Smart Reminders to Promote Home-based Cognitive Training

Study Overview
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Brief Summary
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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
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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).

Official Title
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Adherence Promotion With Person-centered Technology (APPT): Promoting Adherence to Cognitive Intervention

Conditions
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Adherence, Treatment

Intervention / Treatment
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* Behavioral: Adherence Promotion With Person-centered Technology (APPT) System
* Behavioral: Standard Reminder System (Active Control)


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Reminder Only Condition<br>To promote adherence, participants will receive generic reminders when home-based cognitive training has not been completed. This will be in the form of a text message to participants' smart phone. | Behavioral: Standard Reminder System (Active Control)<br>* A typical text message reminder system.<br>|
| Experimental: Smart Adherence Support Condition<br>To promote adherence, participants will receive reminders when home-based cognitive training has not been completed. This will be in the form of a text message to participants' smart phone. In this 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 assessments, 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. | Behavioral: Adherence Promotion With Person-centered Technology (APPT) System<br>* A personalized and adaptive text message reminder system.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adherence (session number) | Number of sessions over 6 months | 6 months | 
| Adherence (session length) | Number of sessions reaching at least 80% of the assigned session duration over 6 months | 6 months | 
| Adherence (holidays) | Number of extended gaps in between sessions over 6 months | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Objective Cognition (predictor of adherence) | A composite measure of objective cognitive ability | Assessed at baseline, predicting adherence variables over 6 months | 
| Subjective Cognition (predictor of adherence) | A composite measure of subjective cognitive deficit | Assessed at baseline, predicting adherence variables over 6 months | 
| Self-Efficacy (predictor of adherence) | A composite measure of self-efficacy (beliefs held about ability to complete tasks) | Assessed at baseline, predicting adherence variables over 6 months | 
| Technology Proficiency (predictor of adherence) | A composite measure of proficiency with technology | Assessed at baseline, predicting adherence variables over 6 months | 
| Perceived Training Efficacy (predictor of adherence) | A composite measure of belief in the the efficacy of cognitive training | Assessed at baseline, predicting adherence variables over 6 months | 
| Personality (predictor of adherence) | Measure of stable traits | Assessed at baseline, predicting adherence variables over 6 months | 
| Dementia Worry (predictor of adherence) | A composite measure of anxiety over cognitive decline | Assessed at baseline, predicting adherence variables over 6 months | 
| Busyness Scale (predictor of adherence) | Self-reported environmental demands of day-to-day life | Assessed at baseline, predicting adherence variables over 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adherence, cognitive intervention, memory support, artificial intelligence, aging, technology