Background: Informal caregivers of home-dwelling people with dementia experience significant unmet needs. However, family physician teams as primary health care gatekeepers for aging populations in China remain an underused resource for structured caregiver support. Objective: This hybrid effectiveness-implementation study aimed to evaluate a policy-aligned integration of the World Health Organization’s iSupport web-based program with China’s family physician contract services for informal dementia caregivers while systematically assessing implementation determinants using the Consolidated Framework for Implementation Research (CFIR). Methods: A cluster randomized controlled trial enrolled 120 informal caregivers of people with dementia in Beijing randomly assigned to either the intervention group (n=60) receiving the family physician team–guided iSupport intervention plus usual care or the control group (n=60) receiving usual care plus only iSupport registration. Caregiver burden (primary outcome) and quality of life, social support, and learning behaviors (secondary outcomes) were assessed at baseline and the postintervention time point. Intention-to-treat analysis was applied. The quantitative data were analyzed using linear mixed models and generalized linear mixed models. Implementation barriers and facilitators were explored through CFIR-guided thematic analysis of semistructured interviews with 34 stakeholders. Results: The intervention revealed no substantial between-group differences in caregiver burden (β=–3.80, 95% CI –11.25 to 3.65, P=.32), quality of life (β=–1.55, 95% CI –6.59 to 3.49, P=.55), or social support (β=0.85, 95% CI –2.86 to 4.56, P=.65). However, it demonstrated significantly improved learning behaviors in the intervention group (β=2.35, 95% CI 1.03-3.67; P

Supporting dementia carers is a global priority. As a Randomised Controlled Trial (RCT) (n = 352) of the Word Health Organization recommended, an internationally disseminated ‘iSupport’ e-health intervention was conducted, revealing no measurable benefits to the wellbeing of adult dementia carers. This process evaluation contributes original insights of the trial outcomes. Its aims were to ascertain the usability and acceptability of iSupport, participant engagement and adherence to iSupport, and contextual factors influencing its implementation and potential impact. The process evaluation followed a mixed-method design. The following data were collected from all participants randomised to iSupport (n = 175): (1) post-intervention evaluation questionnaire (n = 93) containing the 10-item System Usability Scale and bespoke items exploring acceptability, engagement, and perceived impact; (2) qualitative interviews (n = 52) with a sub-sample of participants who were purposively sampled according to age, scores on the outcome measures, and gender, as these interviews aimed to generate contextual detail and explanatory accounts; and (3) ‘Access’ data from the iSupport platform (n = 175). Descriptive statistics was used to report on the frequency of survey responses whilst a thematic analysis approach was followed to identify themes from the qualitative interview data. Data sets were analysed independently and then used with respect to one another in order to generate explanatory pathways related to the usability, acceptability, and the impact of iSupport. Despite good trial retention, 8.3% of participants (n = 32) did not spend any time on iSupport, and 54% (n = 94) spent between 30 min and 1.5 h. Factors driving this were the following: time constrains, method of delivery, and content characteristics. Positive impacts of iSupport were also described. Participants, including those with extensive caring experience, reported how iSupport had made them feel reassured, valued, and more able to ask for help. They also reported having an improved outlook on their caring role and on the needs and feelings of the person living with dementia. Research and practice should focus on exploring blended delivery, including self-directed and interactive components, such as regular contact with a health professional. These insights are critical for supporting the global implementation and adaptation of iSupport and offer valuable directions for future research.

@rainbow .@therainbow highfive #nnnnudelnugggler s iam a straight male and i say human rights are homo rights are womensrights are childrensrights isupport thegirls unconditionally the males i tolerate ‎ ‎ I am Christian KISS BabyAWACS - Raw Independent Sophistication#THINKTANK + #INTEL #HELLHOLE #BLOG Inquiry@BabyAWACS.com FluffyBunnySheepleSecuritySolutions@BabyAWACS.com Helpful? support. donnate. pay.

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