AzTrials
AzTrials

Caregiving StressNCT06880822

Closed-Loop and Neuroplasticity-Based Mindfulness Program for Family Caregivers

A study testing Closed-Loop and Neuroplasticity-Based Mindfulness Program, Traditional Mindfulness Program (Without the Closed-Loop Approach) and Psychoeducation in people with Caregiving Stress, run by The Hong Kong Polytechnic University.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

The aim of this study is to evaluate the effectiveness of a closed-loop and neuroplasticity-based mindfulness program for reducing stress among family caregivers of people with dementia. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Caregiving Stress
What is being tested?
Closed-Loop and Neuroplasticity-Based Mindfulness Program, Traditional Mindfulness Program (Without the Closed-Loop Approach) and Psychoeducation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
189 participants
Where
No sites listed yet
Study dates
1 Apr 2025to Apr 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 or above;
  • Family caregiver of an individual who has been living in the community with a confirmed medical diagnosis of any type of dementia (verified through NGO records or care recipient's medical records) for more than one year;
  • Living in the same household as the care recipient;
  • Providing care with daily contact of 4 hours or more.

Who cannot join

  • Has participated in any structured mind-body intervention or structured psychosocial intervention within 6 months prior to recruitment;
  • Has an acute psychiatric condition that is potentially life-threatening or would limit participation in the study (indicated by answering "yes" to any of the six questions on the Columbia Suicide Severity Rating Scale).

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Patrick Kor, PhD contact

27665622

patrick.kor@polyu.edu.hk

About this study

Official title: Effects of a Closed-Loop and Neuroplasticity-Based Mindfulness Program for Reducing Stress in Family Caregivers of People with Dementia: a Randomized Controlled Trial with a Process Evaluation

The aim of this study is to evaluate the effectiveness of a closed-loop and neuroplasticity-based mindfulness program for reducing stress among family caregivers of people with dementia. Participants will be randomly assigned to one of three groups: the closed-loop and neuroplasticity-based mindfulness program, a traditional mindfulness program, or brief education on dementia care. The closed-loop and neuroplasticity-based mindfulness program will include three weekly face-to-face training sessions (90 minutes each) and daily guided self-practice over 8 weeks via a mobile application. The traditional mindfulness program will not include the closed-loop approach but will feature general mindfulness practices with the same group size, duration, and frequency as the closed-loop program. The family caregivers in the control group will receive self-directed e-learning on dementia care with support from a registered nurse experienced in dementia care or elderly care, maintaining the same group size, duration, and frequency as the intervention groups. Evaluations will be conducted at baseline (0 weeks), immediately post-intervention (8 weeks), and during a follow-up assessment (6 months). All groups will complete the same assessments at the same time points.

Read the detailed description

Demanding caregiving tasks and uncertainty about disease progression cause high levels of stress in family caregivers of people with dementia (PWD), threatening their health and dyadic relationships. While mindfulness-based interventions (MBI) have shown promise in reducing stress, several limitations exist. Most studies used intensive training (weekly 150-minute sessions for 8 weeks), which was demanding for family caregivers and led to high attrition rates (10.5%-17.2%). Additionally, a wandering mind during practice has been the most challenging aspect of mindfulness. Traditional mindfulness practices lack quantifiable metrics of success or performance feedback, making engagement and long-term compliance difficult. Recent studies of online mindfulness programs found they typically duplicated real-world practices, encountering similar implementation challenges. Furthermore, the manualized protocol (e.g., 45 minutes of daily practice) was often unachievable for many caregivers, leading to frustration. Mindfulness training should adapt to individual abilities. To address these limitations, the investigators propose integrating a closed-loop and neuroplasticity-based approach in mindfulness training.

The study will recruit community-dwelling family caregivers of people with dementia from three local nongovernmental organizations (NGOs) providing dementia care services in Hong Kong. After eligibility assessment and consent, participants will be randomly assigned to one of three groups: the closed-loop and neuroplasticity-based mindfulness program, a traditional mindfulness program, or brief education on dementia care.

The closed-loop and neuroplasticity-based mindfulness program comprises three weekly face-to-face mindfulness training sessions (90 minutes each) and daily guided self-practice through a mobile application over 8 weeks. The face-to-face training will incorporate the mobile application and various mindfulness practices to help caregivers integrate mindfulness skills into daily life. Facilitators will provide weekly mobile device follow-up to monitor progress.

Family caregivers in the traditional mindfulness group will practice general mindfulness techniques without the closed-loop approach. These practices will be delivered through a mobile approach with identical group size, duration, and frequency as the intervention group.

The brief education on dementia care group will receive self-directed e-learning supported by an experienced registered nurse. This control group will maintain the same group size, duration, and frequency as the intervention groups. Educational content will include sessions on dementia care, caregiving skills, and group sharing.

