Audiovisual Training Research Articles

A comparison of EEG encoding models using audiovisual stimuli and their unimodal counterparts.

Communication in the real world is inherently multimodal. When having a conversation, typically sighted and hearing people use both auditory and visual cues to understand one another. For example, objects may make sounds as they move in space, or we may use the movement of a person's mouth to better understand what they are saying in a noisy environment. Still, many neuroscience experiments rely on unimodal stimuli to understand encoding of sensory features in the brain. The extent to which visual information may influence encoding of auditory information and vice versa in natural environments is thus unclear. Here, we addressed this question by recording scalp electroencephalography (EEG) in 11 subjects as they listened to and watched movie trailers in audiovisual (AV), visual (V) only, and audio (A) only conditions. We then fit linear encoding models that described the relationship between the brain responses and the acoustic, phonetic, and visual information in the stimuli. We also compared whether auditory and visual feature tuning was the same when stimuli were presented in the original AV format versus when visual or auditory information was removed. In these stimuli, visual and auditory information was relatively uncorrelated, and included spoken narration over a scene as well as animated or live-action characters talking with and without their face visible. For this stimulus, we found that auditory feature tuning was similar in the AV and A-only conditions, and similarly, tuning for visual information was similar when stimuli were presented with the audio present (AV) and when the audio was removed (V only). In a cross prediction analysis, we investigated whether models trained on AV data predicted responses to A or V only test data similarly to models trained on unimodal data. Overall, prediction performance using AV training and V test sets was similar to using V training and V test sets, suggesting that the auditory information has a relatively smaller effect on EEG. In contrast, prediction performance using AV training and A only test set was slightly worse than using matching A only training and A only test sets. This suggests the visual information has a stronger influence on EEG, though this makes no qualitative difference in the derived feature tuning. In effect, our results show that researchers may benefit from the richness of multimodal datasets, which can then be used to answer more than one research question.

Audio-visual training and feedback to learn touch-based gestures

Audio-visual training and feedback to learn touch-based gestures

Perceptual Adaptation to Noise-Vocoded Speech by Lip-Read Information: No Difference between Dyslexic and Typical Readers.

Auditory speech can be difficult to understand but seeing the articulatory movements of a speaker can drastically improve spoken-word recognition and, on the longer-term, it helps listeners to adapt to acoustically distorted speech. Given that individuals with developmental dyslexia (DD) have sometimes been reported to rely less on lip-read speech than typical readers, we examined lip-read-driven adaptation to distorted speech in a group of adults with DD ( N = 29) and a comparison group of typical readers ( N = 29). Participants were presented with acoustically distorted Dutch words (six-channel noise-vocoded speech, NVS) in audiovisual training blocks (where the speaker could be seen) interspersed with audio-only test blocks. Results showed that words were more accurately recognized if the speaker could be seen (a lip-read advantage), and that performance steadily improved across subsequent auditory-only test blocks (adaptation). There were no group differences, suggesting that perceptual adaptation to disrupted spoken words is comparable for dyslexic and typical readers. These data open up a research avenue to investigate the degree to which lip-read-driven speech adaptation generalizes across different types of auditory degradation, and across dyslexic readers with decoding versus comprehension difficulties.

The Effect of Providing Education to Patients Undergoing Coronary Angiography on Vital Signs

PurposeThis study was conducted to determine the effect of providing pre-procedural education to patients undergoing coronary angiography on their vital signs. DesignThe study was a randomized controlled experimental study with a pretest/posttest control group design. MethodsThe study was conducted in the Cardiology Service of a hospital in Eskişehir between November 2021 and April 2022. Power analysis was performed for the sample calculation of the study. Which identified that it was appropriate to include 79 individuals in the experimental group, 79 individuals in the control group and a total of 158 individuals. The experimental group was trained using the "Structured Education Manual" prepared by the researchers. FindingsThe education had an influence on the stabilization of vital signs after the procedure compared to pre-procedure. When the comparison of vital signs before and after the education was analyzed, systolic blood pressure and diastolic blood pressure differed statistically significantly between 11 measurements in both groups (p<0.05). The systolic and diastolic blood pressure of the experimental group measured before the procedure was higher than their other measurements after the procedure. Heart rate, respiratory rate and saturation value in both groups displayed a statistically significant difference between 11 measurements (p<0.05). In the experimental group, heart rate and respiratory rate before the procedure were higher than the post-procedure measurements. The saturation value of the experimental group at 150 minutes after the procedure was higher than the other measurements. ConclusionIt was concluded that the education given to patients before undergoing a coronary angiography procedure had a positive effect on the patients’ vital signs. It is recommended that patients undergoing a coronary angiography procedure be provided with audiovisual training by nurses before the procedure.

