Brain health PRO/Santé cerveau PRO: The development of a web-based program for dementia literacy and risk factor reduction

Abstract

Background: Online educational programs focused on ways to improve brain health could increase participant literacy, empowerment, and engagement in activities that support personal brain health, potentially reducing dementia risk.

Objectives: Our goal was to develop an evidence-based online educational program with a focus on risk and protective factors for dementia. Here we present the rationale and features of the program and include results from a pilot study that assessed usability and acceptability.

Design: This project is part of the Can-Thumbs UP (CTU) initiative. An Intervention Mapping Approach framework and co-construction approach was used to develop the online program. A pre-post pilot open label design was used to test the usability and acceptance of this at-home educational program.

Setting: The program and assessment for the pilot study were delivered fully remotely.

Participants: Twenty community-dwelling older adults (60-83 years of age, 65 % female) living in Canada who were at increased risk of dementia.

Program: The Brain Health PRO/Santé Cerveau PRO is a web-based 45-week program available in French and English. It provides general information and guidance on seven modifiable risk factors for dementia: physical activity, nutrition, cognitively stimulating activities, sleep, social and psychological health, vascular health, and vision/hearing. After completing a brief intake questionnaire, users are provided with an individualized risk profile to personalize priorities and goals. During the course of the program, users receive feedback on lifestyle changes. For this pilot study, participants completed a 15-week version of the program.

Measurements: This pilot study reports measures of usability (System Usability Scale), acceptance (Technology Acceptance Model-2) as well as risk profiles at intake based on self-reported questionnaires.

Results: Two logic models were developed to identify the determinants of risk for dementia and how these could be targeted by the program. A review of dementia risk and protective factors and online educational programs for older adults, as well as co-creation activities with experts, stakeholders, and citizen advisors, were used to identify the determinants, target, format, and content of the program. The pilot study reports excellent usability and acceptance with scores of 80.4/100 and 93.5/120 respectively.

Conclusion: Intervention mapping and co-construction approaches facilitated the design of a program that effectively balances the delivery of scientific content with the specific constraints, needs and abilities of older adults.

Trial registration: NCT05347966.

Keywords: Alzheimer's disease; computer assisted training; modifiable risk factors; multidomain interventions; prevention.

Fig. 1

Step 1 of intervention mapping: Logic model of factors and determinants of cognitive health.

Fig. 2

Step 2 of intervention mapping: Logic model of change.

Fig. 3

Screenshots of Brain Health PRO/Santé Cerveau PRO. a) Dashboard showing some of the functionalities of the program (prioritized topics, completed chapters, gamification). b) Example of a speedometer indicating the individual's risk level for four of the modifiable risk factors. c) Example of a chapter page within the nutrition topic. This is a game to make the person aware of the quality of his/her diet. d) Example of a chapter page within the sleep topic. It provides information on inter-individual differences regarding the amount of sleep a person needs. e) Example of a chapter page within the psychological and social health topic: It gives tips on how to improve the quality of the person's social network. f) Example of a chapter page within the cognitive engagement topic: It gives instruction on how to use a strategy designed to improve memory recall.

Fig. 4

Mean scores for individual items of a) the usability questionnaire; and b) the acceptance questionnaire. The horizontal bars indicate the 95 % confidence intervals.