Outcome measures include perceived caregiving stress (primary outcome), depressive symptoms, peace of mind, caregiving burden, dyadic relationship, dispositional mindfulness, physiological stress, neuropsychiatric symptoms, and caregiving-related productivity loss. Feasibility measures include eligibility and enrollment, attendance rate, self-practice engagement, and retention rate. Evaluations will occur at baseline (0 weeks), post-intervention (8 weeks), and follow-up (6 months). All groups will complete identical assessments at the same time points.

Being tested
Closed-Loop and Neuroplasticity-Based Mindfulness Program, Traditional Mindfulness Program (Without the Closed-Loop Approach), Psychoeducation
Medical subject headings
Caregiver Burden

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Closed-Loop and Neuroplasticity-Based Mindfulness ProgramBehavioural

    The intervention includes three weekly 90-minute face-to-face mindfulness training sessions and daily guided self-practice using a closed-loop, neuroplasticity-based mobile app over 8 weeks. Training integrates mindfulness practices (e.g., mindful eating, body scanning) to help caregivers apply mindfulness in daily life. During self-practice, participants listen to a lesson, monitor distractions, and refocus on their breathing. Initial trials start at 20 seconds, adjusting by 10% if focused or decreasing by 20% if distracted, helping participants regulate attention. Progress is stored to continue in later sessions, with instant feedback during trials and delayed feedback on overall progress. Facilitators provide weekly follow-ups via the app to monitor caregivers' progress.

  • Traditional Mindfulness Program (Without the Closed-Loop Approach)Behavioural

    Family caregivers in the traditional mindfulness group will participate in general mindfulness practices (e.g., mindful eating, body scanning, and mindful walking) without the closed-loop approach. These practices aim to help caregivers learn mindfulness skills and integrate them into their everyday life. Sessions will be delivered through a mobile approach with the same group size, duration, and frequency as the intervention groups.

  • PsychoeducationBehavioural

    Family caregivers in the control group will receive self-directed e-learning on dementia care with support from a registered nurse experienced in dementia care or elderly care. This group will serve as a control for socialization and interaction aspects with peers and the interventionist (nurse). The self-directed learning will be delivered through a mobile approach, maintaining the same group size, duration, and frequency as the intervention groups. Educational content will include brief sessions on dementia care, caregiving skills, and group sharing of caregiving tasks.

Study groups in NCT06880822
Study groupRoleWhat they receive
Closed-Loop and Neuroplasticity-Based Mindfulness ProgramExperimentalNot described
Receives: Behavioral: Closed-Loop and Neuroplasticity-Based Mindfulness Program
Traditional Mindfulness Program (Without the Closed-Loop Approach)Active comparatorNot described
Receives: Behavioral: Traditional Mindfulness Program (Without the Closed-Loop Approach)
PsychoeducationActive comparatorNot described
Receives: Behavioral: Psychoeducation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Perceived Caregiving Stress in the Family Caregiver

    The Perceived Stress Scale (PSS) comprises 10 items rated on a 5-point Likert Scale (0 = never to 4 = very often) to assess perceived stress levels. The total score varies from 0 to 40, with a higher score reflecting more perceived stress. Scores within the ranges of 0-13, 14-26, and 27-40 correspond to low, moderate, and high levels of perceived stress, respectively.

    Measured: 6 months

Secondary outcomes (12)
  1. Depressive Symptoms in the Family Caregiver

    The Center for Epidemiologic Studies Depression Scale (CESD) comprises 20 items rated on a 4-point Likert scale (0 = rarely or none of the time to 3 = most or almost all the time) to assess the severity of depressive symptoms experienced in the past week. The total score ranges from 0 to 60, with a higher score indicating more severe depressive symptoms. Scores within the ranges of 0-14, 15-21, and 22-60 correspond to low, mild to moderate, and a potential indication of major depression, respectively.

    Measured: 6 months

  2. Peace of Mind in the Family Caregiver

    The Peace of Mind Scale (PMS) consists of 7 items rated on a 5-point Likert scale (1 = not at all to 5 = all the time) that assess an internal state of peacefulness and harmony. Two items are reverse-scored. The total score ranges from 7 to 35, with higher scores indicating greater levels of peacefulness and harmony.

    Measured: 6 months

  3. Caregiving Burden in the Family Caregiver

    The Zarit Burden Interview (ZBI) consists of 22 items that measure the impact of caregiving on physical health, emotional well-being, social life, and financial status. Items are rated on a 5-point Likert scale (0 = never to 4 = nearly always). Total scores range from 0 to 88, with higher scores indicating greater caregiving burden.