Assessment of a Teaching Module for Cardiac Auscultation of Horses by Veterinary Students.

Auscultation of heart sounds is an important veterinary skill requiring an understanding of anatomy, physiology, pathophysiology and pattern recognition. This cross-sectional study was developed to evaluate a targeted, audio-visual training resource for veterinary students to improve their understanding and auscultation of common heart conditions in horses. Fourth- and fifth-year 2021 and 2022 Bachelor of Veterinary Science students at the University of Queensland (UQ) were provided the learning resource and surveyed via online pre- and post-intervention surveys. Results were quantitatively analyzed using descriptive statistics and Mann-Whitney U tests. Open-ended survey questions were qualitatively analyzed by thematic analysis and Leximancer™ Version 4 program software analysis. Over the two-year period, 231 fourth-year and 222 fifth-year veterinary students had access to the resource; 89 completed the pre-intervention survey and 57 completed the post-intervention survey. Quantitative results showed the resource helped students prepare for practicals and their perception of competency and confidence when auscultating equine cardiac sounds improved (p < 0.05). Compared to fifth-year students, fourth-year students felt less competent at identifying murmurs and arrythmias prior to accessing the learning resource (p < 0.05). Fourth-year and fifth-year students' familiarity with detection of murmurs improved after completing the learning resource (p < 0.001). Qualitative analysis demonstrated a limited number of opportunities to practice equine cardiac auscultation throughout the veterinary degree, especially during the COVID-19 pandemic, and that integrated audio-visual resources are an effective means of teaching auscultation.

Enhancing learning outcomes through multisensory integration: A fMRI study of audio-visual training in virtual reality

The integration of information from different sensory modalities is a fundamental process that enhances perception and performance in real and virtual environments (VR). Understanding these mechanisms, especially during learning tasks that exploit novel multisensory cue combinations provides opportunities for the development of new rehabilitative interventions.This study aimed to investigate how functional brain changes support behavioural performance improvements during an audio-visual (AV) learning task. Twenty healthy participants underwent a 30 min daily VR training for four weeks. The task was an AV adaptation of a ‘scanning training’ paradigm that is commonly used in hemianopia rehabilitation. Functional magnetic resonance imaging (fMRI) and performance data were collected at baseline, after two and four weeks of training, and four weeks post-training.We show that behavioural performance, operationalised as mean reaction time reduction in VR, significantly improves. In separate tests in a controlled laboratory environment, we showed that the behavioural performance gains in the VR training environment transferred to a significant mean RT reduction for the trained AV voluntary task on a computer screen. Enhancements were observed in both the visual-only and AV conditions, with the latter demonstrating a faster response time supported by the presence of audio cues. The behavioural learning effect also transfers to two additional tasks that were tested: a visual search task and an involuntary visual task.Our fMRI results reveal an increase in functional activation (BOLD signal) in multisensory brain regions involved in early-stage AV processing: the thalamus, the caudal inferior parietal lobe and cerebellum. These functional changes were only observed for the trained, multisensory, task and not for unimodal visual stimulation. Functional activation changes in the thalamus were significantly correlated to behavioural performance improvements.This study demonstrates that incorporating spatial auditory cues to voluntary visual training in VR leads to augmented brain activation changes in multisensory integration, resulting in measurable performance gains across tasks. The findings highlight the potential of VR-based multisensory training as an effective method for enhancing cognitive function and as a potentially valuable tool in rehabilitative programmes.

