Maintaining brain health in the elderly: Barriers and facilitators for an online lifestyle program
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1 Maintaining brain health in the elderly: Barriers and facilitators for an online lifestyle program Linda MP Wesselman, AK Schild, N Coll-Padros, WE van der Borg, JHP Meurs, AM Hooghiemstra, RER Slot, L Sannemann, L Rami, JL Molinuevo, F Bouwman, F Jessen, WM van der Flier, SAM Sikkes, on behalf of the Euro-SCD working group. Vumc Alzheimer Center Amsterdam, The Netherlands l.wesselman@vumc.nl 4th Annual Conference - Behaviour Change for Health: Digital & Beyond, London, UK
2 Alzheimer s disease is on the rise Worldwide increase in Alzheimer s disease cases, driven by the ageing population Huge burden for health care system References: Norton et al. 2014; Scheltens et al. 2016
3 No therapy for Alzheimer s disease Worldwide increase in Alzheimer s disease cases, driven by the ageing population Huge burden for health care system No successful pharmaceutical intervention yet, no treatment possible Therefore, need for prevention References: Norton et al. 2014; Scheltens et al X
4 What should we focus on? Recent report Lancet: Livingstone et al Growing evidence for modifiable risk factors 35% of dementia attributable to combination of 9 modifiable factors Lifestyle factors
5 Who should we focus on? Memory clinic population Individuals at risk for cognitive decline Cognitive complaints but no objective cognitive impairment/decline on tests: Subjective cognitive decline Research: increased risk for Alzheimer s Disease Clinic: motivated to participate in prevention strategies References: Jessen et al. 2014, vd Flier 2014
6 How offer lifestyle prevention? Face-to-face Time consuming Costly By appointment Our goal: reach as many people as possible Online Widely spread reach Inexpensive Available at all times
7 Overall aim: Online lifestyle program Online program for individuals with subjective cognitive decline focusing on lifestyle App or website Information and advice: lifestyle for a healthy brain 5 categories Cognitive activity Social activity Physical activity Nutrition Attitude (e.g. stress management)
8 First step To investigate barriers and facilitators for the use of an online lifestyle program for brain health Participant-centered design = Involving users Contributes to successful implementation and more sustainable innovations. We include participants with SCD from 3 memory clinics: VUmc Alzheimer center Amsterdam, The Netherlands Hospital Clinic Barcelona, Spain University Hospital Clinic Cologne, Germany
9 Methods Surveys & Interviews
10 Methods Surveys & Interviews Preferences, barriers & facilitators for an online lifestyle program SCD subjects N=176 out of 238 (Response rate 69%) Approx. 10 minutes
11 Methods Surveys & Interviews Preferences, barriers & facilitators for an online lifestyle program SCD subjects N=176 out of 238 (Response rate 69%) Approx. 10 minutes In-depth understanding of factors associated with the use of an online lifestyle program SCD subjects N=22 interviews: 14 Amsterdam, 8 Cologne Content analysis Identify important themes
12 Results - Survey Main facilitators Facilitators Trustworthiness 163 (92%) User-friendliness 160 (91%) Up-to-date information 155 (88%)
13 Results - Survey Main facilitators and barriers Facilitators Trustworthiness 163 (92%) User-friendliness 160 (91%) Up-to-date information 155 (88%) Barriers Interaction with other users 46 (26%) Account needed 37 (21%) Mandatory assignments 28 (16%)
14 Results - Survey Main facilitators and barriers Facilitators Trustworthiness 163 (92%) User-friendliness 160 (91%) Up-to-date information 155 (88%) Barriers Interaction with other users 46 (26%) Account needed 37 (21%) Mandatory assignments 28 (16%) Strikingly, only 51% checks trustworthiness of source
15 Results Semi-structured interviews Program characteristics It is difficult, you know? Barriers For instance, I read an article on heart failure, including many patients. Then I ask myself, Personal factors Content analysis how do - Identified I know whether barriers and this research is scientifically facilitators for grounded? the use of I an have online no clue. lifestyle program Quote Outdated and non-relevant content Fixed frequency Time constraints Limited digital skills Psychological factors Trustworthy, scientific, interesting content Program characteristics Functionalities Personalization Facilitators User friendliness Need for total package of information Personal factors Confirmation of what you do and know Motivation for a healthy brain
16 Conclusion First step, in developing een online lifestyle program for individuals with subjective cognitive decline. Barriers and facilitators: program characteristics as well as personal factors Main facilators are: Thrustworthiness, userfriendliness and personalization of the platform Main barriers are: Interaction with other users and psychological factors.
17 How can you use this information? Involving future users provides many useful insights When involving users, go beyond program characteristics, also explore personal facilitators and barriers Pay attention especially to personal barriers; and involve users in how to diminish them. Our next step: We develop a personalized online lifestyle program for brain health, taking into account all these barriers and facilitators. l.wesselman@vumc.nl
18 Let s talk barriers and facilitators during coffee l.wesselman@vumc.nl
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