TY  - JOUR
AU  - Xiang, Xiaoling
AU  - Kayser, Jay
AU  - Sun, Yihang
AU  - Himle, Joseph
PY  - 2021
DA  - 2021/11/22
TI  - Internet-Based Psychotherapy Intervention for Depression Among Older Adults Receiving Home Care: Qualitative Study of Participants’ Experiences
JO  - JMIR Aging
SP  - e27630
VL  - 4
IS  - 4
KW  - internet-based cognitive behavioral therapy
KW  - homebound older adults
KW  - home care
KW  - direct care workers
KW  - depression
KW  - qualitative study
AB  - Background: Depression is common among homebound older adults. Internet-based cognitive behavioral therapy (iCBT) is a promising but understudied approach for treating depression among older adults with disabilities. Objective: This study aims to understand the experiences of homebound older adults who participated in a pilot feasibility trial of an iCBT for depression. Methods: The participants included 21 homebound older adults who participated in a generic iCBT program that was not specifically designed for older adults and 8 home care workers who assisted in the iCBT program. Informants completed semistructured individual interviews, which were transcribed verbatim and analyzed using methods informed by grounded theory. A hierarchical code structure of themes and subthemes was developed after an iterative process of constant comparisons and questionings of the initial codes. The data analysis was conducted by using dedoose, a web app for mixed methods research. Results: Three themes and various subthemes emerged related to participants’ experience of the iCBT intervention, as follows: intervention impact, which involved subthemes related to participants’ perceived impact of the intervention; challenges and difficulties, which involved subthemes on the challenges and difficulties that participants experienced in the intervention; and facilitators, which involved subthemes on the factors that facilitated intervention use and engagement. Conclusions: iCBT is a promising intervention for homebound older adults experiencing depression. Home care workers reported improved relationships with their clients and that the program did not add a burden to their duties. Future programs should involve accessible technical features and age-adapted content to improve user experience, uptake, and adherence. Trial Registration: ClinicalTrials.gov NCT04267289; https://clinicaltrials.gov/ct2/show/NCT04267289 
SN  - 2561-7605
UR  - https://aging.jmir.org/2021/4/e27630
UR  - https://doi.org/10.2196/27630
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34813491
DO  - 10.2196/27630
ID  - info:doi/10.2196/27630
ER  -