Performance of two educational approaches in increasing knowledge of high-school students about COVID-19 during the first wave of pandemic

ObjectivesThe coronavirus disease (COVID-19) pandemic has greatly altered peoples’ daily lives. Teachers and students were found quite unprepared for the emergence of the first COVID-19 wave. So, improving the knowledge of students about COVID-19 is an important issue. MethodsIn this study, 240 high students attended. Two interventions with the same contents, but in different ways, were delivered. A structured questionnaire was utilized to collect data on demographic information, and information about the behavioral intention toward COVID-19 before and after the educational interventions as well as a control group that received no educational intervention. Resultsstudents in all arms had similar baseline knowledge of COVID-19. The results of the post-analysis showed the efficiency of educational techniques in increasing students' knowledge about COVID-19. So the audio-visual training method performed significantly better than the visual training method (p = 0.03). Both approaches achieved better scores than the control group (P < 0.001). ConclusionDuring the outbreak of COVID-19, multimedia-based learning is a more effective educational approach and can improve the learning outcomes related to COVID-19 and achieve learning goals without close contact than written materials.

Feasibility and acceptability of online opioid overdose education and naloxone distribution: Study protocol and preliminary results from a randomized pilot clinical trial

Drug overdose is the leading cause of accidental death in the United States, with over 70% of drug related fatalities resulting from the use of opioids. Federal agencies have responded to this crisis with various recommendations including enhancing harm reduction approaches such as training laypersons to administer naloxone through Opioid Overdose Education and Naloxone Distribution (OEND) programs. Several studies have demonstrated that OEND programs effectively reduce opioid overdose mortality and are both safe and cost-effective, however, they are typically implemented in urban areas as part of large medical center research programs, needle exchanges, or drug treatment programs. Individuals living in areas without these programs or services lack access to critical and life-saving OEND. The current study examined the acceptability and feasibility of online recruitment, online opioid overdose education, and remote distribution of naloxone kits. Persons who illicitly use opioids and are at risk for overdose were recruited through online media and completed an opioid use questionnaire. If interested in receiving opioid overdose and naloxone administration training, participants completed pre- and post-intervention knowledge questionnaires, engaged in audiovisual training, and were randomized to either receive a naloxone kit or be given information on where they could obtain one. Preliminary results indicate feasibility and acceptability as evidenced by strong recruitment and retention, as well as high participant satisfaction ratings. Successful implementation of remote OEND through this project supports future employment of similar remote programs to expand this critical harm reduction strategy to high-risk individuals in areas lacking traditional OEND programs. Trial Registration #Clinitaltrials.gov- NCT04303000.

Audiovisual Training in Virtual Reality Improves Auditory Spatial Adaptation in Unilateral Hearing Loss Patients.

Unilateral hearing loss (UHL) leads to an alteration of binaural cues resulting in a significant increment of spatial errors in the horizontal plane. In this study, nineteen patients with UHL were recruited and randomized in a cross-over design into two groups; a first group (n = 9) that received spatial audiovisual training in the first session and a non-spatial audiovisual training in the second session (2 to 4 weeks after the first session). A second group (n = 10) received the same training in the opposite order (non-spatial and then spatial). A sound localization test using head-pointing (LOCATEST) was completed prior to and following each training session. The results showed a significant decrease in head-pointing localization errors after spatial training for group 1 (24.85° ± 15.8° vs. 16.17° ± 11.28°; p < 0.001). The number of head movements during the spatial training for the 19 participants did not change (p = 0.79); nonetheless, the hand-pointing errors and reaction times significantly decreased at the end of the spatial training (p < 0.001). This study suggests that audiovisual spatial training can improve and induce spatial adaptation to a monaural deficit through the optimization of effective head movements. Virtual reality systems are relevant tools that can be used in clinics to develop training programs for patients with hearing impairments.

Feasibility of Developing Audiovisual Material for Training Needs in a Vietnam Orphanage: A Mixed-Method Design

Disabled children living in orphanages in low-income countries may not have access to the therapy they need. The COVID-19 pandemic has complicated the situation dramatically, making online training activities a possible innovative option to meet the real needs of local staff. This study aimed to detect the training needs of the local staff of an orphanage in Vietnam, as well as develop an audiovisual training material and measure its feasibility. Training needs were identified through a focus group carried out by the volunteers of Fisios Mundi, a nongovernmental organization. The audiovisual training material was developed to meet these specific needs. Lastly, its feasibility was evaluated, in terms of both content and format, through an ad hoc questionnaire. Nine volunteers participated in the project. Twenty-four videos were created and structured around five themes. This study expands the body of knowledge on how an international cooperation project can be developed in a pandemic situation. The audiovisual training material content and format created in this project was considered by the volunteers as very feasible and useful for training the staff of a Vietnamese orphanage.

