A Text Messaging Intervention to Support Latinx Family Caregivers of Individuals With Dementia (CuidaTEXT): Development and Usability Study

Abstract

Background Latinx family caregivers of individuals with dementia face many barriers to caregiver support access. Interventions to alleviate these barriers are urgently needed. Objective This study aimed to describe the development of CuidaTEXT, a tailored SMS text messaging intervention to support Latinx family caregivers of individuals with dementia. Methods CuidaTEXT is informed by the stress process framework and social cognitive theory. We developed and refined CuidaTEXT using a mixed methods approach that included thematic analysis and descriptive statistics. We followed 6 user-centered design stages, namely, the selection of design principles, software vendor collaboration, evidence-based foundation, caregiver and research and clinical advisory board guidance, sketching and prototyping, and usability testing of the prototype of CuidaTEXT among 5 Latinx caregivers. Results CuidaTEXT is a bilingual 6-month-long SMS text messaging–based intervention tailored to caregiver needs that includes 1-3 daily automatic messages (n=244) about logistics, dementia education, self-care, social support, end of life, care of the person with dementia, behavioral symptoms, and problem-solving strategies; 783 keyword-driven text messages for further help with the aforementioned topics; live chat interaction with a coach for further help; and a 19-page reference booklet summarizing the purpose and functions of the intervention. The 5 Latinx caregivers who used the prototype of CuidaTEXT scored an average of 97 out of 100 on the System Usability Scale. Conclusions CuidaTEXT’s prototype demonstrated high usability among Latinx caregivers. CuidaTEXT’s feasibility is ready to be tested.

Analysis of Engagement withCuidaTEXT, a Text Message Intervention for Dementia Caregiver Support among Latinos

“…This represents the first text message intervention for caregiver support of individuals with ADRD among Latinos or any other ethnic group, and has shown high levels of acceptability, and preliminary efficacy. 18,19 For this reason, exploring the associations between the level of engagement with the intervention and these outcomes is crucial. We hypothesized that higher engagement with CuidaTEXT would provide higher levels of support, which in turn would lead to higher levels of satisfaction and decreases in depressive symptoms.…”

“…An in-depth description of the intervention and its development has been previously reported. 18,19 The intervention was designed from the beginning with and for Latino caregivers with the support of a team including bicultural, bilingual researchers, and informed by the Stress Process Framework and Social Cognitive Theory. 20,21 These messages include the identification of barriers to desired behaviors (e.g., problem solving, relaxation techniques, or exercising), setting of realistic goals, encouragement of gradual practice to increase healthy behaviors, integration of testimonials and videos to promote vicarious learning, integration of praise, social support, and education to increase dementia knowledge.…”

“…To our knowledge there is only one text message intervention to provide ADRD caregiver support, CuidaTEXT. 18,19 This intervention specifically targeted Latino caregivers, and has shown promising feasibility, acceptability, and preliminary efficacy by providing crucial resources, information and emotional support to this specific population. 18 While waiting to explore the fully-powered efficacy of this intervention, the potential of caregiver engagement with ADRD caregiver support text message interventions is still to be exploited.…”

Modifying Text Messages from a Faith-Based Physical Activity Intervention with Latino Adults in Response to the COVID-19 Pandemic

“…32,33 Bilingual text messages have been used in health promotion efforts 13 and may be a useful tool to support mental health for Latino adults. 34 For existing health promotion text message projects, including those serving Latinos, the pandemic presented an opportunity to take on a new role disseminating information and support about COVID-19. However, we are not aware of any prior studies examining how existing text message efforts have made this pivot.…”