The WeACT Program for Family Caregivers of People Living With Dementia

Family caregivers of people living with dementia often experience psychological distress (such as depressive symptoms and stress) and face practical barriers to accessing support. This study will evaluate WeACT, a research-developed, self-paced, web-based acceptance and commitment therapy (ACT) skills program designed to support caregivers' mental health outcomes in a scalable format. This is a one-group, pretest-posttest mixed-methods pilot study conducted fully online. All enrolled participants will receive access to the WeACT program. The study will assess feasibility and user experience and will explore pre-to-post changes in caregiver mental health outcomes and ACT-related processes. WeACT includes six self-paced weekly ACT modules and a tailored daily practice section. Each weekly module includes ACT skills training materials. The daily practice section provides brief, in-the-moment ACT skill coaching based on participants' current self-ratings. Recruitment will occur by distributing a study flyer across the United States. Interested individuals will contact the study team and complete an online eligibility screening survey. Eligible individuals will complete electronic informed consent and then complete pretest questionnaires online. After completing baseline procedures, participants will receive program access and study-specific login credentials. Participants will be encouraged to complete one module per week and to use the daily practice section regularly during the intervention period. After completing the program modules, participants will complete posttest questionnaires online and participate in a one-time individual interview. Interviews will be conducted and recorded using the HIPAA-compliant version of Microsoft Teams. Feasibility will be evaluated using recruitment, retention, and adherence indicators and by documenting reasons for ineligibility and dropout. The program will also capture engagement and in-program response data. Pretest and posttest questionnaires will be used to explore changes in caregiver mental health outcomes and ACT-related processes and to assess perceived feasibility, acceptability, appropriateness, and usability at posttest. Qualitative interviews will be used to understand participant experiences and identify recommendations to refine the program and study procedures. Analyses will focus on feasibility and descriptive characterization of engagement. Pre-to-post changes will be explored using paired statistical tests as appropriate. Daily practice data will be explored using multilevel modeling to estimate average change and individual variability over time. Interview data will be analyzed using thematic analysis to summarize common experiences and improvement suggestions. All data will be collected electronically using university-approved secure platforms (Qualtrics, the WeACT program hosted on the secure USF Microsoft Azure environment, and HIPAA-compliant Microsoft Teams). WeACT is not publicly available and is accessible only to enrolled participants. Participants will use study-specific login credentials. Identifying information will be collected only as needed for study operations (e.g., communication and compensation) and stored separately from research data. Study data will be stored in secure, access-controlled USF systems (including USF Box), with access restricted to authorized study personnel. Only de-identified, aggregate results will be used for dissemination.

• Acceptability of Intervention Measure [Time frame: Post-intervention (~6-8 weeks)]
• Intervention Appropriateness Measure [Time frame: Post-intervention (~6-8 weeks)]
• Feasibility of Intervention Measure [Time frame: Post-intervention (~6-8 weeks)]
• System Usability Scale (SUS) [Time frame: Post-intervention (approximately 6-8 weeks)]
• Change in Patient Health Questionnaire-9 (PHQ-9) scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]
• Change in Generalized Anxiety Disorder-7 (GAD-7) scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]
• Change in Perceived Stress Scale-10 (PSS-10) scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]
• Change in World Health Organization Quality of Life-BREF (WHOQOL-BREF)- Psychological Health Subscale scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]
• Change in Zarit Burden Interview (ZBI) scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]
• Change in Marwit-Meuser Caregiver Grief Inventory-Brief Form (MM-CGI-BF) scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]
• Change in Caregiver Guilt Questionnaire (CGQ) scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]
• Change in Brief Experiential Avoidance Questionnaire (BEAQ) scores from baseline to post-intervention [Time frame: Baseline to post-intervention (approximately 6-8 weeks)]