The effects of the presence of a face and direct eye gaze on voice identity learning.

We rarely become familiar with the voice of another person in isolation but usually also have access to visual identity information, thus learning to recognize their voice and face in parallel. There are conflicting findings as to whether learning to recognize voices in audiovisual vs audio-only settings is advantageous or detrimental to learning. One prominent finding shows that the presence of a face overshadows the voice, hindering voice identity learning by capturing listeners' attention (Face Overshadowing Effect; FOE). In the current study, we tested the proposal that the effect of audiovisual training on voice identity learning is driven by attentional processes. Participants learned to recognize voices through either audio-only training (Audio-Only) or through three versions of audiovisual training, where a face was presented alongside the voices. During audiovisual training, the faces were either looking at the camera (Direct Gaze), were looking to the side (Averted Gaze) or had closed eyes (No Gaze). We found a graded effect of gaze on voice identity learning: Voice identity recognition was most accurate after audio-only training and least accurate after audiovisual training including direct gaze, constituting a FOE. While effect sizes were overall small, the magnitude of FOE was halved for the Averted and No Gaze conditions. With direct gaze being associated with increased attention capture compared to averted or no gaze, the current findings suggest that incidental attention capture at least partially underpins the FOE. We discuss these findings in light of visual dominance effects and the relative informativeness of faces vs voices for identity perception.

Prospective Media Translators in Audio-Visual Training: Towards a Critical Discourse Analysis of Gender-Bias in Subtitling

This article dwells on the significance of translation training in gender-related issues. It focuses on raising the question of gender bias in audio-visual translation (AVT). The latter is posited to maintain the same patriarchal visions found in language use as in culture. To this end, the classroom is viewed as the perfect space where prospective translators are engaged in questioning how gender is part and parcel of the source texts as multi-dimensional and ‘polisemiotic’ in nature, and how lexical and semantic choices are significantly powerful to reveal underlying ideologies, subjectivities, attitudes and mind-sets. This research is corpus-based. It was carried out with my under-graduate students studying the module of ‘Translation 2.’ Multi-modal text samples containing problematic gender issues were purposefully selected to bring forth the reactions that I sought to make. By adopting critical discourse analysis (CDA) with its three dimensional framework: the descriptive, interpretive and explanatory, in a pedagogically collaborative learning environment, the subtitled texts with the classroom activities and the group discussions were meant to measure how training in AVT translation can practically sensitize future translators to the salience of gender-bias in mainstream media hence triggering in them the need for change. Through all the covered phases of the classroom training, gender is duly addressed to have an all-encompassing approach to subtitling in English, French and Arabic. The main goal is to gauge the consistency of a male-dominated discourse that permeates all media channels. It is geared towards helping trainees as individuals, rather than professionals, to overcome the challenges posed by all the patriarchal ideologies from one language to another.&#x0D;

Design and Evaluation of a School-based Sustained Attention Training Program with Parental Involvement for Preschoolers in Rural China

ABSTRACT Research Findings: Sustained attention is a fundamental cognitive function for young children’s development. We investigated the effects of school-based audiovisual game training with parental involvement on sustained attention (SA) in 5–6-year-old Chinese children. Totally 75 children and their parents participated and were assigned into three groups. The School Practice Intervention (SPI) group and the Parental Involvement Intervention (PII) group underwent an eight-week audiovisual game training, while the No Intervention (NI) group participated in regular activities and received no intervention. We tested participants’ visual and auditory sustained attention at four time points, i.e., pretest, middle test, posttest, and follow-up test. Results indicated that (1) children in PII and SPI groups had significantly greater visual and auditory sustained attention than the NI group in posttest and follow-up test; (2) the PII group showed better SA than the SPI group in posttest and follow-up test; (3) visual SA of experimental groups improved significantly since the middle test, while the improvement of auditory SA emerged since posttest. Practice or Policy: The play-based audiovisual training in a school setting effectively enhances SA for 5–6-year-olds, and parental involvement benefits the intervention. More efforts should be made to improve auditory sustained attention. The educational implications of these findings were discussed.

