Internet-delivered self-help Acceptance and Commitment Therapy for family carers of people with dementia (iACT4CARERS): A mixed-methods process evaluation of reach and recruitment

Howe, David, Couchman, Abbey, Katangwe-Chigamba, Thando, Farquhar, Morag ORCID: https://orcid.org/0000-0001-7991-7679, Gould, Rebecca L., McCracken, Lance M., Flanagan, Emma, Ashford, Polly-Anna, Richmond, Erica and Kishita, Naoko ORCID: https://orcid.org/0000-0001-8453-2714 (2026) Internet-delivered self-help Acceptance and Commitment Therapy for family carers of people with dementia (iACT4CARERS): A mixed-methods process evaluation of reach and recruitment. Aging and Mental Health. ISSN 1360-7863 (In Press)

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Abstract

Objectives: A mixed-methods process evaluation was conducted alongside a randomised controlled trial of iACT4CARERS, an eight-session, online, self-help Acceptance and Commitment Therapy intervention with minimal therapist support for family carers of people with dementia. The study examined the reach of the intervention and factors influencing recruitment to inform equitable implementation. Methods: Demographic data from 565 screened carers and interviews with 30 referrers across UK health services were analysed. Results: The screened sample was predominantly aged 50-79 years (82.5%), female (77%), and White (91.7%). Five themes were identified: referrers’ coordinated referrals, mutual motivation, and community outreach supported engagement; referrers’ trust-building, tailored communication, and timely approaches facilitated participation; carers’ time constraints and referrers’ assumptions about older carers’ digital skills influenced recruitment; proactive outreach was important for engaging ethnic minority carers; and cultural perceptions of mental health created barriers to participation. Conclusions: The sample was broadly comparable with previous estimates of the UK dementia carer population. For the equitable implementation of interventions such as iACT4CARERS, coordinated recruitment across health, social care, and voluntary organisations, alongside centralised intervention delivery, may be critical. Outreach can be further strengthened by enhancing referrers’ communication and empowerment skills, including challenging assumptions about older carers’ digital abilities.

Item Type:	Article
Additional Information:	Data Availability Statement: De-identified participant data will be available on reasonable request following publication of the trial results. Requests should be submitted to the corresponding author and include the required data fields and intended use, supported by a protocol or research plan where possible. Requests will be reviewed on a case-by-case basis, and a data-sharing agreement with the study sponsor will be required before data release.
Uncontrolled Keywords:	dementia,caregivers,anxiety,depression,diversity,process evaluation,das in place,data availability statement: de-identified participant data will be available on reasonable request following publication of the trial results. requests should be submitted to the corresponding author and include the required data fields and intended use, supported by a protocol or research plan where possible. requests will be reviewed on a case-by-case basis, and a data-sharing agreement with the study sponsor will be required before data release.,2026 ,/dt/atira/pure/keyword/DAStatement/das_in_place
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Depositing User:	LivePure Connector
Date Deposited:	05 Nov 2026 10:20
Last Modified:	05 Nov 2026 10:20
URI:	https://ueaeprints.uea.ac.uk/id/eprint/104976
DOI:	issn:1360-7863

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