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Essery R, Pollet S, Bradbury K, Western MJ, Grey E, Denison-Day J, Smith KA, Hayter V, Kelly J, Somerville J, Stuart B, Becque T, Zhang J, Slodkowska-Barabasz J, Mowbray F, Ferrey A, Yao G, Zhu S, Kendrick T, Griffin S, Mutrie N, Robinson S, Brooker H, Griffiths G, Robinson L, Rossor M, Ballard C, Gallacher J, Rathod S, Gudgin B, Phillips R, Stokes T, Niven J, Little P, Yardley L. Parallel randomized controlled feasibility trials of the "Active Brains" digital intervention to protect cognitive health in adults aged 60-85. Front Public Health 2022; 10:962873. [PMID: 36203694 PMCID: PMC9530972 DOI: 10.3389/fpubh.2022.962873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/30/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Multidomain interventions to address modifiable risk factors for dementia are promising, but require more cost-effective, scalable delivery. This study investigated the feasibility of the "Active Brains" digital behavior change intervention and its trial procedures. Materials and methods Active Brains aims to reduce cognitive decline by promoting physical activity, healthy eating, and online cognitive training. We conducted 12-month parallel-design randomized controlled feasibility trials of "Active Brains" amongst "lower cognitive scoring" (n = 180) and "higher cognitive scoring" (n = 180) adults aged 60-85. Results We collected 67.2 and 76.1% of our 12-month primary outcome (Baddeley verbal reasoning task) data for the "lower cognitive score" and "higher cognitive score" groups, respectively. Usage of "Active Brains" indicated overall feasibility and satisfactory engagement with the physical activity intervention content (which did not require sustained online engagement), but engagement with online cognitive training was limited. Uptake of the additional brief telephone support appeared to be higher in the "lower cognitive score" trial. Preliminary descriptive trends in the primary outcome data might indicate a protective effect of Active Brains against cognitive decline, but further investigation in fully-powered trials is required to answer this definitively. Discussion Whilst initial uptake and engagement with the online intervention was modest, it was in line with typical usage of other digital behavior change interventions, and early indications from the descriptive analysis of the primary outcome and behavioral data suggest that further exploration of the potential protective benefits of Active Brains are warranted. The study also identified minor modifications to procedures, particularly to improve online primary-outcome completion. Further investigation of Active Brains will now seek to determine its efficacy in protecting cognitive performance amongst adults aged 60-85 with varied levels of existing cognitive performance.
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Affiliation(s)
- Rosie Essery
- University of Southampton, Southampton, United Kingdom,*Correspondence: Rosie Essery
| | | | - Katherine Bradbury
- University of Southampton, Southampton, United Kingdom,NIHR ARC Wessex, Southampton, United Kingdom
| | | | | | | | | | | | - Joanne Kelly
- University of Southampton, Southampton, United Kingdom
| | | | - Beth Stuart
- University of Southampton, Southampton, United Kingdom,Queen Mary University of London, London, United Kingdom
| | - Taeko Becque
- University of Southampton, Southampton, United Kingdom
| | - Jin Zhang
- University of Southampton, Southampton, United Kingdom
| | | | | | - Anne Ferrey
- University of Oxford, Oxford, United Kingdom
| | - Guiqing Yao
- University of Leicester, Leicester, United Kingdom
| | - Shihua Zhu
- University of Southampton, Southampton, United Kingdom
| | - Tony Kendrick
- University of Southampton, Southampton, United Kingdom
| | | | | | | | | | - Gareth Griffiths
- NIHR Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | | | | | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Southampton, United Kingdom
| | - Bernard Gudgin
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Rosemary Phillips
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Tom Stokes
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - John Niven
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Paul Little
- University of Southampton, Southampton, United Kingdom
| | - Lucy Yardley
- University of Southampton, Southampton, United Kingdom,University of Bristol, Bristol, United Kingdom
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Essery R, Pollet S, Smith KA, Mowbray F, Slodkowska-Barabasz J, Denison-Day J, Hayter V, Bradbury K, Grey E, Western MJ, Milton A, Hunter C, Ferrey AE, Müller AM, Stuart B, Mutrie N, Griffin S, Kendrick T, Brooker H, Gudgin B, Phillips R, Stokes T, Niven J, Little P, Yardley L. Planning and optimising a digital intervention to protect older adults' cognitive health. Pilot Feasibility Stud 2021; 7:158. [PMID: 34407886 PMCID: PMC8371874 DOI: 10.1186/s40814-021-00884-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
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.
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Affiliation(s)
- Rosie Essery
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK.
| | - Sebastien Pollet
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Kirsten A Smith
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Fiona Mowbray
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Joanna Slodkowska-Barabasz
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - James Denison-Day
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Victoria Hayter
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | | | | | - Alexander Milton
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Cheryl Hunter
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Anne E Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore.,Centre for Sport & Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Beth Stuart
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Simon Griffin
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tony Kendrick
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Bernard Gudgin
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Rosemary Phillips
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Tom Stokes
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - John Niven
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Paul Little
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK. .,School of Psychological Science, University of Bristol, Bristol, UK.
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