An mHealth Stress Management Intervention for Latino Millennial Caregivers: Pilot Feasibility Randomized Controlled Trial.

Background: Latino millennial caregivers comprise over one-quarter of millennial family caregivers in the United States. Latino millennial family caregivers face unique challenges due to cultural, structural, and economic burdens that may increase stress and stress-related health effects. These caregivers also report time limitations due to their multiple roles. Technology may be a way to deliver an accessible and flexible intervention to support stress management and emotional regulation in this population.

Objective: This study aimed to evaluate the feasibility, acceptability, and preliminary outcomes of a culturally tailored mobile health (mHealth) intervention to support stress management and emotional regulation for Latino millennial caregivers.

Methods: Participants (N=30) were recruited nationally in the United States using a recruitment agency and were randomized to the intervention or waitlist control groups. The 4-week fully automated intervention included daily mindfulness exercises and journaling prompts delivered via a custom mHealth platform. The waitlist control group received a written handout with mindfulness, journaling, and support information. Feasibility data, including recruitment and retention rates and intervention adherence, and postintervention acceptability surveys were collected. Study outcome measures were collected electronically at baseline and 2, 4, and 6 weeks. Primary outcomes included caregiver burden and perceived stress, and secondary outcomes included well-being, informational support, and emotional support. Feasibility and acceptability data were analyzed descriptively alongside study outcome measure data from participants who completed week 6 data collection (n=21). No efficacy testing was conducted.

Results: Enrollment was completed in 12 weeks (N=30), with a 70% (21/30) retention. Participants showed differential adherence, with 60% (6/10) completing a daily journal activity and 30% (3/10) completing a daily mindfulness activity. Adherence patterns were reflected in the acceptability findings, with journaling being preferred over mindfulness. Preliminary outcomes showed varying patterns between the intervention and control groups, with the intervention group showing decreased median burden levels from before (median 20, IQR 15-27.25) to after the intervention (median 15, IQR 10.50-28.75) but increased median stress levels from 19.50 (IQR 12-26.75) to 21 (IQR 8.75-22.75), while the control group burden and stress levels remained the same before and after the intervention. Positive affect and well-being and informational support increased for both groups. Median emotional support levels increased from 15 (IQR 12-20) before the intervention to 16 (IQR 13-19) after the intervention for the control group and decreased from 14.5 (IQR 11.5-17.75) to 14 (IQR 12-17.25) for the intervention group.

Conclusions: Findings demonstrate areas for further intervention iteration to address both adherence and acceptability issues with the mindfulness component of the intervention. Intervention implementation also needs to be addressed, including participant retention rates. Our team will use lessons learned alongside feedback from Latino millennial caregivers to address these issues.