A text message intervention to support latino dementia family caregivers (CuidaTEXT): feasibility study.

OBJECTIVES: To test the feasibility, acceptability, and preliminary efficacy of CuidaTEXT: a bidirectional text message intervention to support Latino dementia family caregivers. METHODS: CuidaTEXT is a six-month, bilingual intervention tailored to caregiver needs (e.g., education, problem-solving, resources). We used convenience sampling and reached 31 potential participants via clinics, registries, community promotion, and online advertising. We enrolled 24 Latino caregivers in a one-arm trial and assessed feasibility, acceptability, and preliminary efficacy within six months. RESULTS: None of the participants unsubscribed from CuidaTEXT and 83.3% completed the follow up survey. Most participants (85.7%) reported reading most text messages thoroughly. All participants reported being very or extremely satisfied with the intervention. Participants reported that CuidaTEXT helped a lot (vs not at all, a little, or somehow) in caring for their care recipient (71.4%; n = 15), for themselves (66.7%; n = 14), and understanding more about dementia (85.7%; n = 18). Compared to baseline, at six months caregiver behavioral symptom distress (0-60) decreased from 19.8 to 12.0 and depression (0-30) from 8.8 to 5.4 (p < .05). CONCLUSIONS: CuidaTEXT demonstrated high levels of feasibility, acceptability, and preliminary efficacy among Latino caregivers. CLINICAL IMPLICATIONS: CuidaTEXT's feasibility and potential for widespread implementation holds promise in supporting Latino caregivers of people with dementia.

Impact of the COVID-19 pandemic on Latino families with Alzheimer's disease and related dementias: Perceptions of family caregivers and primary care providers.

Latinos experience disproportionately poor outcomes in dementia and COVID-19, which may synergistically impact their health. We explored the impact of the COVID-19 pandemic among Latino families with dementia via a qualitative descriptive study of 21 informal caregivers of Latinos with dementia and 24 primary care providers. Two themes arose: The impact of a global pandemic (e.g., accelerated cognitive and physical decline, or caregivers choosing between risking finances and the family's infection given the work situation) and Developing resilience to the effects of the pandemic (e.g., caregivers seeking vaccination sites, moving in with the care recipient and adopting telehealth).

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

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.

Exploring Latinidad, Migration Processes, and Immigrant Experiences: Experiences Influencing Latino Health.

INTRODUCTION: Over the last few decades, Latino migration to the U.S. has re-shaped the ethnic composition of the country, and influenced the meaning of "ethnic" and "racial" identity. The purpose of this qualitative study was to explore the definition and meaning of being Latino and how this may guide the development of interventions to promote their health. METHODS: Twenty-six Latino immigrants living in Kansas completed a socio-demographic survey and semi-structured interviews to assess and explore personal immigration experiences and perspectives on the meaning of being Latino in the U.S. RESULTS: Participant reports were grouped into eight themes on Latino identity that were organized by geographic origin, family roots/ties, and acculturation. Immigration experiences were described as both positive and negative with most participants experiencing discrimination and loneliness, but also reports of improved quality of life. Further, most participants reported a strong sense of Latinidad; that Latino immigrant communities in the U.S. are interdependent and supportive of each other. CONCLUSIONS: The experience of being a member of a minority group might contribute to the development of a cohesive sense of Latino identity as participants acculturate to the U.S. while preserving a sense of attachment to their culture of origin. Future interventions should be sensitive to migration experiences as they might influence changes in health behaviors.

"Every day I think about your messages": assessing text messaging engagement among Latino smokers in a mobile cessation program.

INTRODUCTION: Mobile health interventions are a promising mode to address tobacco-related disparities among Latinos, the largest minority group and the highest users of text messaging technology. The purpose of this pilot study was to assess engagement in a smoking cessation intervention delivered via text message (Kick Buts) among Latino smokers. METHODS: We relied on a community-based recruitment strategy to enroll 20 Latino smokers in Kick Buts. Outcome measures included biochemically verified abstinence at 12 weeks, participant text messaging interactivity with the program, and satisfaction. RESULTS: Participants' mean age was 40.7 years old (SD=14.6). Most of the participants were male (70%), did not have health insurance (75%), and reported low nicotine-dependence (60%). The majority of participants (75%) sent at least one text message to the program. On average, participants who interacted with the program sent 31.8 (SD=39.7) text messages. Eight themes were identified in participants' messages (eg, well-being, self-efficacy, strategies to quit, extra-treatment social support, etc). At 12 weeks, 30% of the participants were biochemically verified as abstinent. CONCLUSION: A smoking cessation text message intervention generated high engagement among Latinos and resulted in noteworthy cessation rates. Future studies should assess the relationship of text messaging interactions with psychological effects (eg, intra-treatment social support, therapeutic alliance, and perceived autonomy support).