Background: Family carers of older adults often experience significant mental health challenges, including anxiety and depression. Although online coaching interventions have been found to reduce anxiety and depressive symptoms in carers, only a few studies have examined the broader impact of applying online self-help interventions for enhancing resilience and overall well-being in carers. This study evaluates the effectiveness of a self-directed e-coaching intervention for family carers of older adults aimed at reducing anxiety and depressive symptoms, while also assessing its impact on enhancing their resilience and overall well-being, particularly for those with mild levels of carer needs.
Objective: This study aims to evaluate the effectiveness of a self-directed e-coaching intervention in reducing symptoms of anxiety and depression among carers of older adults using the 7-Item Generalized Anxiety Disorder Scale (GAD-7) and 9-Item Patient Health Questionnaire (PHQ-9), respectively, and also to examine secondary outcomes to determine its broader impact, including improvement in the level of carer needs, quality of life, caregiving burden, self-care efficacy, and resilience.
Methods: This is a 3-arm randomized controlled trial that involves family carers of older adults living in Hong Kong, who will be randomly assigned to one of the e-coaching intervention groups or the control group through an online platform. The e-coaching intervention will consist of structured modules for self-directed learning on lifestyle intervention, family relationships, and emotion regulation. Participants in the intervention groups will either receive full content or partial content tailored to their caregiving needs. A total of 240 participants will complete the GAD-7 and PHQ-9 assessments at baseline, postintervention, and at a 3-month follow-up to evaluate changes in anxiety and depression scores. Secondary outcome measures will include standardized measurements assessing the level of carer needs, quality of life, caregiving burden, self-care efficacy, and resilience. It is hypothesized that participants in both e-coaching intervention groups will demonstrate a statistically significant reduction in anxiety and depressive symptoms at both postintervention and 3-month follow-ups compared to the control group, in terms of reductions in GAD-7 and PHQ-9 scores.
Results: This randomized trial was funded for an original project period from January 2023 to January 2028. The enrollment commenced in April 2025 and is ongoing, with the expectation of closing enrollment in May 2026. We anticipate that data analyses will be completed by September 2026.
Conclusions: The anticipated findings from this study could provide valuable insights into the potential of e-coaching as an accessible self-help intervention for improving mental health outcomes among carers of older adults, particularly those classified with mild levels of carer needs. If successful, this self-directed approach may offer a scalable solution to alleviate psychological distress and enhance overall well-being and resilience in this vulnerable population. The results will inform future mental health strategies and interventions tailored for carers, ultimately fostering a healthier caregiving environment.
Keywords: 7-Item Generalized Anxiety Disorder Scale; 9-Item Patient Health Questionnaire; GAD-7; PHQ-9; anxiety; caregivers; depression; mental health; online intervention.
© Tom Chun Wai Tsoi, Kenneth Yu Hon Kwok, Wai Sze Chan, Vera Mun Yu Tang, Tarani Chandola, Jianchao Quan, Chun Yu Yu, Vivian Weiqun Lou. Originally published in JMIR Research Protocols (https://www.researchprotocols.org).