Acceptability and feasibility of an app-based just-in-time-adaptive self-management intervention for care partners: Protocol for the CareQOL pilot trial

Noelle Carlozzi, Sung Won Choi, Zhenke Wu, Jennifer Miner, Angela Lyden, Christopher Graves, Angelle Sander, Jitao Wang, Srijan Sen (2021). JMIR Research Protocol

Abstract

Background: Care partners (i.e., informal family caregivers) of individuals with health problems are faced with considerable physical and emotional stress, often with substantial negative impact on the health-related quality of life (HRQOL) of both the care partner and care-recipient. Given that these individuals are often overwhelmed by their caregiving interventions, low burden self-management interventions are needed to support caregivers to ensure better patient outcomes.

Objective: The primary objective of this study is to describe an intensive data collection protocol that involves the delivery of a personalized just-in-time adaptive intervention (JITAI) that incorporates passive mobile sensor data feedback (sleep and activity data from a Fitbit ®), and real-time self-reporting of HRQOL via study specific app called CareQOL to provide personalized feedback via app alert.

Methods: Participants from three diverse care partner groups will be enrolled (care partners of persons with spinal cord injury [SCI]; care partners of persons with Huntington disease [HD]; and care partners of persons with hematopoietic cell transplantation [HCT]). Participants are randomized either to a control group, where they will wear the Fitbit® and provide daily reports of HRQOL over a three-month (90 day) period (without the personalized feedback), or the JITAI group, where they will wear the Fitbit®, provide daily reports of HRQOL and receive personalized pushes for 3 months. At the end of the study, participants complete a feasibility and acceptability questionnaire, and metrics regarding adherence and attrition are calculated.

Results: This trial opened for recruitment in November 2020. Data collection was completed in June 2021, and the primary results are expected to be published in winter 2021. Conclusions: This trial will determine the feasibility and acceptability of an intensive app-based intervention in three distinct caregiver groups: care partners for persons with a chronic condition that was caused by a traumatic event (i.e. SCI); 2) care partners for persons with a progressive, fatal neurodegenerative disease (i.e., HD); and 3) care partners for persons with an episodic cancer condition that requires intense, prolonged inpatient and outpatient treatment (persons with HCT).

Trial Registration: ClinicalTrial.gov NCT045556591; https://clinicaltrials.gov/ct2/show/NCT045556591

Key words: caregivers; quality of life; Spinal Cord Injuries; Huntington Disease; Hematopoietic Stem Cell Transplantation; Feasibility Studies; self-management; mobile applications; outcome assessment