    Measured: 6 months

  4. Dyadic Relationship Between the Family Caregiver and the Care Recipient

    The Dyadic Relationship Scale (DRS) measures the quality of the dyadic relationship between the family caregiver and the care recipient. This scale consists of two versions: the patient version (10 items) and the caregiver version (11 items). Both versions include two subscales: dyadic strain and positive dyadic interaction. They are rated on a 4-point Likert scale (1 = strongly disagree, 4 = strongly agree). Higher scores on each of these scales indicate higher levels of strain and positive interaction, respectively.

    Measured: 6 months

  5. Dispositional Mindfulness in the Family Caregiver

    The Mindful Attention Awareness Scale (MAAS) consists of 15 items that measure the core characteristics of dispositional mindfulness: receptive awareness and present-moment attention. Items are rated on a 6-point scale (1 = almost always to 6 = almost never). Total scores range from 15 to 90, with higher scores indicating greater levels of dispositional mindfulness.

    Measured: 6 months

  6. Physiological Stress in the Family Caregiver

    Physiological stress will be measured by heart rate variability (HRV) using the CorSense Heart Rate Variability Finger Sensor. HRV will be interpreted following the Guidelines for the Standard Measurement and Interpretation of HRV (European Society of Cardiology and the North American Society of Pacing and Electrophysiology) using the frequency-domain method.

    Measured: 6 months

  7. Work Productivity and Activity Impairment in the Family Caregivers

    The Work Productivity and Activity Impairment Questionnaire for Caregivers (WPAI:CG) consists of 6 items that measure productivity loss due to caregiving responsibilities. The questionnaire assesses four main outcomes: absenteeism (percentage of work time missed due to caregiving), presenteeism (percentage impairment while working due to caregiving), work productivity loss (percentage overall work impairment due to caregiving), and activity impairment (percentage activity impairment due to caregiving). The recall period is 7 days. Higher scores indicate greater impairment and less productivity. Total work productivity loss scores range from 0 to 100%, with higher percentages indicating greater impairment.

    Measured: 6 months

  8. Neuropsychiatric Syndromes in the Care Recipient

    The Neuropsychiatric Inventory (NPI) measures neuropsychiatric syndromes that occur in Alzheimer's disease and other neurodegenerative disorders. The NPI is administered by the family caregiver and consists of the following domains: Delusions, Hallucinations, Agitation/Aggression, Depression/Dysphoria, Anxiety, Elation/Euphoria, Apathy/Indifference, Disinhibition, Irritability/Lability, and Aberrant Motor Behavior. Each domain is rated based on its frequency (1 = rarely, less than once per week; 4 = very often, once or more per day) and severity (1 = mild, producing little distress in the patient; 3 = severe, very disturbing to the patient and difficult to redirect). A total score can be obtained for each domain by multiplying the frequency and severity ratings. The total score of the NPI is obtained by summing the scores across all domains, with a higher score indicating more severe neuropsychiatric syndromes.

    Measured: 6 months

  9. Feasibility of Eligibility and Enrollment

    Number of eligible participants, and the proportion of those eligible that enrolled will be assessed.

    Measured: 8 weeks

  10. Feasibility of Attendance Rate

    Number and proportion of attended participants.

    Measured: 8 weeks

  11. Feasibility of Engagement to Self-Practice

    Engagement with mindfulness practice will be determined by the duration of mindfulness practice as recorded through the participants' mobile application.

    Measured: 6 months

  12. Feasibility of Retention Rate

    Number and proportion of participants completing all assessments.

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2025
  2. Study start1 Apr 2025 (estimated)
  3. Primary completionApr 2027 (estimated)
  4. Study completionApr 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
189 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06880822
Sponsor's protocol ID
HSEARS20240722001
Status last verified
Mar 2025
First submitted
12 Mar 2025
Last updated
20 Mar 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The intervention protocol will be published.

Publications

  • Kor PPK, Chou KL, Tsang APL, Mak WWS, Galante J, Ho RTH, Wong SYS, Cheung DSK, Liu JYW, Zarit SH. Effects of a closed-loop mindfulness-based program for reducing stress in family caregivers of people with dementia: a study protocol of a randomized controlled trial. BMC Psychol. 2025 Jul 1;13(1):681. doi: 10.1186/s40359-025-02919-2.

    PubMed 40597419

Questions about this trial

What is this clinical trial studying?

A study testing Closed-Loop and Neuroplasticity-Based Mindfulness Program, Traditional Mindfulness Program (Without the Closed-Loop Approach) and Psychoeducation in people with Caregiving Stress, run by The Hong Kong Polytechnic University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 20 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Patrick Kor, PhD (27665622, patrick.kor@polyu.edu.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Perceived Caregiving Stress in the Family Caregiver (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06880822, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Mar 2025.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in