Characterizing Digital Mindfulness Intervention Utilization and Weekly Assessments in Caregivers of Persons Living With Dementia: Secondary Analysis of a Randomized Controlled Trial

Abstract Background Caregivers of persons living with dementia are at increased risk of reporting high stress. Mindfulness-based interventions (MBIs) teach caregivers mindfulness skills and are effective at reducing stress. Digital MBIs are a feasible way to improve access to MBIs for caregivers of persons living with dementia. Yet, caregiver improvement with digital MBI utilization is less defined in the literature. Objective The goal of this secondary data analysis was to characterize weekly mindfulness and stress ratings among caregivers of persons living with dementia and to examine how digital MBI utilization impacted these ratings throughout 12 weeks of a feasibility trial. Methods Participants were eligible for this secondary analysis if they were randomized to the digital MBI condition (Healthy Minds Program for Caregivers [HMP-C], n=46) and completed weekly ratings over the 12-week trial. At baseline and at the end of each week of the trial, participants rated their mindfulness and stress in the past week from 0 to 10. Weekly HMP-C utilization was defined as the time spent using HMP-C in the week prior to the weekly ratings. Descriptive statistics and visualizations were used to characterize mindfulness and stress ratings. Generalized linear mixed models were used to estimate the effect of mindfulness on stress and the effect of HMP-C utilization on stress and mindfulness throughout the trial (α=.05). Results Baseline mindfulness and stress ratings were 4 (IQR 3-6, range 0‐8) and 7 (IQR 6.5-8, range 4‐10), respectively. Stress had the greatest decrease between baseline and week 3 (−2 points on average), whereas mindfulness had the greatest increase between baseline and week 4 (+2.5 points on average). There was a significant fixed effect of baseline mindfulness on baseline stress (β=.5, P