Developing and Testing a Brief Mindfulness Just-in-Time Adaptive Intervention to Reduce Stress Among Caregivers of People With Dementia: Quasi-Experimental Study.
Patrick Pui Kin Kor, Alex Pak Lik Tsang, Daphne Sze Ki Cheung, Steven H Zarit, Haoran Xie, Min Qian, Kay Chen Tan, Yuanqing Zheng, Amanda Man Ying Chu, Kee Lee Chou
JMIR aging June 5, 2026 DOI: 10.2196/87316 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Single-arm pretest-posttest design Peer reviewed |
|---|---|
| Sample size | 120 |
| Population | Community-dwelling caregivers of people with dementia |
| Intervention | mindfulness just-in-time adaptive intervention (JITAI) |
| Duration | 18-day intervention |
| Topics | Meditation |
| Keywords | Android app Dementia caregiving Just-in-time adaptive intervention Mobile health Receptivity Stress |
| Key points | The intervention was feasible and acceptable, with significant pre-post reductions in perceived stress, depressive symptoms, and caregiver burden, and increases in positive aspects of caregiving and sleep quality. |
Abstract
Dementia caregiving entails chronic, fluctuating stress with downstream risks to caregivers' mental health and quality of care. Mindfulness-based interventions can reduce caregiver stress; however, moment-to-moment fluctuations in stress may limit receptivity to practice at any given time. We developed a brief mindfulness just-in-time adaptive intervention (JITAI) that aims to deliver support at the right moment by using machine learning algorithms to optimize notification timing based on receptivity to engage in brief mindfulness practices. This study aims to evaluate the feasibility, acceptability, and effectiveness of a brief mindfulness JITAI for caregivers of people with dementia on stress, depressive symptoms, caregiver burden, sleep, quality of life, and trait mindfulness. A single-arm, pretest or posttest design was adopted. A total of 120 community-dwelling caregivers were recruited to participate in the 18-day intervention, which included 4 days of psychoeducation delivered via videos and phone coaching, alongside an in-app brief, low-dose mindfulness-based stress reduction component. From days 5 to 11, prompts were delivered either by a static machine learning model trained on prior pilot data or at random times, with equal probability. From days 12 to 18, three delivery models were used with equal probability, namely static, random, and adaptive models, which updated per participant using accumulating receptivity data. Feasibility and acceptability were assessed post intervention. Standardized measures of stress, depressive symptoms, caregiver burden, positive aspects of caregiving, sleep, quality of life, and trait mindfulness were collected via phone interviews at baseline and post intervention. Retention was 100%. Most participants (111/120, 92.5%) found the app easy to use, 81.7% (98/120) perceived it as helpful for stress management, and 80% (96/120) would recommend it to other caregivers. Pre-post analyses indicated significant reductions in perceived stress (P<.001), depressive symptoms (P<.001), and caregiver burden (P=.003), as well as a significant increase in positive aspects of caregiving (P<.001) and subjective sleep quality (P=.02). Health-related quality of life and trait mindfulness did not change significantly. A brief, smartphone-delivered mindfulness JITAI for caregivers of people with dementia was feasible and acceptable, with high retention and positive user evaluations. Pre-post findings suggest reductions in perceived stress, depressive symptoms, and caregiving burden, alongside increased positive aspects of caregiving and improved sleep, supporting the potential of adaptive, technology-enabled interventions to provide timely support to caregivers.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cites 11
- Effects of Low-Dose Mindfulness-Based Stress Reduction (MBSR-ld) on Working Adults Health Education & Behavior May 9, 2008
- An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing Mindfulness May 21, 2018
- Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials Clinical Interventions in Aging September 1, 2017
- Effects of a closed-loop mindfulness-based program for reducing stress in family caregivers of people with dementia: a study protocol of a randomized controlled trial. BMC Psychology July 1, 2025
- Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain Mindfulness May 24, 2023
and 6 more in the library