Background: Although several face-to-face programs are dedicated to informal caregivers of persons with dementia, they are\nnot always accessible to overburdened or isolated caregivers. Based on a face-to-face intervention program, we adapted and\ndesigned a Web-based fully automated psychoeducational program (called Diapason) inspired by a cognitive approach.\nObjective: This study aimed to evaluate through a pilot unblinded randomized controlled trial the efficacy and acceptability of\na Web-based psychoeducational program for informal caregivers of persons with Alzheimer�s disease (PWAD) based on a mixed\nmethods research design.\nMethods: We recruited and randomized offline 49 informal caregivers of a PWAD in a day care center in Paris, France. They\neither received the Web-based intervention and usual care for 3 months (experimental group, n=25) or only usual care (control\ngroup, n=24). Caregivers� perceived stress (PSS-14, primary outcome), self-efficacy, burden, perceived health status, and depression\n(secondary outcomes) were measured during 3 face-to-face on-site visits: at baseline, at the end of the program (month 3), and\nafter follow-up (month 6). Additionally, semistructured interviews were conducted with experimental group caregivers at month\n6 and examined with thematic analysis.\nResults: Intention-to-treat analysis did not show significant differences in self-perceived stress between the experimental and\ncontrol groups (P=.98). The experimental group significantly improved their knowledge of the illness (d=.79, P=.008) from\nbaseline to month 3. Of the 25 participants allocated to the experimental group, 17 (71%) finished the protocol and entirely viewed\nat least 10 of 12 online sessions. On average, participants used the website 19.72 times (SD 12.88) and were connected for 262.20\nminutes (SD 270.74). The results of the satisfaction questionnaire showed that most participants considered the program to be\nuseful (95%, 19/20), clear (100%, 20/20), and comprehensive (85%, 17/20). Significant correlations were found between\nrelationship and caregivers� program opinion (P=.01). Thus, positive opinions were provided by husbands and sons (3/3), whereas\nqualified opinions were primarily reported by daughters (8/11). Female spouses expressed negative (2/3) or neutral opinions\n(1/3). Caregivers expected more dynamic content and further interaction with staff and peers.\nConclusions: In this study, quantitative results were inconclusive owing to small sample size. Qualitative results indicated/showed\nlittle acceptance of the program and high expectations from caregivers. Caregivers did not rule out their interest in this kind of intervention provided that it met their needs. More dynamic, personalized, and social interventions are desirable. Our recruitment\nissues pointed out the necessity of in-depth studies about caregivers� help-seeking behaviors and readiness factors.
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