Quasi-experimental Analysis Research Articles

Evaluating the Environmental Benefits of Public Transportation Development on Urban Air Quality in China: Evidence from a Quasi-Experimental Analysis

China's swift urbanization and motorization have profoundly affected urban air quality, with transportation accounting for a substantial portion of urban air pollution. This study examines the effect of enhancements in public transportation on air quality in Chinese cities, with a particular emphasis on PM2.5 concentrations as a critical metric. Employing a Difference-in-Differences (DiD) methodology, we examine data from cities that executed substantial public transport enhancements between 2000 and 2020, contrasting them with cities that did not implement analogous measures. Findings demonstrate that enhancements in public transportation correlate with substantial decreases in PM2.5 concentrations, especially in urban areas with elevated baseline pollution levels. The results underscore the significance of sustainable transportation strategies in alleviating air pollution and enhancing public health. This study enhances the literature by delivering a thorough empirical examination of the environmental effects of public transport investments in China and has practical implications for urban authorities.

Computational thinking in complex problem solving based on data analysis: exploring the role of problem representation using the Tower of Hanoi

This article investigates the role of problem representation in complex problem-solving based on quasi-experimental data analysis, specifically within the context of computational thinking. Using the Tower of Hanoi task, researchers compared the performance of computer science students (with algorithmic background) and non-computer science students (novices). The data research results revealed that participants with stronger problem representation skills, i.e., computer science students, demonstrated superior problem-solving abilities, particularly as task difficulty increased. Additionally, practice was found to significantly improve problem-solving efficiency for novices, suggesting that enhancing problem representation skills through experience can effectively boost complex problem-solving abilities. The data research highlights the critical role of problem representation in computational thinking and provides valuable insights for programming practices, emphasizing the importance of developing problem representation skills to foster effective problem-solving in complex scenarios.

Impact of 24-hour pharmacy call response on time to antibiotics in open fractures

Abstract Purpose Open fractures are associated with significant morbidity after trauma, which is driven, in part, by infection. Current literature and guidelines recommend that this patient population receive antimicrobial prophylaxis within 1 hour of emergency department (ED) arrival to minimize the risk of infection. The primary aim of this study was to investigate whether the addition of a trauma response to a pharmacy resident on-call program resulted in antibiotic administration within 1 hour of presentation to a higher proportion of patients with open fractures. Methods This was a retrospective, observational, quasi-experimental analysis that was conducted at an academic medical facility with a level 1 trauma center for patients presenting to the ED from January 2019 to December 2020 (preimplementation period) and from January 2021 to December 2022 (postimplementation period). Patients were included if they were 18 years of age or older and presented to the ED with an open fracture(s). Patients with independent fractures of fingers and those who died in route to or in the ED were excluded. The primary outcome was the proportion of patients with antibiotic administration within 1 hour of ED presentation for patients with open extremity fractures. Results A total of 292 patients met the eligibility criteria (49% in the preimplementation group and 51% in the postimplementation group). Patients were predominantly male (61% vs 58%), with an overall median age of 46 years. Following implementation of the on-call pharmacy resident trauma response, a significantly higher proportion of patients received antibiotics within 1 hour of presentation (70% vs 83%; P = 0.019). The median (interquartile range) time to antimicrobial administration was also significantly shorter in the postimplementation group (31 [16-68] minutes vs 19 [10-50] minutes; P = 0.005). Conclusion The addition of a 24-hour on-call pharmacy resident response in the ED was associated with improved antibiotic administration within 1 hour of presentation in patients with open fractures.

