@Article{info:doi/10.2196/66914,
author="de Arriba Mu{\~{n}}oz, Antonio
and Civitani Monzon, Elisa
and Ferrer, Maria Pilar
and Ferrer-Lozano, Marta
and Quer-Palomas, Silvia
and Nu{\~{n}}ez, Joia
and Xifra-Porxas, Alba
and Aim{\'e}e Mees Mlatiati, Francesca
and Bilionis, Ioannis
and Berrios, Ricardo C
and Fern{\'a}ndez-Luque, Luis",
title="Empowering Caregiver Well-Being With the Adhera Caring Digital Program for Family Caregivers of Children Living With Type 1 Diabetes: Mixed Methods Feasibility Study",
journal="JMIR Pediatr Parent",
year="2025",
month="Jul",
day="9",
volume="8",
pages="e66914",
keywords="type 1 diabetes; caregiver wellbeing; digital health; digital program; coaching; diabetic; diabetes; T1D; pediatrics; children; chronic; endocrinology; CGM; glucose; caregiving; caregiver; carer; informal care; family care; parents; parental; guardian; continuous glucose monitoring",
abstract="Background: Caregivers of children living with type 1 diabetes (T1D) face multiple challenges that significantly impact their mental health and quality of life. The well-being of caregivers directly affects the management of the child's condition. The Adhera Caring Digital Program (ACDP) is a comprehensive, digitally delivered program, designed to support family caregivers in enhancing self-management and well-being. This study aims to assess how the ACDP influences caregivers' mood, emotional well-being, and health-related quality of life within the context of T1D. Objective: This study aimed to evaluate the impact of ACDP on caregivers' psychological well-being and caregiving outcomes. Methods: This was a two-step, prospective, mixed methods study targeting caregivers of children living with T1D who were under the care of a pediatric endocrinologist at Miguel Servet Children's University Hospital in Zaragoza, Spain. In substudy 1 (SS1), qualitative and quantitative data were collected to optimize the ACDP. In substudy 2 (SS2), caregivers used the optimized ACDP for three months. Psychometric assessments were conducted at baseline and follow-up to evaluate positive mood states, general well-being, self-efficacy, and lifestyle behaviors. This paper focuses on SS2. Results: Ninety caregivers participated in SS2. Positive affect significantly increased (P<.001), and negative affect decreased (P<.001) on the Positive and Negative Affect Schedule (PANAS). Depression, anxiety, and stress scores were reduced (P<.001) on the Depression, Anxiety and Stress Scale-21 Items (DASS-21). General well-being, measured by the Mental Health Continuum-Short Form (MHC-SF) and self-efficacy, assessed using General Self-Efficacy Scale (GSE), improved significantly (P<.001). Health-related quality of life (HrQoL) scores and Mediterranean Diet Quality Index scores increased modestly (P=.03, and P=.04, respectively). Conclusions: The ACDP intervention improved caregivers' psychological well-being and self-efficacy. These findings highlight the potential of digital solutions to support caregiver mental health and positively influence diabetes management. Future research should explore long-term outcomes and scalability. Trial Registration: ClinicalTrials.gov NCT05483803; https://clinicaltrials.gov/ct2/show/NCT05483803 ",
issn="2561-6722",
doi="10.2196/66914",
url="https://pediatrics.jmir.org/2025/1/e66914",
url="https://doi.org/10.2196/66914"
}