures were completed at baseline and at four follow-up time points.

Results: In total, 23 participants completed the newly developed Inlife intervention. Despite the high number of low-active users (17/23, 73%), Inlife had a good feasibility score of 7.1 (range: 1-10). The Calendar and Timeline were used most frequently and contributed to better care coordination and positive interactions.

Conclusions: Although the Inlife platform received a sufficient feasibility rating, the uptake was not optimal. Therefore, the Inlife platform was adapted to limit the number of low-active users and improve user friendliness. Recommendations for additional treatment adherence were provided. The development according to the MRC framework and the sufficient feasibility rating of Inlife formed the basis for a future effectiveness study.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Iterative development and piloting process…
Fig 1. Iterative development and piloting process informed by the elements of the MRC framework.

References

    1. WHO. Dementia a public health priority : World Health Organisation; 2012 [cited 2016 25 November].
    1. Carbonneau H, Caron C, Desrosiers J. Development of a conceptual framework of positive aspects of caregiving in dementia. Dementia. 2010;9(3):327–53.
    1. de Vugt M, Dröes R-M. Social health in dementia. Towards a positive dementia discourse. Aging & Mental Health. 2017;21(1):1–3.
    1. Leinonen E, Korpisammal L, Pulkkinen LM, Pukuri T. The comparison of burden between caregiving spouses of depressive and demented patients. Int J Geriatr Psychiatry. 2001;16(4):387–93.
    1. Schulz R, Martire LM. Family caregiving of persons with dementia: prevalence, health effects, and support strategies. The American journal of geriatric psychiatry. 2004;12(3):240–9.
    1. Beeson RA. Loneliness and depression in spousal caregivers of those with Alzheimer’s disease versus non-caregiving spouses. Arch Psychiatr Nurs. 2003;17(3):135–43.
    1. Pinquart M, Sörensen S. Correlates of physical health of informal caregivers: a meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2007;62(2):P126–P37.
    1. Monahan DJ, Hooker K. Health of spouse caregivers of dementia patients: The role of personality and social support. Soc Work. 1995;40(3):305–14.
    1. Cohen S, McKay G. Social support, stress and the buffering hypothesis: A theoretical analysis. Handbook of psychology and health. 1984;4:253–67.
    1. Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310–57.
    1. Droes R. In Beweging; over psychosociale hulpverlening aan demente ouderen [In movement; on psychosocial care for elderly withdementia]. Nijkerk, The Netherlands: Intro; 1991.
    1. Wills TA, Shinar O. Measuring perceived and received social support. Social support measurement and intervention: A guide for health and social scientists. 2000:86–135.
    1. Amieva H, Stoykova R, Matharan F, Helmer C, Antonucci TC, Dartigues J-F. What aspects of social network are protective for dementia? Not the quantity but the quality of social interactions is protective up to 15 years later. Psychosom Med. 2010;72(9):905–11. doi:
    1. Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11–27. Epub 2014/02/27. doi: .
    1. Dam AEH, Boots LM, van Boxtel MP, Verhey FR, de Vugt ME. A mismatch between supply and demand of social support in dementia care: a qualitative study on the perspectives of spousal caregivers and their social network members. Int Psychogeriatr. 2017:1–12. doi:
    1. Boots LM, Wolfs CA, Verhey FR, Kempen GI, de Vugt ME. Qualitative study on needs and wishes of early-stage dementia caregivers: the paradox between needing and accepting help. Int Psychogeriatr. 2015;27(06):927–36.
    1. Boots LM, de Vugt ME, van Knippenberg RJ, Kempen GI, Verhey FR. A systematic review of Internet-based supportive interventions for caregivers of patients with dementia. Int J Geriatr Psychiatry. 2014;29(4):331–44. Epub 2013/08/22. doi: .
    1. Blom MM, Zarit SH, Zwaaftink RBG, Cuijpers P, Pot AM. Effectiveness of an Internet intervention for family caregivers of people with dementia: results of a randomized controlled trial. PLoS One. 2015;10(2):e0116622 doi:
    1. Blom MM, Bosmans JE, Cuijpers P, Zarit SH, Pot AM. Effectiveness and cost-effectiveness of an internet intervention for family caregivers of people with dementia: design of a randomized controlled trial. BMC Psychiatry. 2013;13(1):17.
    1. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655 doi:
    1. Dam AEH, de Vugt ME, Klinkenberg IP, Verhey FR, van Boxtel MP. A systematic review of social support interventions for caregivers of people with dementia: Are they doing what they promise? Maturitas. 2016;85:117–30. doi:
    1. Meiland F, Innes A, Mountain G, Robinson L, van der Roest H, García-Casal JA, et al. Technologies to Support Community-Dwelling Persons With Dementia: A Position Paper on Issues Regarding Development, Usability, Effectiveness and Cost-Effectiveness, Deployment, and Ethics. JMIR Rehabil Assist Technol. 2017;4(1):e1 Epub 16.01.2017. doi: .
    1. Sutherland J, Schwaber K. The Scrum Guide The Definitive Guide to Scrum: Rules of the Game. Scrum. 2011 [cited 2016 22 September]. .
    1. Jaspers MW. A comparison of usability methods for testing interactive health technologies: methodological aspects and empirical evidence. Int J Med Inform. 2009;78(5):340–53. doi:
    1. Boots LM, de Vugt ME, Withagen HE, Kempen GI, Verhey FR. Development and initial evaluation of the web-based self-management program “partner in balance” for family caregivers of people with early stage dementia: an exploratory mixed-methods study. JMIR research protocols. 2016;5(1).
    1. Glueckauf RL, Ketterson TU, Loomis JS, Dages P. Online support and education for dementia caregivers: overview, utilization, and initial program evaluation. Telemed J E Health. 2004;10(2):223–32. doi:
    1. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS quarterly. 1989:319–40.
    1. Lund AM. Measuring Usability with the USE Questionnaire 12. 2001.
    1. Reijnders J, van Heugten C, van Boxtel M. Keep Your Brain Fit! A Psychoeducational Training Program for Healthy Cognitive Aging: A Feasibility Study. Educational Gerontology. 2015;41(8):613–20. doi:
    1. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support. J Pers Assess. 1990;55(3–4):610–7. doi:
    1. Kempen G, Van Eijk L. The psychometric properties of the SSL12-I, a short scale for measuring social support in the elderly. Social Indicators Research. 1995;35(3):303–12.
    1. De Jong Gierveld J, Van Tilburg T. Manual of the Loneliness Scale 1999. Department of Social Research Methodology, Vrije Universiteit Amsterdam, Amsterdam (updated version 1801 02). 1999.
    1. Vernooij-Dassen MJ, Felling AJ, Brummelkamp E, Dauzenberg MG, Bos GA, Grol R. Assessment of caregiver's competence in dealing with the burden of caregiving for a dementia patient: a Short Sense of Competence Questionnaire (SSCQ) suitable for clinical practice. J Am Geriatr Soc. 1999;47(2):256–7.
    1. IBM Corp. Released 2016. IBM SPSS Statistics for Macintosh VA, NY: IBM Corp., inventor.
    1. Kerkhof YJ, Graff MJ, Bergsma A, de Vocht HH, Dröes R-M. Better self-management and meaningful activities thanks to tablets? Development of a person-centered program to support people with mild dementia and their carers through use of hand-held touch screen devices. Int Psychogeriatr. 2016:1–13.
    1. Bujnowska-Fedak MM, Pirogowicz I. Support for e-health services among elderly primary care patients. Telemedicine and E-health. 2014;20(8):696–704. doi:
    1. Schaller S, Marinova-Schmidt V, Setzer M, Kondylakis H, Griebel L, Sedlmayr M, et al. Usefulness of a Tailored eHealth Service for Informal Caregivers and Professionals in the Dementia Treatment and Care Setting: The eHealthMonitor Dementia Portal. JMIR research protocols. 2016;5(2).
    1. Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with Alzheimer's disease. Nurs Res. 1995;44(3):166–72.
    1. Kim H. Understanding Internet use among dementia caregivers: results of secondary data analysis using the US caregiver survey data. Interactive journal of medical research. 2015;4(1).
    1. Wright KB, Miller CH. A measure of weak-tie/strong-tie support network preference. Communication Monographs. 2010;77(4):500–17.
    1. Wittenberg-Lyles E, Washington K, Demiris G, Oliver DP, Shaunfield S. Understanding social support burden among family caregivers. Health communication. 2014;29(9):901–10. doi:
    1. Aalbers T, Baars MA, Qin L, de Lange A, Kessels RP, Rikkert MGO. Using an eHealth Intervention to Stimulate Health Behavior for the Prevention of Cognitive Decline in Dutch Adults: A Study Protocol for the Brain Aging Monitor. JMIR research protocols. 2015;4(4).
    1. Bennett GG, Glasgow RE. The delivery of public health interventions via the Internet: actualizing their potential. Annu Rev Public Health. 2009;30:273–92. doi:
    1. Cacioppo JT, Fowler JH, Christakis NA. Alone in the crowd: the structure and spread of loneliness in a large social network. J Pers Soc Psychol. 2009;97(6):977 doi:
    1. de Jong Gierveld J, van Tilburg T, Dykstra P. Loneliness and Social Isolation Vangelisti Anita & Perlman Daniel (eds), The Cambridge Handbook of Personal Relationships, second edition, Cambridge University Press; 2016. p. 1–30.
    1. Lubben J, Blozik E, Gillmann G, Iliffe S, von Renteln Kruse W, Beck JC, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. The Gerontologist. 2006;46(4):503–13.

Source: PubMed

3
구독하다