# Co-Developing a Culturally Responsive, Theory-Informed Dyadic Mind–Body Intervention to Improve Sleep and Wellbeing in People with Dementia and Their Caregivers in the UK

## TL;DR

A culturally tailored mind-body program for dementia patients and caregivers was co-developed, showing promise for improving sleep and wellbeing.

## Contribution

A novel culturally responsive dyadic mind–body intervention was co-developed using behavioral theory and community input.

## Key findings

- The co-developed intervention demonstrated high cultural resonance and feasibility among diverse communities.
- Key determinants of engagement included cognitive load, cultural meaning, and dyadic support.
- The structured co-design process offers a replicable model for future non-pharmacological dementia interventions.

## Abstract

What are the main findings?
A culturally grounded, theory-informed dyadic mind–body intervention was successfully co-developed with people with dementia, caregivers, and diverse community stakeholders, demonstrating high cultural resonance, acceptability, and feasibility.Behavioural analysis identified key determinants of engagement—such as cognitive load, cultural meaning, dyadic support, and practical barriers—which guided the selection of effective behaviour change techniques integrated into the final 8-week programme.

A culturally grounded, theory-informed dyadic mind–body intervention was successfully co-developed with people with dementia, caregivers, and diverse community stakeholders, demonstrating high cultural resonance, acceptability, and feasibility.

Behavioural analysis identified key determinants of engagement—such as cognitive load, cultural meaning, dyadic support, and practical barriers—which guided the selection of effective behaviour change techniques integrated into the final 8-week programme.

What are the implications of the main findings?
The development work provides a strong foundation for conducting a feasibility trial to evaluate implementation, acceptability, and preliminary effects on sleep, caregiver wellbeing, and dyadic coping across diverse communities.The structured, culturally responsive co-design process offers a replicable model for developing future non-pharmacological interventions in dementia care, particularly where cultural adaptation and dyadic approaches are essential.

The development work provides a strong foundation for conducting a feasibility trial to evaluate implementation, acceptability, and preliminary effects on sleep, caregiver wellbeing, and dyadic coping across diverse communities.

The structured, culturally responsive co-design process offers a replicable model for developing future non-pharmacological interventions in dementia care, particularly where cultural adaptation and dyadic approaches are essential.

Background: Sleep disturbances are common in dementia and adversely affect both the person with dementia and their caregiver. Non-pharmacological options exist but are seldom dyadic or culturally tailored, limiting their reach and relevance across diverse communities. Objective: We aimed to co-develop DREAM (Dyadic Resilience, Engagement, Awareness & Mind–body intervention)—an 8-week dyadic mind–body programme (mindfulness + gentle Tai Chi) for improving sleep and wellbeing in people with dementia and their caregivers. Methods: The process was informed by Intervention Mapping (Stages 1–4) and underpinned by established behaviour change frameworks, including the Behaviour Change Wheel (BCW), the COM-B model (Capability, Opportunity, Motivation → Behaviour), and the Theoretical Domains Framework (TDF), to systematically identify determinants of engagement. Co-design involved dementia–caregiver dyads, Patient and Public Involvement (PPI) contributors, clinicians, mind–body practitioners, and community stakeholders. Results: The intervention was co-developed and culturally grounded through engagement with White British, Caribbean, Chinese, and South Asian communities. Participants reported high cultural resonance, endorsing DREAM’s concise practices, caregiver-supported home routines, and delivery in trusted community venues. Behavioural insights highlighted the importance of motivational framing (perceived dyadic benefits, cultural meaning), practical enablement (simplified guidance, prompts/cues, environmental restructuring), and caregiver facilitation to support adherence. Conclusions: DREAM demonstrates the practicability of using Intervention Mapping to co-develop a culturally responsive, theory-informed dyadic mind–body intervention for people with dementia and their caregivers. This groundwork supports progression to a feasibility trial focused on implementation processes and preliminary sleep and wellbeing outcomes.