Flavored E-Cigarette Sales Restrictions and Young Adult Tobacco Use

More than one-quarter of US residents live in states or localities that restrict sales of flavored electronic nicotine delivery systems (ENDS), often as a means to reduce youth vaping. Yet, how these policies affect young adult vaping and smoking remains unclear. To estimate the effects of ENDS flavor restrictions on ENDS use and cigarette smoking among young adults (age 18-29 years) in the US. This quasi-experimental analysis used annual survey data from the 2016 to 2023 Behavioral Risk Factor Surveillance System (BRFSS), a series of nationally- and state-representative, repeated cross-sectional surveys of noninstitutionalized civilian adults in the US. Two-way fixed-effects specifications were estimated to assess how ENDS flavor restrictions affect young adults' use of ENDS and cigarettes. Analyses were adjusted for potential confounders including concurrent tobacco control policies, respondent demographic characteristics, and socioeconomic factors. Data analyses were conducted in November 2023 and repeated in October 2024 to incorporate newly released 2023 survey data. Current and daily use of ENDS and of cigarettes as measured in the BRFSS. Balanced panel analyses of 242 154 individuals aged 18 to 29 years consistently found that state ENDS flavor restrictions were associated with statistically significant reductions in daily vaping and increases in daily cigarette smoking. Estimates were similar across robustness checks, with the main specification showing 3.6 (95% CI, -5.0 to -2.1) percentage point (ppt) reductions in daily vaping and 2.2 ppt increases in daily cigarette smoking (95% CI, 1.0 to 3.4) relative to changes in states without restrictions. These estimates are equivalent to an 80% reduction in daily vaping and 22% increase in daily smoking compared with 2018 mean rates. The findings of this quasi-experimental analysis of BRFSS survey data indicate that state restrictions on flavored ENDS sales were associated with reduced vaping among young adults but may have unintentionally increased cigarette smoking, potentially offsetting public health gains. These findings suggest that alleviating the burden of tobacco-related disease will require regulatory strategies that balance reducing vaping with preventing increases in more lethal, combustible tobacco use.

4-Factor prothrombin complex concentrates and factor VIII inhibitor bypass activity use in cardiac surgery.

The objective of this study was to compare total thromboembolic complications between 4-factor prothrombin complex concentrate (4F-PCC) with factor VIII inhibitor bypassing activity (FEIBA) when utilized during cardiac surgery. A quasi-experimental analysis of retrospective data from consecutive patients. A tertiary care university hospital. Patients undergoing cardiac surgery with cardiopulmonary bypass. Patients received either 4F-PCC or FEIBA after discontinuation of cardiopulmonary bypass and reversal of heparin with protamine. Medical records were reviewed for thromboembolic events (stroke, arterial or venous thrombosis, pulmonary embolism, myocardial infarction), acute kidney injury, ischemic bowel, death, duration of intensive care unit and hospital stay, clinical and surgical characteristics and blood product utilization. A comparison of the clinical and surgical variables demonstrated a mean effect size of 0.33 imbalance between groups that was reduced to 0.18 after propensity score weighting. The propensity scores weighted analysis found an incidence of composite thromboembolic events of 39% in the 4F-PCC (n = 90) and 47% in the FEIBA (n = 50) group, difference -8 (-24% to 12%), P = 0.13. Individual thromboembolic events, acute kidney injury, ischemic bowel, mortality, and length of intensive care unit or hospital stay was not different among groups. Patients who received FEIBA had greater chest tube drainage and received more cryoprecipitate intraoperatively. Patients who received 4F-PCC received more fresh frozen plasma transfusions postoperatively. Among cardiac surgery patients, there was no difference in thromboembolic events between patients who received 4F-PCC or FEIBA when used as an adjunct to blood product administration.

Healthcare access in humanitarian settings: Mobile services successes and limits in Afghanistan

With an ever-increasing number of humanitarian emergencies being declared around the globe, identifying effective methods to provide healthcare access to affected communities is all the more relevant to health practitioners. Mobile health services have been widely implemented by international and national actors to reach underserved communities in humanitarian contexts. Nonetheless, little rigorous evidence exists on the effects of such services. Our work contributes to filling the knowledge gap by studying the role of mobile health teams (MHTs) in Afghanistan after the institution of the Taliban De Facto Authority in 2021. We conduct correlational and quasi-experimental analysis of country-wide survey data and matched with geo-localised information on MHTs and their related service delivery points (SDPs) – at least in part of the country – from WHO and UNICEF. Our findings show mobile services enhance recent access to health care by about 11 percentage points (about 14% over comparison) based on our preferred model. We also identify a decreasing effect of number of MHTs and SDPs on healthcare access. Our results indicate that higher number of mobile services do not necessarily translate to better access, although strong differences exist between underserved and better served areas within the country.

Spatio-temporal quasi-experimental methods for rare disease outcomes: the impact of reformulated gasoline on childhood haematologic cancer

Abstract Although some pollutants emitted in vehicle exhaust, such as benzene, are known to cause leukaemia in adults with high exposure levels, less is known about the relationship between traffic-related air pollution (TRAP) and childhood haematologic cancer. In the 1990s, the US EPA enacted the reformulated gasoline program in select areas of the U.S., which drastically reduced ambient TRAP in affected areas. This created an ideal quasi-experiment to study the effects of TRAP on childhood haematologic cancers. However, existing methods for quasi-experimental analyses can perform poorly when outcomes are rare and unstable, as with childhood cancer incidence. We develop Bayesian spatio-temporal matrix completion methods to conduct causal inference in quasi-experimental settings with rare outcomes. Selective information sharing across space and time enables stable estimation, and the Bayesian approach facilitates uncertainty quantification. We evaluate the methods through simulations and apply them to estimate the causal effects of TRAP on childhood leukaemia and lymphoma.

