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

Essery R 1 , Pollet S 2 , Smith KA 2 , Mowbray F 2 , Slodkowska-Barabasz J 2 , Denison-Day J 2 Show all authors , Hayter V 2 , Bradbury K 2 , Grey E 3 , Western MJ 3 , Milton A 4 , Hunter C 5 , Ferrey AE 6 , Müller AM 7 , Stuart B 8 , Mutrie N 9 , Griffin S 10 , Kendrick T 8 , Brooker H 11 , Gudgin B 12 , Phillips R 12 , Stokes T 12 , Niven J 12 , Little P 8 , Yardley L 13

Affiliations 

  • 1 Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK. r.a.essery@soton.ac.uk
  • 2 Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
  • 3 Department for Health, University of Bath, Bath, UK
  • 4 School of Psychological Science, University of Bristol, Bristol, UK
  • 5 University Hospitals Plymouth NHS Trust, Plymouth, UK
  • 6 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  • 7 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore
  • 8 Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
  • 9 Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
  • 10 Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  • 11 University of Exeter Medical School, Exeter, UK
  • 12 Public and Patient Involvement (PPI) representative, Southampton, UK
  • 13 Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK. lucy.yardley@bristol.ac.uk
Pilot Feasibility Stud, 2021 Aug 18;7(1):158.
PMID: 34407886 DOI: 10.1186/s40814-021-00884-2

Abstract

BACKGROUND: By 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of 'Active Brains': a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults.

METHODS: During the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional 'guiding principles' and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content.

RESULTS: Scoping reviews and qualitative interviews suggested that the same intervention content may 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 intervention content and functionality that appeared highly acceptable amongst a sample of 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 development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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