Abstract
AIM(S): To explore the feasibility and acceptability of acoustic monitoring and real-time recommendations for stress detection and management (i.e., smarthealth intervention). DESIGN: This qualitative study used a framework of acceptability for healthcare interventions. METHODS: From January 2021 to December 2023 in the U.S.A., we interviewed 10 family caregivers who had completed the 4-month smarthealth intervention. The caregivers shared their user experiences and feedback on the system's feasibility and acceptability. Data were analysed using abductive thematic analysis, incorporating the framework of acceptability for healthcare interventions and the collected data. RESULTS: Seven themes and 19 categories emerged: attitudes, burden, ethicality, intervention adherence, intervention coherence, perceived effectiveness and suggestions. Feedback on the smarthealth intervention was mixed. Some found it beneficial, citing accuracy, ease of use and increased awareness. However, others felt burdened during its use, primarily due to time constraints. CONCLUSION: The smarthealth intervention can potentially improve caregivers' awareness of themselves and caregiving situations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Future directions should involve adapting the smarthealth intervention to consider diverse caregiving scenarios and incorporating a larger sample of caregivers. IMPACT: This is the first study to offer a voice detection system and real-time stress management recommendations to caregivers of people living with dementia. An individualised approach should be considered to improve the system's effectiveness. This includes providing personalised intervention components, considering caregivers' time and establishing a user-friendly system with high accessibility. The findings can be a cornerstone for smarthealth interventions influencing dementia caregivers' self-care and emotional regulation. REPORTING METHOD: Standards for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: Members of the public and service users from a memory clinic and social media platforms contributed to the study by reviewing recruitment materials. TRIAL REGISTRATION: This trial's study protocol was registered with ClinicalTrials.gov (ID No. NCT04536701) on 3 September 2020 (https://classic. CLINICALTRIALS: gov/ct2/show/NCT04536701).