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Background While nonprofessional caregivers often experience a sense of fulfillment when they provide care, there is also a significant risk of emotional and physical burnout. Consequently, this can negatively affect both the caregiver and the person being cared for. Intervention programs can help empower nonprofessional caregivers of people with chronic diseases and develop solutions to decrease the physical and psychological consequences resulting from caregiving. However, most clinically tested intervention programs for nonprofessional caregivers require face-to-face training, and many caregivers encounter obstacles that hinder their participation in such programs. Consequently, it is necessary to design internet-based intervention programs for nonprofessional caregivers that address their needs and test the efficacy of the programs. Objective The aim of this study was to evaluate the effectiveness of a smartphone app–based intervention program to increase positive mental health for nonprofessional caregivers. Methods This study was a randomized controlled trial of 3 months’ duration. A total of 152 caregivers over 18 years of age with a minimum of 4 months’ experience as nonprofessional caregivers were recruited from primary health care institutions. Nonprofessional caregivers were randomized into two groups. In the intervention group, each caregiver installed a smartphone app and used it for 28 days. This app offered them daily activities that were based on 10 recommendations to promote positive mental health. The level of positive mental health, measured using the Positive Mental Health Questionnaire (PMHQ), and caregiver burden, measured using the 7-item short-form version of the Zarit Caregiver Burden Interview (ZBI-7), were the primary outcomes. Users’ satisfaction was also measured. Results In all, 113 caregivers completed the study. After the first month of the intervention, only one factor of the PMHQ, F1–Personal satisfaction, showed a significant difference between the groups, but it was not clinically relevant (0.96; P=.03). However, the intervention group obtained a higher mean change for the overall PMHQ score (mean change between groups: 1.40; P=.24). The results after the third month of the intervention showed an increment of PMHQ scores. The mean difference of change in the PMHQ score showed a significant difference between the groups (11.43; P<.001; d=0.82). Significant changes were reported in 5 of the 6 factors, especially F5–Problem solving and self-actualization (5.69; P<.001; d=0.71), F2–Prosocial attitude (2.47; P<.001; d=1.18), and F3–Self-control (0.76; P=.03; d=0.50). The results of the ZBI-7 showed a decrease in caregiver burden in the intervention group, although the results were inconclusive. Approximately 93.9% (46/49) of the app users indicated that they would recommend the app to other caregivers and 56.3% (27/49) agreed that an extension of the program’s duration would be beneficial. Conclusions The app-based intervention program analyzed in this study was effective in promoting positive mental health and decreasing the burden of caregivers and achieved a high range of user satisfaction. This study provides evidence that mobile phone app–based intervention programs may be useful tools for increasing nonprofessional caregivers’ well-being. The assessment of the effectiveness of intervention programs through clinical trials should be a focus to promote internet-based programs in health policies. Trial Registration ISRCTN Registry ISRCTN14818443; http://www.isrctn.com/ISRCTN14818443 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-019-7264-5

Background To assess the effectiveness of a smartphone app-based intervention compared to a regular intervention of caregivers in primary health care institutions. The intervention is aimed at increasing positive mental health and decreasing caregiver’s burden. Methods/design Randomized and controlled trial with an experimental group and a control group. Subjects: 108 caregivers over 18, with a minimum of 4 months of experience as caregivers. Description of the intervention: an intervention with a smartphone app ( n = 54) or a regular intervention for caregivers ( n = 54). Each caregiver installs a smartphone app and uses it for 28 days. This app offers them a daily activity (Monday-Friday). These activities are related to the Decalogue of Positive Mental Health, which was designed ad hoc by a group of experts. The outcomes will be the score of caregiver burden, the positive mental health and participant satisfaction. These results will be assessed after the first, third and sixth month. Discussion The results of this study will offer evidence of the effectiveness of an intervention using a free smartphone app. If its effectiveness is proven and the results are acceptable, this could lead to a rethinking of the intervention offered to caregivers in primary care. Trial registration Clinical Register ISRCTN14818443 (date: 24/05/2019).

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Background Taking care of chronic or long-term patients at home is an arduous task. Non-professional caregivers suffer the consequences of doing so, especially in terms of their mental health. Performing some simple activities through a mobile phone app may improve their mindset and consequently increase their positivity. However, each caregiver may need support in different aspects of positive mental health. In this paper, a method is defined to calculate the utility of a set of activities for a particular caregiver in order to personalize the intervention plan proposed in the app. Methods Based on the caregivers’ answers to a questionnaire, a modular averaging method is used to calculate the personal level of competence in each positive mental health factor. A reward-penalty scoring procedure then assigns an overall impact value to each activity. Finally, the app ranks the activities using this impact value. Results The results of this new personalization method are provided based on a pilot test conducted on 111 caregivers. The results indicate that a conjunctive average is appropriate at the first stage and that reward should be greater than penalty in the second stage. Conclusions The method presented is able to personalize the intervention plan by determining the best order of carrying out the activities for each caregiver, with the aim of avoiding a high level of deterioration in any factor.

BACKGROUND Caregivers focus on the caregiver and not themselves. This can negatively affect the caregiver and the person being cared. Intervention programs can help empower caregivers of people with chronic diseases and can develop solutions to decrease the physical and psychological consequences resulting from caregiving. However, most of intervention programs for caregivers clinically tested are presential and many of the caregivers don’t have time to assist. This make important to create internet-based intervention programs and test their efficacy. OBJECTIVE Evaluate the effectiveness of a smartphone app-based intervention program to increase Positive Mental Health (PMH) compared. METHODS This study was a 3-moth long, randomized trial. A total of 152 caregivers over 18 with a minimum of 4 month of experience as caregivers were included. The caregivers were randomly divided into two equal size groups. In the intervention group, each caregiver installs a smartphone app and uses it for 28 days. This app offers them a daily activity related to the Decalogue of PMH. The level of PMH and caregiver burden was the primary outcome and the secondary outcome will be related to the satisfaction with the app by the intervention group RESULTS 113 caregivers completed the study. After the 1st month intervention, although no significant mean changes were obtained between groups, the intervention group obtained higher mean change than the control group. The mean change of the burden in the control group was higher after the first month and lower in the intervention group. A significantly mean change was obtained after the third month, with an increase of 14.94 in the intervention group in the total score of the PMH questionnaire. CONCLUSIONS The app-based intervention program analyzed in this study can be considered effective promoting PMH and decreasing burden and with a high range of satisfaction from the users. Evidence from this study shows that mobile phone app-based interventions program may be useful tools for increasing caregiver’s wellbeing. Interventions programs evidence assessed by a clinical trial should be a focus to promote internet-based programs in health policies. CLINICALTRIAL ISRCTN14818443 (date: 24/05/2019) INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1186/s12889-019-7264-5