Improving Outcomes for Care Partners of Individuals With Traumatic Brain Injury: Results for a mHealth Randomized Control Trial of the CareQOL App.
Noelle E Carlozzi, Jonathan P Troost, Srijan Sen and 6 others
PMID 39798892WHAT IT FOUND
Adding personalized self-care push notifications to a self-monitoring app did not improve health-related quality of life for care partners of people with TBI.
Some scores worsened. Only participants who actively engaged with the app showed improvements, suggesting engagement matters more than the prompts.
Key findings
01There were no significant differences in monthly health-related quality of life outcomes between the self-monitoring only group and the group receiving self-monitoring plus push notifications.
02Approximately one-third of all participants improved, one-third stayed the same, and one-third got worse, regardless of which study arm they were assigned to.
03Participants who reported greater engagement with the app were more likely to show improvement, though this finding was not significant after correcting for multiple comparisons.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Both study arms received an active intervention (self-monitoring), so it is unclear if the app itself helped or harmed compared to no intervention. The study included care partners providing minimal assistance, so results may not apply to those with high caregiving burden. The personalization of push notifications was subtle and may not have been effective. Daily assessments used computer adaptive testing, which created confusion and high error rates at the start of each week. The study period coincided with the COVID-19 pandemic, which may have influenced caregiving demands and health outcomes.
Declared interests
Dr. Troost has a financial relationship with Novartis unrelated to this work. All other authors declared no conflicts of interest. The study was funded by the NIH.
The easy way to misread this
Do not conclude that self-monitoring apps are ineffective for TBI care partners. The study compared self-monitoring alone against self-monitoring plus prompts, and found no added benefit from the prompts. It did not test self-monitoring against no intervention, so the baseline effect of the app itself remains unknown.