A digital mindfulness application for African American caregivers of people living with HIV/AIDS: feasibility trial findings

As people living with HIV/AIDS (PLWHA) live longer, they increasingly rely on informal caregivers. African American caregivers of PLWHA may face elevated risk for stress-related health problems from caregiving demands, HIV-related stigma, racial discrimination, and limited access to culturally responsive services. Mindfulness-based interventions can reduce caregiver stress, but in-person delivery may not be feasible. This study evaluated the feasibility of an enhanced digital mindfulness app for these caregivers, addressing recruitment, engagement, retention, and acceptability. A sequential mixed-methods design included qualitative interviews (n = 15) to guide enhancements, followed by a 4-week single-group feasibility trial (n = 30) with national online recruitment; participants received Android phones and data plans. Of 140 individuals screened, 30 enrolled and all completed the trial and both assessments. More than half used the app 6–7 days per week, compared with 1.8 days in the pilot trial. Usability and satisfaction were high: 83.3% scored in the acceptable range on the System Usability Scale, and all would recommend the app. Baseline anxiety and depression risk were high, though stigma and discrimination were not. Psychosocial measures were examined descriptively only, as the trial was not powered to detect change. Findings support a future randomized controlled trial.