Learning challenging L2 sounds via computer‐assisted training: Audiovisual training with an airflow model

AbstractBackgroundTeaching Mandarin as a second language (L2) has become an important profession and an important research area. The acquisition of unaspirated and aspirated consonants in Mandarin has been reported to be rather challenging for L2 learners.ObjectivesIn the current study, a 3‐D airflow model was integrated into the virtual talking head for audiovisual pronunciation training in these Mandarin consonants.MethodsUsing the eye‐tracking technique, Experiment 1 investigated L2 learners' general acceptance and gauged attention distribution online while learning with the system. To further compare training efficacy, learning outcomes were evaluated by randomly dividing Japanese learners of Mandarin into different training groups using the 3‐D tutor with and without an airflow model, respectively, in Experiment 2.Results and ConclusionsEye‐tracking results showed that the talking head was well accepted, and was successful in directing L2 learners' attention to the visual modality of the airflow model marking the contrast in aspiration. Furthermore, the additional visual cue of the airflow model helped enhance their production of the aspirated Mandarin stops. Moreover, this computer‐assisted training approach was shown to be robust as the advantage of training with an airflow model can be generalized to novel syllables with a change of tones or rimes.

Audio-Visual Training Improves Awareness and Willingness of Cervical Cancer Screening among Healthy Indian Women: Findings from a Survey.

Priya GaneshkumarObjectives We evaluated the impact of a standardized, simple audio-visual (AV) training video developed in regional languages on cervical cancer awareness among apparently healthy women and their willingness to undergo regular cervical cancer screening. Materials and Methods This cross-sectional noninterventional multicentric survey was conducted in 69 centers across 14 states in India and one center in UAE among women aged between 18 and 88 years attending clinics for a variety of indications. Using a short questionnaire, cervical cancer awareness and willingness to undergo cervical cancer screening were assessed before and after the AV training. Statistical Analysis In addition to descriptive analysis, improvement in awareness after the AV training was assessed using McNemar's test, and comparison of responses between subgroups was performed using Pearson chi-squared test. Results The survey was completed by 3,188 apparently healthy women (mean age: 36.8 ± 11.3 years). Before AV training, correct answers were given to only 4/6 questions by majority of the participants; most participants were unaware about the main cause of cervical cancer (1,637/3,188, 51.4%), availability of cervical cancer screening tests (1,601/3,188, 50.2%), and cervical cancer vaccines (1,742/3,188, 54.6%). Only 576 women (18.1%) had undergone cervical cancer screening in the past. After the AV training, the proportion of women correctly responding to all six questions improved significantly (p < 0.05), and 84.4% (2691/3188) women showed willingness to undergo periodic cervical cancer screening. Compared to unmarried and professional women, although married women and home-makers had lower awareness scores, the latter subgroups had more often undergone previous cervical cancer screening. Conclusion It is possible to improve cervical cancer awareness among healthy women, and to enhance their willingness to undergo regular cervical cancer screening tests using a simple, six minute-long, standardized AV training material.

Thanks or Tanks: Training with Tactile Cues Improves Learners’ Accuracy of English Interdental Consonants in an Oral Reading Task

ABSTRACT The present study investigates whether training second language pronunciation with tactile cues facilitates the production of non-native sounds involving accessible articulatory features. In a between-subjects experiment with a pretest-training-posttest design, 50 Turkish learners of English received audiovisual training on a set of target words and sentences containing two English interdental fricatives, /θ/ and /ð/, in one of two conditions, tactile and non-tactile. The tactile condition involved self-touching the tongue as it protruded during pronunciation of the two target sounds. Participants’ pronunciation performance was assessed through a word-imitation task, a sentence-imitation task, and a discourse reading task. Results showed that while both training conditions helped learners to improve their pronunciation performance in all three tasks, the tactile condition triggered greater improvements in the discourse reading task. These results extend previous findings on the benefits of tactile input for speech perception and suggest the efficacy of multisensory training paradigms for improving second language pronunciation.