The impact of the COVID-19 pandemic on the dispensing of systemic anti-cancer therapy (SACT) in Ireland: A population based study

ObjectivesThe COVID-19 pandemic had considerable implications for cancer related care. This study aimed to examine its impact on the dispensing of systemic anti-cancer therapy (SACT) in Ireland. Study designA repeated cross-sectional design was used which involved a quasi-experimental interrupted time series analysis (ITSA), and autoregressive integrated moving average (ARIMA) models. MethodsThis nationally representative study utilised monthly pharmacy claims (i.e. dispensing) data from community and hospital schemes. Dispensed items among individuals prescribed any SACT from January 2019 to April 2021 were included. ResultsDuring the study period, 641,273 SACT items were dispensed, including 57,199 chemotherapeutic agents (8.9 %), 15,970 immunotherapeutic agents (2.5 %), 87,813 targeted therapies (13.7 %), and 480,291 (74.9 %) endocrine therapies. There were on average 3.3 and 4.1 fewer immunotherapy and targeted therapy agents, respectively, dispensed per 100,000 population per month post-March 2020 (vs. expected), compared to the level prior to March 2020. For endocrine therapy, there was a significant slowing of the trend post-March 2020 compared to the pre-pandemic period (slope change = −1.72, 95 % CI -2.9 to −0.5; p<0.01). ConclusionThere was a significant level decrease in the dispensing of immunotherapy and targeted therapy during the first year of the pandemic, and a slowing of the trend for endocrine therapies. However, no differences in the dispensing of other SACT were observed.

The Effect of Coaching Support Method on Interdialytic Weight Gain (IDWG) Changes Among Hemodialysis Patients

This research aimed determine impact of Coaching Support Method on IDWG values in CKD patients receiving hemodialysis. This quasi-experimental analysis, conducted in 2023, engaged 28 hemodialysis patients in Garut, Indonesia. Subjects were randomly assigned to the control (n = 14) and intervention (n = 14) groups, The intervention was performed in case group as 4 training sessions during 2 weeks based on coaching support. IDWG values were rechecked before and after intervention. Data analysis was performed using SPSS, applying dependent and independent t-tests, with statistical significance set at p &lt; 0.05. The mean scores of IDWG values showed statistically difference before and after intervention in the intervention group (p-value &lt; 0.05)). Additionally, the mean scores of IDWG values showed statistically difference in intervention group and control group (p-value &lt; 0.05) following the two-week session. Coaching Support Method can be done as an effective method in hemodialysis patient for reducing IDWG values in CKD patients receiving hemodialysis.

High-flow nasal cannulas versus standard oxygen therapy for moderate bronchiolitis: a quasi-experimental analysis.

In the last decades none of the medical therapies investigated have shown clear efficacy in the treatment of bronchiolitis, and literature agrees on a general de-implementation of pharmacological therapies, recognizing an effective role only to nutritional support and oxygen therapy. High-flow nasal cannulas (HFNC) has become increasingly popular in the last decade, despite its lack of clear efficacy. Recent randomized controlled trials (RCT) comparing standard oxygen therapy (SOT) and HFNC did not demonstrate significant benefit of HFNC. To acquire more clinical data on HFNC efficacy we performed a retrospective, quasi-experimental analysis of patients admitted for bronchiolitis in the epidemic seasons 2021-2022 and 2022-2023. To assess the efficacy of SOT and HFNC we used a pragmatic approach, a fuzzy regression discontinuity design, which is a quasi-experimental test. Unlike RCTs, this process is not a true randomization, but may be interpreted as quasi-randomization in an observational setting. HFNC did not reduce length of oxygen therapy (LOO) nor length of hospitalization (LOS) (respectively, p: 0.383 and p: 0.454). Treatment failure was not significantly different in the treatment groups (p: 0.354). It is crucial to perform additional RCTs with uniform protocols to determine the efficacy of HFNC more accurately in the treatment of bronchiolitis. HFNC does not reduce LOO, suggesting that early use of HFNC does not change the course of disease in moderate bronchiolitis. In view of the greater complexity and higher cost, HFNC should not be routinely used as first-line treatment in children with moderate respiratory distress and mild hypoxemia.

