Acceptance and Commitment Training for Family Caregivers of People with Neurodevelopmental Disabilities: Protocol for a Collaborative Implementation Study (Preprint)
Notice bibliographique
Résumé
BACKGROUND Family caregivers of individuals with neurodevelopmental disabilities (NDDs) often experience stress, anxiety, and depression; however, few evidence-based interventions are designed to improve their mental well-being. To address this gap, we developed an acceptance and commitment training (ACT) group–based workshop cofacilitated by trained caregivers and clinicians (Caring for the Caregiver Acceptance and Commitment Training [CC-ACT]). OBJECTIVE This study evaluates the real-world implementation of this innovative, evidence-based ACT workshop aimed at enhancing caregiver mental health and resilience. METHODS Guided by the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) implementation science framework, this study examines the workshop across these 5 domains. We delivered the CC-ACT workshops virtually or in-person across 11 intervention sites in Canada, including hospital and community agencies that provide services to children with NDDs and their families. Family caregivers (ie, a parent, grandparent, or adult sibling) of someone with an NDD were eligible to participate in the workshops, with site-specific criteria set by each host agency. Caregivers participated in preintervention, postintervention, and 3-month follow-up assessments measuring stress, resilience, and self-compassion using validated instruments (21-item Depression, Anxiety and Stress Scale; Parenting Stress Index, 4th Edition; Brief Family Distress Scale; Multi-System Model of Resilience Inventory; and Self-Compassion Scale–Short Form), alongside ACT process measures (Cognitive Fusion Questionnaire, Valued Living Questionnaire, and Acceptance and Action Questionnaire-II). Implementation fidelity was assessed through checklists and surveys. Focus groups with caregiver facilitators, clinician facilitators, workshop participants, and organizational leaders were held to qualitatively evaluate the implementation process and the caregiver-clinician cofacilitation model. Qualitative data will be analyzed using descriptive content analysis, a flexible approach that can be used to systematically summarize different types of qualitative data. Quantitative data will be analyzed through repeated measures ANOVA and mixed-effects modeling, with subgroup analyses and multiple imputation for missing data. RESULTS The CC-ACT workshops successfully reached 195 caregivers of individuals with NDDs. Two focus groups that included 5 caregiver workshop participants, 13 facilitators, and 5 organizational leaders were conducted. We anticipate that the workshops will demonstrate positive impacts on caregiver well-being, with variability in effectiveness based on participant characteristics and real-world implementation contexts. The findings are expected to identify key predictors of outcomes, equity and access barriers, and best practices for scaling and sustaining high-fidelity, adaptable caregiver interventions across diverse Canadian settings. Funding began in January 2022, data collection was completed in 2024, and data analyses will be completed by the end of 2025. CONCLUSIONS The CC-ACT workshop is a promising approach to enhancing the mental well-being of caregivers of individuals with NDDs. The RE-AIM framework helps capture process data systematically, documenting the balance between fidelity and adaptation. The study findings should support the refinement of implementation strategies and support the broader scalability of the intervention to diverse community settings. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/75049
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,062 | 0,050 |
| Méta-épidémiologie (sens strict) | 0,004 | 0,005 |
| Méta-épidémiologie (sens large) | 0,005 | 0,005 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,006 | 0,003 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,004 | 0,004 |
| Intégrité de la recherche | 0,005 | 0,009 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,065 | 0,012 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».