Reducing the hemodialysis patient stress level through progressive relaxation

Background: Hemodialysis is an effective treatment carried out for patientswith chronic kidney failure to improve the quality of life. 80% of hemodialysis patients experience physical stress disorder and psychosocial stress related to treatment. When faced with stress, the body muscles become tense as the abdomen becomes tense and cramped, the chest feels tight, which impacts physical and psychosocial health, so it is necessary to have stress management training through relaxation techniques. This study aimed to determine the effect of progressive relaxation on stress levels in patients with hemodialysis. Method: This quasi-experimental pre-test and posttest study with a control group design. There were 58 respondents divided into two groups (intervention and control), and each group consisted of 29 people selected by random sampling. Measurement of stress levels using questionnaire Depression Anxiety Stress Scale 42 (DASS 42). Results: The Mann Whitney U Test showed a difference in the decrease instress levels which was statistically significant (p &lt;0.05). Conclusion: The audio-visual progressive relaxation training conducted at least two times a week for three weeks effectively reduces stress levels in patients undergoing hemodialysis therapy for at least one month. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 540-546

Lipreading: A Review of Its Continuing Importance for Speech Recognition With an Acquired Hearing Loss and Possibilities for Effective Training.

The goal of this review article is to reinvigorate interest in lipreading and lipreading training for adults with acquired hearing loss. Most adults benefit from being able to see the talker when speech is degraded; however, the effect size is related to their lipreading ability, which is typically poor in adults who have experienced normal hearing through most of their lives. Lipreading training has been viewed as a possible avenue for rehabilitation of adults with an acquired hearing loss, but most training approaches have not been particularly successful. Here, we describe lipreading and theoretically motivated approaches to its training, as well as examples of successful training paradigms. We discuss some extensions to auditory-only (AO) and audiovisual (AV) speech recognition. Visual speech perception and word recognition are described. Traditional and contemporary views of training and perceptual learning are outlined. We focus on the roles of external and internal feedback and the training task in perceptual learning, and we describe results of lipreading training experiments. Lipreading is commonly characterized as limited to viseme perception. However, evidence demonstrates subvisemic perception of visual phonetic information. Lipreading words also relies on lexical constraints, not unlike auditory spoken word recognition. Lipreading has been shown to be difficult to improve through training, but under specific feedback and task conditions, training can be successful, and learning can generalize to untrained materials, including AV sentence stimuli in noise. The results on lipreading have implications for AO and AV training and for use of acoustically processed speech in face-to-face communication. Given its importance for speech recognition with a hearing loss, we suggest that the research and clinical communities integrate lipreading in their efforts to improve speech recognition in adults with acquired hearing loss.

Patients With Breast Cancer Receiving Chemotherapy: Effects of Multisensory Stimulation Training on Cognitive Impairment.

Patients with breast cancer receiving chemotherapy can experience chemotherapy-related cognitive impairment (CRCI). This study observed the interventional effects of multisensory stimulation training on CRCI in patients with breast cancer receiving chemotherapy. Eighty patients with breast cancer receiving chemotherapy at a grade A tertiary hospital in Tangshan City, Hebei Province, China, were divided into two intervention groups (audiovisual and multisensory) by random sampling (40 patients per group). After four intervention cycles, participants' cognitive and executive function scores were higher in the multisensory group than in the audiovisual group. Multisensory stimulation training had stronger effects than audiovisual training and effectively attenuated CRCI and executive dysfunction caused by breast cancer chemotherapy. Given the convenience and ease of use, multisensory stimulation has good potential for application in clinical practice.

African-American Lay Pastoral Care Facilitators’ Perspectives on Dementia Caregiver Education and Training

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary education. Data were collected through a telephone-based, focus group interview with nine ACTS 2 facilitators deploying grounded theory techniques. We identified six themes: personal reflections on facilitator roles and responsibilities, satisfaction with existing written materials, desire for supplementary audiovisual training materials, desire for additional training on data management and reporting, importance of peer support, and fostering a faith-integrated culture within the program. Our findings underscore the importance of engaging African American faith communities in fostering dementia caregiving skills training and support. We further highlight the implications of providing community-based training for African American facilitators to foster caregiver emotional well-being and physical health.