Planning policies to restrict fast food and inequalities in child weight in England: a quasi-experimental analysis.

England has one of the highest childhood obesity rates in Europe. To promote a healthier food environment in 2015, Gateshead Council in North East England introduced planning guidelines effectively banning any new fast-food outlets. Our aim was to investigate whether this policy led to any reductions in childhood overweight and obesity prevalence and the inequalities in these outcomes. We used data from the National Child Measurement Programme, the Food Standards Agency Food Hygiene Rating Scheme data, and the Office of National Statistics between 2012 and 2020. We estimated a difference-in-differences model employing propensity score matching to identify a control group. We found no significant change in population-level childhood overweight and obesity in Gateshead compared with control areas. In subgroup analysis by area-level deprivation, we found that the quintile of deprivation with the highest proportion of fast-food outlets had a statistically significant reduction of 4.8% in the prevalence of childhood overweight and obesity compared with control areas. Restricting fast-food outlets in areas with a high concentration of such outlets as part of a package of policies to reduce childhood obesity may help to reduce prevalence and inequalities in childhood overweight and obesity.

30-Month Impact of Medications for Opioid Use Disorder on Acute Care Utilization in Rural Communities.

To assess both the short- and longer-term impact of offering medications for opioid use disorder (MOUD, ie, methadone, buprenorphine, or naltrexone) on rates of all-cause emergency department (ED) visits and acute inpatient admissions (IP) over a 30-month period among Medicaid enrollees with opioid use disorder (OUD) residing in rural communities. A quasi-experimental retrospective analysis of longitudinal Medicaid claims data among continuously enrolled adult patients with OUD residing in 71 predominantly rural counties in the United States between 2018 and 2020. A cohort of patients receiving MOUD treatment was compared against a contemporaneous propensity score-matched comparison group consisting of those who received no MOUD during the period. The sample included 5370 patients with OUD in each group. At the index period (ie, the month in which any MOUD was used for the first time), buprenorphine was the most commonly used MOUD (82% of the MOUD treatment group). By the eighth month since the index period, MOUD use dropped below 60% among the MOUD treatment group. Over the 30-month post-MOUD period, MOUD treatment was associated with 24% (112 vs 148 per 1000 per month) and 52% (21 vs 44) lower rates of ED visit and IP admission rates, respectively (P < 0.001), relative to the comparison group. Moreover, the reductions persisted well after the 18th month period. Receipt of MOUD was associated with both immediate- and long-term lower rates in acute care utilization rates among adult Medicaid beneficiaries with OUD residing in rural communities despite significant treatment discontinuation.

A quasi-experimental evaluation of RADAR: response awareness, de-escalation, and referral for people with behavioral health issues

ABSTRACT This paper describes the implementation and evaluation of RADAR (Response Awareness, De-Escalation, and Referral), a hybrid CIT/co-response program for people with behavioral health issues (PBHI). RADAR emphasized information sharing between police, PBHI, and behavioral health professionals and targeted outreach to PBHI by a police officer and clinician working in partnership. We evaluated RADAR using a quasi-experimental analysis of calls for service and incident data, an officer survey, and interviews with key personnel. While RADAR did not significantly reduce calls, incidents, or physical contact and resistance relative to a comparison jurisdiction, the survey and interviews suggest that it did help to shift the department’s culture and organizational perceptions around collaborative responses to PBHI. The practical implications of our findings for police agencies seeking to implement co-responder programs include the need to focus on sustainability; relationship building between the police, PBHI, and clinicians; and technological solutions to improve data collection and evaluation efforts.

Application of Android-Based SDIDTK Development Stimulation Media on the Developmental Abilities of Preschool

A nation's future depends on children's success in achieving optimal growth and development. One of the efforts to achieve optimal development is screening and developmental stimulation. Implementation of development stimulation requires media. The media used is android-based media designed by researchers, including gross and fine motor stimulation, speech and language, as well as socialization and independence. The purpose of this study was to determine the effect of developmental stimulation media on the developmental abilities of preschoolers. The method used is a quasi-experimental design test analysis using univariate analysis (frequency distribution) and bivariate (Wilcoxon tests). The number of respondents was 75 (35 children in the intervention group and 35 children in the control group). In the intervention group, development stimulation was carried out using an android-based development stimulation media SDIDTK while in the control group used PPT material after the post-test. The results showed that there was a significant difference between average ability: gross movement, fine movement, speech and language, and socialization and independence of children in the intervention group and the control group after treatment (p-value &lt; 0.005 and α= 0.05). IT-based stimulation media (android) can be used as an alternative in stimulating development in preschool-aged children.

