Enablers and Barriers of Online Mindfulness-Based Interventions for Informal Carers: A Mixed-Methods Systematic Review

Abstract

Objectives Informal carers are an integral part of any health care system. However, provision of informal care is associated with caregiver burden and decreased wellbeing. Mindfulness programs can reduce caregiving burden and improve wellbeing among informal carers, but they face challenges when participating in face-to-face programs. Studies have explored the effects of online delivery of mindfulness programs for informal carers. However, the enablers and barriers for participation are not well understood. This review aimed to synthesise the evidence and provide a comprehensive understanding of the enablers and barriers to participation in online mindfulness programs among this population. Methods A mixed-methods systematic review was conducted following the Joanna Briggs Institute mixed-methods systematic review approach and using eight databases. All empirical studies published in English and involving informal carers aged over 18 years were included. Critical appraisal was conducted using the Mixed Methods Appraisal Tool. Thematic analysis was conducted to integrate the data. Results Nine studies were included: three quantitative, two qualitative, and four mixed methods. Three subthemes for enablers and barriers were developed. Three subthemes for enablers included self-motivation, positive experience of mindfulness, and program structure and delivery. Three subthemes for barriers included lack of self-motivation, external factors preventing participation, and program structure and delivery. The enablers and barriers were interrelated within and across the identified themes. Conclusions A comprehensive synthesis of current evidence was provided for consideration when developing online mindfulness-based interventions for informal carers. Further investigation is recommended, particularly in relation to the enablers and barriers to engagement by informal carers. Preregistration The review protocol was registered with PROSPERO (CRD42023409311).