Implementation of an Internet-Based Acceptance and Commitment Therapy for Promoting Mental Health Among Migrant Live-in Caregivers in Canada: Protocol

Kenneth Po-Lun Fung; Mandana Vahabi; Masoomeh Moosapoor; Abdolreza Akbarian; Jenny Jing-Wen Liu; Josephine Pui-Hing Wong

doi:10.2196/31211

Implementation of an Internet-Based Acceptance and Commitment Therapy for Promoting Mental Health Among Migrant Live-in Caregivers in Canada: Protocol

JMIR Res Protoc. 2021 Sep 13;10(9):e31211. doi: 10.2196/31211.

Authors

Kenneth Po-Lun Fung^#^{1

2}, Mandana Vahabi^#^{3

4}, Masoomeh Moosapoor³, Abdolreza Akbarian³, Jenny Jing-Wen Liu², Josephine Pui-Hing Wong^#^{3

5}

Affiliations

¹ Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
² Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
³ Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada.
⁴ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
⁵ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

^# Contributed equally.

PMID: 34515642
PMCID: PMC8694237
DOI: 10.2196/31211

Abstract

Background: Psychological distress, isolation, feelings of powerlessness, and limited social support are realities faced by temporary migrant live-in caregivers in Canada. Furthermore, they experience multiple barriers in accessing mental health services due to their long work hours, limited knowledge of health resources, precarious employment, and immigration status.

Objective: The Women Empowerment - Caregiver Acceptance & Resilience E-Learning (WE2CARE) project is a pilot intervention research project that aims to promote the mental well-being and resiliency of migrant live-in caregivers. The objectives include exploring the effectiveness of this program in achieving the following: (1) reducing psychological distress (depression, anxiety, and stress); (2) promoting committed actions of self-care; and (3) building mutual support social networks. Further, participants' satisfaction with the intervention and their perceived barriers to and facilitators of practicing the self-care strategies embedded in WE2CARE will be examined.

Methods: A total of 36 live-in caregivers residing in the Greater Toronto Area will be recruited and randomly assigned to either the intervention or waitlist control group. The intervention group will receive a 6-week web-based psychosocial intervention that will be based on Acceptance and Commitment Therapy (ACT). Standardized self-reported surveys will be administered online preintervention, postintervention, and at 6 weeks postintervention to assess mental distress (Depression, Anxiety and Stress Scale), psychological flexibility (Acceptance and Action Questionnaire), mindfulness (Cognitive and Affective Mindfulness Scale - Revised), and resilience (Multi-System Model of Resilience Inventory). In addition, two focus groups will be held with a subset of participants to explore their feedback on the utility of the WE2CARE program.

Results: WE2CARE was funded in January 2019 for a year. The protocol was approved by the research ethics boards of Ryerson University (REB 2019-036) and the University of Toronto (RIS37623) in February and May 2019, respectively. Data collection started upon ethics approval and was completed by May 2020. A total of 29 caregivers completed the study and 20 participated in the focus groups. Data analyses are in progress and results will be published in 2021.

Conclusions: WE2CARE could be a promising approach to reducing stress, promoting resilience, and providing a virtual space for peer emotional support and collaborative learning among socially isolated and marginalized women. The results of this pilot study will inform the adaptation of an ACT-based psychological intervention for online delivery and determine its utility in promoting mental health among disadvantaged and vulnerable populations.

International registered report identifier (irrid): DERR1-10.2196/31211.

Keywords: acceptance commitment therapy; empowerment; mental health; migrant live-in caregiver; resiliency; women.

©Kenneth Po-Lun Fung, Mandana Vahabi, Masoomeh Moosapoor, Abdolreza Akbarian, Jenny Jing-Wen Liu, Josephine Pui-Hing Wong. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2021.