This study will evaluate the effectiveness of a personalized, web-based training intervention that was developed to teach use of an Electronic Memory and Management Aid (EMMA) application. The app-based system is designed to support everyday memory, daily activity management and positive health behavior engagement for older adults with subjective cognitive complaints or mild cognitive impairment. The investigators will also evaluate the degree to which a clinician is needed to oversee the uptake and utilization of the EMMA app during the web-based training intervention.
Participants will be randomly assigned to one of two groups, "Technical Support Only" group (T-only group) and "Technical + Clinician Support" group (T+C group). Participants will be enrolled in the study for 6 months. Participants who pass initial phone screening criteria will participate in a 2-3 hour neurocognitive assessment over zoom to establish baseline cognition, prior to beginning the intervention. Participants will also complete questionnaires and a real-world measure assessing daily functioning. After the initial assessment is complete, participants will be given one-month to learn to use the EMMA app by completing the self-paced intervention via the adaptive, web-based training platform, which includes six lessons. EMMA device-use will be captured throughout the study by the app itself. A component of the self-paced, web-based intervention involves setting goals related to using the EMMA app. A clinician will monitor the training data and goals the T+C group participants make and conduct brief problem-solving and goal-refining sessions during the intervention weeks. These sessions are expected to be 10-15 minutes. To keep training on track, the T-only group will receive brief phone check-ins to monitor progression through the web-based intervention. Following training, there will no longer be any differences in the treatment of both groups, which will be monitored for an additional three months. Immediately following training and at the end of the 3 month monitoring period, all participants will complete the battery of questionnaires and answer a semi-structured phone interview. In addition, at the end of the 3 month follow-up, all participants will again complete the neurocognitive assessment and real-world measure of daily functioning.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
Participants will complete six sessions of training to support uptake and habit formation of EMMA app use with a personalized web-based training platform.
Participants will receive weekly brief check-ins with clinicians to motivate and support the problem-solving and habit formation aspects of the web-based training.
Washington State University - Pullman; Study Remote
Pullman, Washington, United States
RECRUITINGChange in EMMA app use daily interactions
Total daily use interactions derived from the EMMA app will provide a measure of how much the app is being used.
Time frame: continuous data collection through study completion up to 6 months
Change in Daily Assessment of Independent Living and Executive Skills (DAILIES)
To measure participants capacity to complete instrumental activities of daily living (IADLs) at home, participants complete a series of brief tasks that resemble typical IADLs (e.g., paying utility bills, running errands, filling out a rebate form) six days a week for three weeks (total score; range 0-93; higher scores indicate better performance).
Time frame: at baseline and 6 month follow-up
Change in Cognitive Self-efficacy Questionnaire (CSEQ)
Self-report measure of a participants confidence in their everyday cognitive abilities (mean score; range 0-10; higher scores represent better self-reported confidence in cognitive abilities).
Time frame: at baseline, immediately post-training and 6 month follow-up
Change in Patient-Reported Outcome Measurement Information System 29 general (PROMIS-29)
Self-report measure assessing a participants mental and physical health (T-score with mean of 50 and standard deviation of 10; higher scores represent worse symptomology)
Time frame: at baseline, immediately post-training and 6 month follow-up
Change in Coping Self-efficacy Scale (CSES)
Self-report measure of coping abilities (total score; range 1-130; higher scores represent greater self-perceived coping abilities)
Time frame: at baseline, immediately post-training and 6 month follow-up
Change in Everyday Compensation questionnaire (Ecomp)
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TREATMENT
Masking
SINGLE
Enrollment
50
Self-report of everyday compensatory strategy use (mean score; range 0-4; higher scores represent better self-reported use of everyday compensatory strategies).
Time frame: at baseline, immediately post-training and 6 month follow-up
Change in Patient-Reported Outcome Measurement Information (PROMIS) System Applied Cognition
Self-perception of cognitive abilities (T-score with mean of 50 and standard deviation of 10; higher scores represent worse symptomology).
Time frame: at baseline, immediately post-training and 6 month follow-up
Change in Self-Efficacy for Appropriate Medication Use Scale (SEAMS)
Self-perception of medication management abilities (total score, range 13-39, higher scores are associated with greater self-efficacy for adherence to medications)
Time frame: at baseline, immediately post-training and 6 month follow-up