Compass for Care: A Theory-driven Mobile Solution to Promote Well-being Among Caregivers of Individuals With ADRD

Developed from the 29 and 22-item versions, the shortened 12-item Zarit Burden Interview measure assesses subjective burden among caregivers of individuals with dementia. Caregivers were asked to rate items (e.g., Do you feel… that your health has suffered because of your involvement with your relative?) on a 5-point scale (0 = never, 1 = rarely, 2 = sometimes, 3 = quite frequently, and 4 = nearly always. Scores are summed to produce a total score (range 0 to 48), with higher scores indicating a higher level of burden and a worse outcome. Cronbach's alpha is .88.

Depression was assessed using the Patient Health Questionnaire (PHQ)-8, which is an 8-item measure that asks the number of days in the past two weeks the respondent had experienced each of the Diagnostic and Statistical Manual (DSM) symptoms of depression. Response options are on a 4-point scale (0 = not at all, 1 = several days, 2 = more than half the days, and 3 = nearly every day). Scores are summed to produce a total score (range 0 to 24), with higher scores indicating greater symptoms of depression and a worse outcome. Cronbach's alphas across studies/populations vary (e.g. 0.82, 0.89, 0.92).

Developed by ProChange, this 3-item measure assesses three key drivers of resilience: mindset, meaning, and social connections. Items are rated on a 5-point scale (1 = never, 2 = rarely, 3 = sometimes, 4 = often, and 5 = almost always). Raw scores were summed and standardized to produce a total scale score (range 0 to 100), with higher scores indicating greater resilience and a better outcome. Cronbach's alpha is .81.

The WHO-5 is a widely used measure that assesses well-being. Respondents were asked to rate 5 items (e.g., I have felt calm and relaxed) in relation to how they've felt over the last two weeks. Items are rated on a 5-point scale (0 = at no time, 1 = some of the time, 2 = less than half the time, 3 = more than half the time, and 4 = most of the time). Scores were summed to produce a total score (range 0 to 25), with higher scores indicating greater mental well-being and a better outcome. Reported Cronbach's alphas vary (e.g., range from 0.81 to 0.90).

Originally developed in 1983, the Perceived Stress Scale (PSS) includes 10 items (e.g., In the last month, how often have you felt that you were unable to control the important things in your life) focused on varied situations. Respondents rate the items on a 5-point scale (0 = never, 1 = almost never, 2 = sometimes, 3 = fairly often, and 4 = very often). Negatively worded items are reversed scored and scores are summed to produce a total score (range 0 to 40), with higher scores indicating greater perceptions of stress and a worse outcome. Cronbach's alpha ≥ 0.75.

This measure of well-being assesses factors associated with increased risk for adverse emotional and physical outcomes among caregivers. Caregivers are asked to rate 13 items (e.g., ability to manage day to day caregiving) on a 5-point scale (1 = gotten much worse, 2 = gotten somewhat worse, 3 = stayed the same, 4 = improved somewhat, and 5 = improved a lot over the past month). The total score was computed by calculating the average of all items (range 0 to 25), with higher scores indicating greater appraisal of self-improvement in well-being and a better outcome. Cronbach's alpha is .88.

In its World Poll administered in 150 countries, Gallup, Inc. uses the 2-item Cantril Self-Anchoring Scale and a simple scoring algorithm to assess subjective well-being. Respondents are asked to rate their current life-and then to rate their future life, "say about five years from now"-on a ladder where 0 represents the worst possible life and 10 best possible life. Individuals who rate their current life a "7" or higher AND their future life an "8" or higher are classified as "thriving." Individuals who rate both their current and future lives a "4" or lower are classified as "suffering." All others are "struggling." Those who were classified as "suffering" or "struggling" were collapsed into one category-"not thriving". The probability of "thriving" vs. "not thriving" was assessed.