Background It is estimated that 564,000 Canadians are currently living with dementia and there are approximately 486,000 to 1.1 million informal family/friend caregivers. Family/friend caregivers often receive little to no education or training about dementia but are expected to provide ongoing support for a complex condition. Web-based family/friend caregiver interventions may be helpful, but little is known about how best to implement them. Objective The objectives of this study were to 1) design and develop a novel education prescription application to help scale and spread web-based dementia education to family/friend caregivers, 2) conduct user testing, and 3) conduct a larger-scale field trial. Methods A novel education prescription web-based application was designed and developed. Initial user testing used task completion and the “think aloud” technique with a small sample of representative clinicians who work with people living with dementia and family/friend caregivers. Following iterative incorporation of feedback, a larger field trial was conducted with a convenience sample of clinicians. Account invitations were sent to 55 clinicians and, following a 2-month trial period, surveys were administered to participants including the System Usability Scale and the Net Promoter Score. Results During the initial user testing phase, participants (N=7) from representative disciplines easily completed associated tasks, and had very positive feedback with respect to the usability of the application. The System Usability Scale score during this phase was 91.4. Suggestions from feedback were incorporated into the application. During the larger field trial phase, participants (total N=55; activated account n=17; did not activate account n=38) were given access to the iGeriCare education prescription application. During this period, 2 participants created educational prescriptions; a total of 3 educational prescriptions were sent. Survey completers who did not activate their account (n=5) identified that their lack of use was due to time constraints, competing priorities, or forgetting to use the application. Survey completers who activated their account (n=5) identified their lower use was due to lack of time, lack of eligible family/friend caregivers during trial period, and competing priorities due to the COVID-19 pandemic. The System Usability Scale score during this phase was 78.75, and the Net Promoter Score was 50. Conclusions Study findings indicate a generally positive response for the usability of a web-based application for clinicians to prescribe dementia education to family/friend caregivers. The dissonance between the promising data and widespread enthusiasm for the design and purpose of the education prescription application found in the initial user testing phase and subsequent lack of significant adoption in the field trial represents both an important lesson for other novel health technologies and a potential area for further investigation. Further research is required to better understand factors associated with implementation of this type of intervention and impact on dissemination of education to family/friend caregivers.

BACKGROUND It is estimated that 564,000 Canadians are currently living with dementia and there are approximately 486,000 to 1.1 million informal family caregivers. Family caregivers often receive little to no education or training about dementia, but are expected to provide ongoing support for a complex condition. Web-based caregiver interventions may be helpful, but little is known about how best to implement them. OBJECTIVE The objectives of this study were to: 1) design and develop a novel education prescription application to help scale and spread web-based dementia education to family caregivers; 2) conduct user testing; and 3) conduct a larger-scale field trial. METHODS A novel education prescription web-based application was designed and developed. Initial user testing used task completion and the ‘think aloud’ technique with a small sample of representative clinicians who work with people living with dementia and their caregivers. The System Usability Scale (SUS) was also administered. Following iterative incorporation of feedback, a larger field trial was conducted with a convenience sample of clinicians who had previously expressed an interest in the app. Account invitations were sent to 55 clinicians and, following a two-month trial period, surveys were administered to participants including SUS and the Net Promoter Score (NPS). RESULTS During the initial user testing phase, participants (n=7) from representative disciplines easily completed associated tasks, and had very positive feedback with respect to the usability of the app. The SUS during this phase was 91.4. Suggestions from feedback were incorporated into the app. During the larger field trial phase, participants (total n=55; activated account n=17; did not activate account n=38) were given access to the iGeriCare education prescription application. During this period, two participants created educational prescriptions; a total of 3 educational prescriptions were sent. Survey completers who did not activate their account (n=5) identified that their lack of use was due to time constraints, competing priorities, or forgetting to use the app. Survey completers who activated their account (n=5) identified their lower use was due to lack of time, lack of eligible caregivers during trial period, and competing priorities due to the COVID-19 pandemic. The SUS score during this phase was 78.75, and the NPS was 50. Despite the low levels of activation and use of the app, there was generally positive feedback from those participants that completed the surveys. CONCLUSIONS Study findings indicate a generally positive response for the usability of a web-based application for clinicians to prescribe dementia education to caregivers. Further research is required to better understand factors associated with implementation of this type of intervention, and impact on dissemination of education to caregivers.