A Mobile App (CareFit) Supporting Physical Activity for Informal Carers of People With Dementia: Mixed Methods Feasibility and Adaptation Study

Background: Informal carers are critical in looking after people with dementia. The value of all informal care as a total in the United Kingdom is now estimated to be £184 billion (US $249 billion). However, many carer groups are inadequately supported and face poor mental and physical health with limited opportunities for physical activity. There is a public health priority to address such challenges and a lack of innovation regarding approaches to promote physical activity.

Objective: This study aimed to co-design, adapt, and explore the feasibility of a novel cross-platform approach to support physical activity among carers of people with dementia.

Methods: Project stages included a co-design phase followed by a feasibility study guided by both the reach, effectiveness, adoption, implementation, and maintenance and Medical Research Council complex intervention frameworks. Co-design involved 3 development “sprints,” gaining feedback from a range of stakeholders (eg, carers, support professionals, charities, researchers, and developers) and identifying priority areas. Our feasibility study involved the evaluation of our recruitment, intervention, and outcome approaches over 8 weeks (target population: N=50) with participants. Participants were recruited from local community networks in Scotland as well as research study registries.

Results: We successfully co-designed, developed, and user tested the CareFit app. Final app design included a simplified navigation system and increased delivery of video content as well as a more personalized delivery approach. In total, 41 carers of people with dementia were recruited, with 21 (51%) completing the 8-week study. Study retention was considerably lower for carers with higher levels of physical activity at baseline as opposed to those with lower levels (5/14, 36% vs 16/27, 59%, respectively). CareFit was rated as “acceptable” on the System Usability Scale, and we observed common user patterns of behavior (eg, an initial focus on the Learn section). The feasibility study results demonstrated that the intervention appeared safe for use (no adverse events reported) and the video content for carers was well received. A greater depth of social elements appears critical for future development. Although professional stakeholders did not reach consensus on the outcome of greatest utility, the outcome measures tested were largely suitable for future use in this group, including novel sedentary behavior and muscle and balance measures.

Conclusions: Many carers of people with dementia do not have the same access to physical activity as noncarers. Our findings show key challenges regarding recruitment and retention. Although we cannot currently recommend progression to a randomized controlled trial, we conclude that further work is needed to better understand the “active ingredients” of the intervention outlined. This includes exploring the delivery of a preventative intervention earlier in the carer trajectory—something critical for adoption and long-term use.