Adherence, Treatment
Conditions
Keywords
adherence, cognitive intervention, memory support, artificial intelligence, aging, technology
Brief summary
This study will examine whether among older adults an adaptive and personalized reminder system can better support adherence to home-based cognitive training over typical reminder systems.
Detailed description
Many cognitive training interventions are associated with poor adherence, and poor adherence is associated with fewer benefits. Further, poor adherence in cognitive intervention studies can interfere with answering fundamental questions regarding intervention efficacy. This study will compare the effects of non-adaptive and smart adherence support systems. Participants will be asked to engage in frequent home-based cognitive training on a computer tablet. In the smart adherence support condition, participants will receive adaptive and tailored reminders based on dynamic algorithms that deploy reminders in a way that considers participant preferences, days and times of previous successful engagement, the success of previous reminder attempts, and answers to brief questions contained within reminder prompts. Parameter weights for these variables will be adjusted dynamically over a 6-month assessment period to ensure that reminders are deployed when they are most likely to be acted upon. This study will investigate adherence to training sessions, multiple times each week for 6 months, representing a large challenge to adherence. Participants will be randomly assigned to one condition or another, and adherence at home will be monitored. This will be an Individually Randomized Group-Treatment Trial (IRGT).
Interventions
BEHAVIORALAdherence Promotion With Person-centered Technology (APPT) System
A personalized and adaptive text message reminder system.
BEHAVIORALStandard Reminder System (Active Control)
A typical text message reminder system.
Sponsors
Florida State University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
BASIC_SCIENCE
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
Measures of adherence will be automatically collected and thus assessors will be blind to this outcome. Data will be coded and analyzed with arbitrary condition markers to mask condition during analysis. Participants will not be explicitly told which condition they are in, but will be aware of the reminder messages they are receiving, and thus are not truly blind.
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 65 years of age or older * normal or corrected to normal visual acuity * must pass a dementia screening
Exclusion criteria
* Parkinson's, Alzheimer's disease, or any other neurodegenerative disease * terminal illness * blindness or deafness * severe motor impairment * not living in the Tallahassee area for the entire 6 month study period * unable to read at or above 6th grade level
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adherence (holidays) | 6 months | Number of extended gaps in between sessions over 6 months |
| Adherence (session number) | 6 months | Number of sessions over 6 months |
| Adherence (session length) | 6 months | Number of sessions reaching at least 80% of the assigned session duration over 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-Efficacy (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | A composite measure of self-efficacy (beliefs held about ability to complete tasks) |
| Technology Proficiency (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | A composite measure of proficiency with technology |
| Perceived Training Efficacy (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | A composite measure of belief in the the efficacy of cognitive training |
| Dementia Worry (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | A composite measure of anxiety over cognitive decline |
| Busyness Scale (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | Self-reported environmental demands of day-to-day life |
| Personality (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | Measure of stable traits |
| Objective Cognition (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | A composite measure of objective cognitive ability |
| Subjective Cognition (predictor of adherence) | Assessed at baseline, predicting adherence variables over 6 months | A composite measure of subjective cognitive deficit |
Other
| Measure | Time frame | Description |
|---|---|---|
| Interview | 6 months | Interview assessing experience in study |
Countries
United States
Outcome results
None listed