Whitebird 2013.

Methods	Study design: randomised controlled trial Study grouping: parallel group
Participants	Inclusion criteria: Primary carer of individuals with dementia living in the community Older than 21 Satisfying requirements for intervention participation No participation in a community carer support programme or similar programme (meditation or yoga and others) Moderate‐to‐high level of self perceived stress Exclusion criteria: Psychiatric hospitalisations in the previous 2 years Diagnoses of mental illness in the previous 2 years Taking antipsychotic or anticonvulsion medication Thoughts of harming themselves in the previous 6 months Characteristics of carers: N = 78 Mean age: 56.8 (SD 9.9) Percentage of females: 88.5% Relationship to individuals with dementia: adult children (74.4%); spouse, sibling, or friend (25.6%) Average levels of carers' depressive symptoms at baseline (measured by CESD): 17.9 (SD 8.9) for participants in the intervention group, 19.2 (SD 11.8) for participants in the control group Average levels of carer burden at baseline (measured by subjective stress burden subscale of MBCBS): 16.7 (SD 2.3) for participants in the intervention group, 16.9 (SD 2.8) for participants in the control group
Interventions	MBSR Duration: 8 weeks No. of sessions: 8 sessions, 2.5 hours per session Frequency: weekly Delivery: face‐to‐face, group Content of intervention: class activities ("sitting and walking meditation, body scan meditation, and gentle Hatha yoga and stretching exercises") 5‐hour retreat day home practice: participants were encouraged to practice daily A standard community caregiver education and social support (CCES) Duration: 8 weeks No. of sessions: 8 sessions, 2.5 hours per session Frequency: weekly Delivery: face‐to‐face, group Content of intervention: class activities (education, group‐based discussion, and social support) 5‐hour wellness day home practice: participants were encouraged to implement what they had learned
Outcomes	Carers' depressive symptoms Outcome type: continuous outcome Reporting: fully reported Scale: CESD Data value: endpoint Carers' anxiety Outcome type: continuous outcome Reporting: fully reported Scale: STAI‐state Data value: endpoint Carer burden Outcome type: continuous outcome Reporting: fully reported Scale: MBCBS‐subjective stress burden subscale Data value: endpoint
Identification	Sponsorship source: National Center for Complementary and Alternative Medicine of the National Institutes of Health under award number R21AT003654 Country: USA
Notes	Adherence to intervention: 83% of participants attended at least 7 of the 8 weekly sessions; MBSR participants reported an average of 29 minutes per day of home practice.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "... were randomly assigned using a computerized algorithm for simple randomization" Comment: Adequate allocation concealment
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: It is not possible to blind personnel or participants (or both) to psychosocial interventions of this nature.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Comment: Assessment tools were self reported measures.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Comment: Attrition percentages: 2.6% participants in the intervention group, 12.5% participants in the control group Reasons for attrition: institutionalisation; time constraints; dissatisfaction with assignment to the control group The study used intention‐to‐treat analyses, however the imputation method for missing data was not described.
Selective reporting (reporting bias)	Unclear risk	Comment: We did not find a published protocol.
Other risks of bias	High risk	We suspected a high risk of bias for inexplicable baseline imbalances, as anxiety in the control group was significantly higher than in the intervention group (P < 0.05).

CESD: Center for Epidemiological Studies Depression Scale
 GDS: Geriatric Depression Scale
 MBCBS: Montgomery Borgatta Caregiver Burden Scale
 MBCT: mindfulness‐based cognitive therapy
 MBSR: mindfulness‐based stress reduction
 POMS: Profile of Mood States
 RMBPC: Revised Memory and Behavior Problems Checklist
 SD: standard deviation
 STAI: State‐Trait Anxiety Inventory
 ZBI: Zarit Burden Interview