Benefits by Luck: A Study of Lotteries as a Selection Method for Government Programs

Lotteries could be a just and cost-effective procedure to distribute government benefits in contexts of oversubscription, with the added benefit of allowing assessments of the impact of government programs. However, little is known about whether there is public support for employing lotteries in this context. We examine support for a lottery that selects recipients of new government-built housing units in Brazil and find that neither lotteries participants nor the general public supports their use. We arrive at this result by employing a three-pronged multi-method approach. Quasi-experimental analysis of an original survey of lottery participants reveals that support not only is tepid, but substantially higher among winners than non-winners. In-depth interviews suggest that applicants believe lotteries miss the most deserving beneficiaries. A general population survey experiment reveals that lotteries are not perceived as just or efficient when compared to alternative beneficiary selection methods. While sometimes normatively desirable, the use of lotteries for government programs enjoys limited popular support.

Long-term health outcomes of young patients with low-complexity coronary disease: a weighted analysis according to revascularization strategy.

Age is an important factor weighing on revascularization decisions. We analysed long-term health outcomes of young patients with low-complexity coronary anatomy suitable for both coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), according to revascularization strategy. Patients 60 years old or less, undergoing invasive coronary angiography between January 2007 and December 2015, presenting with proximal left anterior descending artery involvement, left main or multivessel disease and a SYNTAX Score ≤22 were retrospectively selected. An inverse probability of treatment weight methodology generated a pseudopopulation with well-balanced characteristics, which was used to estimate the average treatment effect between PCI (n = 374) and CABG (n = 173). Mean age was 53 ± 7 years old, 27% had diabetes mellitus and 48% presented with an acute coronary syndrome. Mean SYNTAX score was 13.6 ± 4.9 and 68% underwent PCI as index revascularization strategy. In the weighed population, the adjusted hazard of the primary end-point of all-cause death at total follow-up (median 9.3 years; interquartile range 6.9-11.7) was 0.40 (95% confidence interval 0.19-0.7) for CABG vs PCI (incidence rate 5.8 vs 14.0 deaths/1000-person-years). Accounting for death as competing risk, the cumulative hazard of new revascularization (sub-distribution hazard ratio 0.72; 95% confidence interval 0.32-1.25) and any cause hospital readmission (sub-distribution hazard ratio 0.70; 95% confidence interval 0.41-1.07) were lower in CABG patients, as opposed to death/stroke rates at 30 days which were higher with CABG (0.3% vs 1.7%; risk ratio = 5.84). In this quasi-experimental analysis of young patients with coronary artery disease and an equivalent indication for both PCI and CABG, long-term health outcomes were favourably associated with CABG, as compared to PCI. These observations support the need for dedicated randomized trials with longer follow-up in order to better inform lifetime treatment options.

Nudging towards Sleep-Friendly Health Care: A Multifaceted Approach on Reducing Unnecessary Overnight Interventions.

Choice architecture refers to the design of decision environments, which can influence decision-making in health care. Nudges are subtle adjustments in these environments that guide decisions toward desired outcomes. For example, computerized provider order entry within electronic health records (EHRs) recommends frequencies for interventions such as nursing assessments and medication administrations, but these can link to around-the-clock schedules without clinical necessity. This study aimed to evaluate an intervention to promote sleep-friendly practices by optimizing choice architecture and employing targeted nudges on inpatient order frequencies. We employed a quasi-experimental interrupted time series analysis of a multifaceted, multiphase intervention to reduce overnight interventions in a hospital system. Our intervention featured EHR modifications to optimize the scheduling of vital sign checks, neurological checks, and medication administrations. Additionally, we used targeted secure messaging reminders and education on an inpatient neurology unit (INU) to supplement the initiative. Significant increases in sleep-friendly medication orders were observed at the academic medical center (AMC) and community hospital affiliate (CHA), particularly for acetaminophen and heparin at the AMC. This led to a reduction in overnight medication administrations, with the most substantial impact observed with heparin at all locations (CHA: 18%, AMC: 10%, INU: 10%, p < 0.05). Sleep-friendly vital sign orders increased significantly at all sites (AMC: 6.7%, CHA: 4.3%, INU: 14%, p < 0.05), and sleep-friendly neuro check orders increased significantly at the AMC (8.1%, p < 0.05). There was also a significant immediate reduction in overnight neurological checks performed at the AMC. Tailoring EHR modifications and employing multifaceted nudging strategies emerged as promising approaches for reducing unnecessary overnight interventions. The observed shifts in sleep-friendly ordering translated into decreases in overnight interventions. Multifaceted nudges can effectively influence clinician decision-making and patient care. The varied impacts across nudge types and settings emphasizes the importance of thoughtful nudge design and understanding local workflows.

