Co-Developing a Culturally Responsive, Theory-Informed Dyadic Mind–Body Intervention to Improve Sleep and Wellbeing in People with Dementia and Their Caregivers in the UK
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Background: Sleep disturbances are common in dementia and adversely affect both the person with dementia and their caregiver. Non-pharmacological options exist but are seldom dyadic or culturally tailored, limiting their reach and relevance across diverse communities. Objective: To co-develop DREAM (Dyadic Resilience, Engagement, Awareness & Mind–body intervention)—an 8-week dyadic mind–body programme (mindfulness + gentle Tai Chi) for improving sleep and wellbeing in people with dementia and their caregivers. Methods: The process was informed by Intervention Mapping (Stages 1–4) and underpinned by established behaviour change frameworks, including the Behaviour Change Wheel (BCW), the COM-B model (Capability, Opportunity, Motivation → Behaviour), and the Theoretical Domains Framework (TDF), to systematically identify determinants of engagement. Co-design involved dementia–caregiver dyads, Patient and Public Involvement (PPI) contributors, clinicians, mind–body practitioners, and community stakeholders. Results: The intervention was co-developed and culturally grounded through engagement with White British, Caribbean, Chinese, and South Asian communities. Participants reported high cultural resonance, endorsing DREAM’s concise practices, caregiver-supported home routines, and delivery in trusted community venues. Behavioural insights highlighted the importance of motivational framing (perceived dyadic benefits, cultural meaning), practical enablement (simplified guidance, prompts/cues, environmental restructuring), and caregiver facilitation to support adherence. Conclusion: DREAM demonstrates the practicability of using Intervention Mapping to co-develop a culturally responsive, theory-informed dyadic mind–body intervention for people with dementia and their caregivers. This groundwork supports progression to a feasibility trial focused on implementation processes and preliminary sleep and wellbeing outcomes.