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Feasibility and Psychometric Integrity of Mobile Phone-Based Intensive Measurement of Cognition in Older Adults.

ABSTRACT: Background:There is a pressing need for assessment approaches that can be deployed remotely to measure cognitive outcomes in clinical trials and longitudinal aging cohorts. We evaluated the utility of a mobile phone-based intensive measurement study for this purpose. Method:A small cohort of healthy older adults (N = 17, mean age = 73) completed five assessment "bursts" over 12 months, with each measurement burst involving two assessments daily for five consecutive days. Each assessment included brief tests of visual short-term memory and information processing speed, as well as surveys measuring state factors that can affect cognition. Results:At study endpoint we had 94% retention, 97% compliance, and high participant satisfaction. Mobile cognitive test scores demonstrated good reliability, moderate correlations with in-person baseline neuropsychological testing, and significant associations with participant age and education level. Conclusions: Mobile phone-based intensive measurement designs represent a promising assessment approach for measuring cognition longitudinally in older adults.

SUBMITTER: Brewster PWH

PROVIDER: S-EPMC8225552 | biostudies-literature | 2021 Jul-Sep

REPOSITORIES: biostudies-literature

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Feasibility and Psychometric Integrity of Mobile Phone-Based Intensive Measurement of Cognition in Older Adults.

Brewster Paul W H PWH Rush Jonathan J Ozen Lana L Vendittelli Rebecca R Hofer Scott M SM

Experimental aging research 20210301 4

<b>Background:</b>There is a pressing need for assessment approaches that can be deployed remotely to measure cognitive outcomes in clinical trials and longitudinal aging cohorts. We evaluated the utility of a mobile phone-based intensive measurement study for this purpose. <b>Method:</b>A small cohort of healthy older adults (N = 17, mean age = 73) completed five assessment "bursts" over 12 months, with each measurement burst involving two assessments daily for five consecutive days. Each asses ...[more]

PMID: 33648422

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Project description:BackgroundYouth homelessness is a substantial issue, and many youths experiencing homelessness have mental health issues as both a cause and consequence of homelessness. These youths face many barriers to receiving traditional mental health services, and as a result, only a few youths experiencing homelessness receive any form of mental health care.ObjectiveThis project aimed to develop and determine the feasibility and acceptability of engaging young adults (ie, individuals aged 18-24 years) experiencing homelessness in a remotely delivered mental health intervention. This intervention provided brief emotional support and coping skills, drawing from cognitive behavioral principles as an introduction into psychosocial support. The intervention was piloted in a homeless shelter network.MethodsA total of 35 young adults experiencing homelessness participated in a single-arm feasibility pilot trial. Participants received a mobile phone, a service and data plan, and 1 month of support from a coach consisting of up to 3 brief phone sessions, text messaging, and mobile mental health apps. We evaluated feasibility by looking at completion of sessions as well as the overall program and acceptability with satisfaction ratings. We also collected clinical symptoms at baseline and the end of the 1-month support period. We used validity items to identify participants who might be responding inappropriately and thus only report satisfaction ratings and clinical outcomes from valid responses.ResultsMost participants (20/35, 57%) completed all 3 of their phone sessions, with an average of 2.09 sessions (SD 1.22) completed by each participant. Participants sent an average of 15.06 text messages (SD 12.62) and received an average of 19.34 messages (SD 12.70). We found higher rates of satisfaction among the participants with valid responses, with 100% (23/23) of such participants indicating that they would recommend participation to someone else and 52% (12/23) reporting that they were very or extremely satisfied with their participation. We found very little change from pre- to posttreatment on measures of depression (d=0.27), post-traumatic stress disorder (d=0.17), and emotion regulation (d=0.10).ConclusionsThis study demonstrated that it was feasible to engage homeless young adults in mental health services in this technology-based intervention with high rates of satisfaction. We did not find changes in clinical outcomes; however, we had a small sample size and a brief intervention. Technology might be an important avenue to reach young adults experiencing homelessness, but additional work could explore proper interventions to deliver with such a platform.Trial registrationClinicalTrials.gov NCT03620682; https://clinicaltrials.gov/ct2/show/NCT03620682.