Enhancing Adult Literacy in Morocco: A Quasi-Experimental Analysis of Program Effectiveness and Skill Development

This article presents a quasi-experimental study evaluating Morocco's Agency for Adult Education “Literacy for Empowerment” program, using propensity score matching to compare data from participants and nonparticipants. Framed within a theory supporting an all-inclusive concept of literacy, the study was guided by two main questions, and data was collected through literacy-relevant test instruments and a questionnaire. The results suggest that individuals who participated in the program had better skills than those who did not (counterfactual). These skills include: (1) literacy skills, (2) personal life, (3) family sphere, (4) inclusive decision-making skills, (5) social skills, (6) community engagement, and (7) economic empowerment. The article concludes that only a comprehensive approach to literacy education would enhance both the quality and benefits derivable from adult literacy programs, advocating for its expansion throughout both rural and urban areas to ensure universal access to basic education and promote active citizen participation in development initiatives.

Impact of Regulatory Interventions on Ulipristal Acetate 5 mg (Esmya) Use in Spain: An Interrupted Time-Series Analysis.

Since late 2017, the use of ulipristal acetate 5 mg (UPA; Proprietary name: Esmya) has been under review in the European Union, due to an emerging hepatic risk. In February 2018 and in July 2018, the Spanish Agency of Medicines and Medical Devices and the marketing authorization holder put two risk minimization measures (RMM) in place, in order to inform about new safety information and to mitigate this risk. This study aims to assess RMM effectiveness in Spain, by performing an interrupted time-series (ITS) analyses, between 2014 and 2019. Two quasi-experimental ITS analyses to examine the use of UPA before and after the RMM release were performed: (a) an ecological study using aggregated data from a drug consumption database; and (b) a study using primary healthcare data gathered from electronic clinical records. Regulatory interventions were associated with an immediate and significant decrease level of DID (the number of DDD dispensed per 100 000 inhabitants and day) and incidence. The DID was 70% less than expected 12 months after the interventions. This value was 59% for the incidence. However, a change in the slope was not observed and the use started rising again in the last segment of the study period. Despite RMM had an immediate strong impact on UPA use, the last segment upward trend in the long-term might have been affected by the lack of comparable therapeutic alternatives. Further studies should be performed to confirm the increase trend observed and analyze subsequent measures and additional data.

Evaluating the combination of in-person and electronic social networking services for family caregivers of stroke survivors: A quasi-experimental analysis.

The effectiveness of health interventions delivered via a combination of in-person and electronic social networking services for caregivers of stroke survivors remains uncertain. This study evaluates the feasibility of implementing educational and peer support programs for these caregivers through such platforms. Quasi-experimental design. This study included 105 caregiver-survivor dyads, with 54 dyads allocated to the intervention group and the remaining 51 to the control group. The LINE intervention comprised a combination of in-person and electronic social networking services including stroke and rehabilitation education, problem-solving skills training, long-term care information support, and 24-h peer and professional support for caregivers. The outcomes were assessed at baseline, after 1 month, and after 3 months, and encompassed caregivers' care burden, depressive symptoms, perceived social support, and quality of life, as well as the rehabilitation adherence and depressive symptoms of stroke survivors. Generalized estimating equations were used to examine group differences. The data were collected between August 2021 and October 2022. The average age of the caregivers was 48.3 years. Caregivers in the intervention group reported reduced care burdens and enhanced perceptions of social support and quality of life as compared to those in the control group. Additionally, stroke survivors in the intervention group were less likely to exhibit high-risk depressive symptoms. Delivering a stroke caregiver support intervention via in-person and electronic social networking services, such as LINE, effectively reduced the care burden for caregivers of stroke survivors. Additionally, it enhanced caregivers' perceived social support and quality of life. This study demonstrated that caregiver education and peer support programs administered through a combination of in-person and electronic social networking services can serve as an effective support system for the psychosocial health of stroke caregivers. These findings support the integration of such interventions into standard clinical practice by healthcare providers or governmental bodies.