Feasibility, Acceptability, and Preliminary Efficacy of an ACT-based Asynchronous Intervention for Individuals with Dementia

Background: Receiving a dementia diagnosis is associated with significant decreases in subjective well-being and increases in psychological distress. While some cognitive behavioral-based interventions have demonstrated efficacy in improving outcomes among individuals with dementia (IwD), most interventions are completed in-person and require several sessions. More accessible and scalable interventions are needed. Methods: In this preregistered study, we assessed the feasibility, acceptability, and preliminary efficacy of an online, single session intervention based in acceptance and commitment therapy (ACT), titled Compassion Compass, through a mixed methods approach. Seventeen IwD completed the program, pretest, posttest and follow-up surveys, and interviews. Descriptive statistics were used to assess feasibility and acceptability, while generalized estimating equations were used to assess preliminary efficacy. Qualitative data was analyzed using a team-based approach and thematic coding techniques. Results: Our feasibility hypothesis was partially supported, as we fell slightly short of our recruitment goal but had a high adherence rate (94%). We found that the program was highly acceptable via both quantitative and qualitative measures. Quantitative analyses of program efficacy were underpowered and showed no significant changes across time in subjective well-being. However, we identified downward trends in psychological distress (i.e., depression and anxiety) that approached significance. Qualitative data provided strong support for the efficacy of the program, with participants reporting improvements in subjective well-being and the integration of specific skills taught in the program into their daily lives. Conclusions: Findings provide preliminary support for the use of an ACT-based, online single session intervention among IwD and highlight the need for a randomized controlled trial.