Planning and optimising a digital intervention to protect older adults’ cognitive health

Abstract

Background By 2050 worldwide dementia prevalence is expected to triple, rising to 152 million. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults, and key findings arising from this process. Methods A theory-, evidence- and person-based approach to intervention development was undertaken. Scoping reviews and behavioural analysis contributed to intervention planning. Optimisation involved qualitative interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes.Results The development process synthesised findings from planning and optimisation activities. Scoping reviews and qualitative interviews suggested that the same intervention content should be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of highly acceptable intervention content and functionality for target users.Conclusions A digitally-delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention, the insights obtained through our development process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.

Health literacy, dementia knowledge and perceived utility of digital health modalities among future health professionals

“…Research that focuses on the role of digital health in supporting people to reduce their risk of dementia is rapidly emerging. 16,17 As such, there is also a need for health professionals to be knowledgeable and capable of recommending digital health interventions where appropriate. 27,28 Students from health-related programs who participated in the current study had relatively high levels of health literacy but an average knowledge of dementia.…”

“…15 This study seeks to understand the students' preferences for digital modalities to receive health information. Finally, with the rapidly digitalised health environment and development of digital health interventions that focus on dementia prevention and risk reduction, [16][17][18] it is imperative that health professionals are open to using and recommending effective evidence-based digital health interventions that may reduce dementia risk and prevent dementia. Yet research indicates that it is health professionals, rather than consumers, who are resistant to using digital health.…”

Design and deployment of Digital Health Interventions (DHIs) to reduce the risk of the Digital Divide: a systematic scoping review conducted to inform development of the Living with Covid Recovery (LWCR) DHI (Preprint)

“…9. "Active Brains", a web-based programme to support dementia-protective behaviors in older people recruited from general practices in the UK 38 . 10.…”

“…There was also positive feedback for involving 41 end-users in Think Aloud interviews to inform a prototype web-based "Active Brains" programme to support dementia-protective behaviors for older people, and then test in a qualitative study conducted in the UK. The authors found that participants helped improve the usability of the intervention, through their feedback on the layout and usability, with positive comments about the uncluttered web-pages with only a few necessary buttons, 'like turning a page of the book' 38 .…”

“…Greater levels of uptake and usage were seen in those studies that tailored content for low literacy levels/illiteracy through use of animations 38 , pictures 33,37,43 , videos 30,32,35,37,39 and writing for a low reading age 30,39,48 .…”