Project description:The use of technology to facilitate remote patient monitoring and virtual care is desirable due to the challenges of providing healthcare during the COVID-19 pandemic and the need for more efficient and effective methods to care for the expanding older adult population. Further, the collection and sharing of patient generated health data (PGHD) through these technologies holds promise with respect to improving outcomes and reducing the cost of care by facilitating the early detection and treatment of cognitive and health problems. Despite the potential benefits of these technologies, their promise might be hampered by low rates of acceptance and adoption among older adults. In an online survey, we assessed community-dwelling older adults' (N = 92) attitudes towards the use of wearable and mobile technologies for (1) predicting cognitive decline, (2) assisting with adherence to healthy activities, and (3) collecting self-report data to understand current and predict future health states. Participants generally agreed hypothetical technology solutions would be useful (M = 4.20, SD = 0.70 on a 1-5 agreement scale; 5 = "strongly agree"), that they were interested in learning more about these technologies (M = 4.04, SD = 0.74), and that they would be willing to adopt these technologies (M = 3.83, SD = 0.93), though attitudes varied. Although participants were generally positive toward these technologies, they were relatively neutral in terms of their agreement that privacy of generated data was a concern (M = 2.92, SD = 1.02). Privacy concerns were associated with lower interest and willingness to adopt. More positive general technology attitudes and higher mobile device proficiency were associated with greater acceptance and willingness to adopt these technologies. Finally, poorer self-rated health was related to negative attitudes toward these technologies. These findings highlight barriers and potential targets for intervention to increase uptake of these and similar technologies among older adults who may be reluctant to adopt remote monitoring technologies.

Project description:BackgroundPatients with frozen shoulder show limited shoulder mobility often accompanied by pain. Common treatment methods include physiotherapy, pain medication, administration of corticosteroids, and surgical capsulotomy. Frozen shoulder often lasts from months to years and mostly affects persons in the age group of 40 to 70 years. It severely reduces the quality of life and the ability to work.ObjectiveThe objective of this study was to evaluate the feasibility of a mobile health (mHealth) intervention that supports patients affected by "stage two" frozen shoulder. Patients were supported with app-based exercise instructions and tools to monitor their training compliance and progress. These training compliance and progress data supplement the patients' oral reports to the physiotherapists and physicians and can assist them in therapy adjustment.MethodsIn order to assess the feasibility of the mHealth intervention, a pilot study of a newly developed app for frozen shoulder patients was conducted with 5 patients for 3 weeks. The main function of the app was the instruction for exercising at home. Standardized questionnaires on usability such as System Usability Scale (SUS) and USE (Usefulness, Satisfaction, and Ease of use), and Technology Acceptance Model-2 (TAM-2) were completed by the study participants at the end of the study. Additionally, a nonstandardized questionnaire was completed by all patients. The correctness of the exercises as conducted by the patients was assessed by a physiotherapist at the end of the study. The mobility of the shoulder and pain in shoulder movement was assessed by a physiotherapist at the start and the end of the study.ResultsThe pilot study was successfully conducted, and the app was evaluated by the patients after 3 weeks. The results of the standardized questionnaires showed high acceptance (TAM-2) and high usability (SUS) of the developed app. The overall usability of the system as assessed by the SUS questionnaire was very good (an average score of 88 out of 100). The average score of the TAM-2 questionnaire on the intention to further use the app was 4.2 out of 5, which indicated that most patients would use the app if further available. The results of the USE questionnaires highlighted that the patients learned how to use the app easily (an average score of 4.2 out of 5) and were satisfied with the app (an average score of 4.7 out of 5). The frequency of app usage and training was very high based on patient reports and verified by analysis of the usage data. The patients conducted the exercises almost flawlessly.ConclusionsOur results indicate the feasibility of the mHealth intervention, as the app was easy to use and frequently used by the patients. The app supported the patients' physiotherapy by providing clear exercising instructions.

Dataset Information

Feasibility and Psychometric Integrity of Mobile Phone-Based Intensive Measurement of Cognition in Older Adults.

Publications

Feasibility and Psychometric Integrity of Mobile Phone-Based Intensive Measurement of Cognition in Older Adults.

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