Analysis of Latino family caregiver engagement with CuidaTEXT, a text message intervention for dementia caregiver support

Abstract

AbstractBackgroundThe potential of text message caregiver support interventions to improve dementia care outcomes is still to be exploited. This study aims to explore participants’ engagement with a text message intervention for dementia caregiver support, and its association with acceptability and clinical outcomes. We hypothesize that a higher engagement with CuidaTEXT will be associated with increases in caregivers’ satisfaction with the intervention and decreases in depression.MethodCuidaTEXT is a six‐month, bilingual, and bidirectional intervention tailored to caregiver needs (e.g., education, problem‐solving, resources). We enrolled 24 Latino caregivers in a one‐arm feasibility trial. Participants received approximately one automatic daily text message. Participants could receive automatic on‐demand messages by sending specific keywords (e.g., STRESS for messages about stress coping) and on‐demand responses during business hours by chat‐texting with a live coach. In this secondary analysis, we calculated associations between the total number of text messages (engagement) and outcomes (primarily caregiver satisfaction and depression).ResultParticipants sent 1,847 messages to CuidaTEXT; 6.5% sent no messages (no engagement), 0.0% less than 10 (low), 29.0% between 10 and 49 (medium), 22.6% between 50 and 99, and 19.4% more than 100 (high). Engagement was associated with intervention satisfaction (r = 0.6, p = 0.007) and secondary acceptability outcomes (perceptions that CuidaTEXT provided help for their loved one with dementia: r = 0.6, p = 0.003; and to understand dementia: r = 0.6, p = 0.008) except for perceptions that CuidaTEXT provided help for themselves as caregiver (r = 0.3, p = 0.173). Engagement was not associated with change in caregiver depression (r = ‐0.0, p = 0.922) or secondary clinical outcomes (caregiving competence: r = 0.4, p = 0.104; and behavioral symptom‐related distress: r = 0.4, p = 0.076).ConclusionText message engagement is associated with satisfaction but not depression. Encouraging interaction with CuidaTEXT might lead to higher levels of satisfaction with the intervention. However, future research should determine the directionality of these associations.