Evaluating the Preliminary Outcomes and Acceptability of a Virtual Adaptation of Acceptance and Commitment Training for Caregivers of People With Disabilities (“I Am Not Alone”): Mixed Methods Study (Preprint)
Notice bibliographique
Résumé
BACKGROUND Family caregivers of children and youth with neurodevelopmental disabilities report higher levels of stress, anxiety, and depression than other caregivers, yet few evidence-based mental health services are available to support them. Our previous research demonstrated that caregivers benefitted from our in-person group-based acceptance and commitment training (ACT) workshop, which increased their psychological flexibility and improved their mental well-being. During the COVID-19 pandemic, we adapted this intervention to be delivered virtually. OBJECTIVE In this study, we evaluated the program’s impact on caregivers’ psychological flexibility and mental well-being, as well as the acceptability of the virtual program. METHODS A total of 205 family caregivers of neurodivergent people or people with disabilities who registered for a virtual, group-based ACT intervention (10-12 hours across 5 or 6 weeks) from 1 of 27 teams across Canada participated in this research. ACT process (measured via the Cognitive Fusion Questionnaire, Acceptance and Action Questionnaire, Self-Compassion Scale–Short Form, and Valued Living Questionnaire) and mental well-being outcomes (measured through the Patient Health Questionnaire, Parenting Stress Index, Multi-System Model of Resilience Inventory, and Short Warwick-Edinburgh Mental Well-being Scale) were measured before and after the intervention and again at an 8-week follow-up. An acceptability survey was completed after the intervention, including items on satisfaction with virtual aspects of the intervention. RESULTS There was high intervention acceptability related to the virtual format (at least >80% satisfaction) despite variability in individual preferences (preferred in-person format: 28/91, 31%; preferred virtual format: 37/91, 41%; no preference: 26/91, 29%). Significant improvements were found for most ACT processes (fusion: F2,279=63.96; psychological flexibility: F2,264=38.81; values: F2,244=8.32; self-compassion: F2,170=33.59; P<.001 in all cases) and mental well-being measures (parental stress: F2,236=20.27; well-being: F2,137=22.89; mood: F2,15=23.12; resilience: F2,17=32.83; P<.001 in all cases). Pairwise comparisons between preintervention and follow-up showed maintenance of ACT skills (P<.001 in all cases; ηp2 ranged from 0.09 to 0.40) and well-being improvement (P<.001 in all cases; ηp2 ranged from 0.19 to 0.37). Direct content analysis of participants’ qualitative survey responses revealed that cognitive defusion, mindfulness, and acceptance were the most helpful ACT processes. We received feedback for modifications to formatting, pacing, content, and duration of the group to support a wider range of caregiver needs. CONCLUSIONS The virtual, group-based ACT intervention was acceptable and led to positive changes in psychological flexibility and mental well-being among family caregivers of people with disabilities or neurodivergent people, similar to outcomes observed with in-person delivery of the intervention. Further comparison and contrast with in-person programming is needed to ensure accessibility and sustainability of this program.
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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 | 0,012 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
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 ».