Smart Reminders to Promote Home-based Cognitive Training

Adherence Promotion with Person-centered Technology (APPT): Promoting Adherence to Cognitive Intervention

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.

Study Overview

• Status: Completed
• Conditions: Adherence, Treatment
• Intervention / Treatment: Behavioral: Standard Reminder System (Active Control); Behavioral: Adherence Promotion With Person-centered Technology (APPT) System

Detailed Description

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).

• Study Type: Interventional
• Enrollment (Actual): 190
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Florida
    • Tallahassee, Florida, United States, 32306-4301
      • Department of Psychology, Florida State University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes

Description

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

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Reminder Only Condition; 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); A typical text message reminder system.
Experimental: Smart Adherence Support Condition; 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; A personalized and adaptive text message reminder system.

What is the study measuring?

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

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Interview	Interview assessing experience in study	6 months

Collaborators and Investigators

• Sponsor: Florida State University

Study record dates

Study Major Dates

• Study Start (Actual): November 7, 2022
• Primary Completion (Actual): October 31, 2024
• Study Completion (Actual): January 1, 2025

Study Registration Dates

• First Submitted: July 28, 2021
• First Submitted That Met QC Criteria: August 17, 2021
• First Posted (Actual): August 23, 2021

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 20, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: adherence; aging; artificial intelligence; technology; cognitive intervention; memory support
• Other Study ID Numbers: STUDY00000064

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Deidentified adherence data (time and date of intervention engagement) and scored individual difference measures (at the level of the individual) will be shared online.
• IPD Sharing Time Frame: Data will be made available one year after the publication of the first primary outcome paper or two years after the collection of the final participants' data, whichever come first.
• IPD Sharing Access Criteria: Data will be freely available online.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No