Related Experiment Video
Updated: Jun 20, 2025
Walk with Me Hybrid Virtual/In-Person Walking for Older Adults with Neurodegenerative Disease
Published on: June 16, 2023
Optimizing the Implementation of a Lifestyle Dementia Prevention Intervention for Older Patients in an Academic
Ryan A Mace1,2, Christopher Lyons1, Joshua E Cohen1
1Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Boston, MA, USA.
Background:
Interventions that promote healthy lifestyles are critical for the prevention of Alzheimer's disease and Alzheimer's disease related dementias (AD/ADRD). However, knowledge of the best practices for implementing AD/ADRD prevention in healthcare settings remains limited.
Objective:
We aimed to qualitatively identify barriers and facilitators to implementing a clinical trial of a novel lifestyle intervention (My Healthy Brain) in our medical center for older patients with subjective cognitive decline who are at-risk for AD/ADRD.
Methods:
We conducted focus groups with 26 healthcare professionals (e.g., physicians, psychology, nursing) from 5 clinics that treat older patients (e.g., memory care, psychiatry). Our qualitative analysis integrated two implementation frameworks to systematically capture barriers and facilitators to AD/ADRD prevention (Consolidated Framework for Implementation Science Research) that impact implementation outcomes of acceptability, appropriateness, and feasibility (Proctor's framework).
Results:
We found widespread support for an RCT of My Healthy Brain and AD/ADRD prevention. Participants identified barriers related to patients (stigma, technological skills), providers (dismissiveness of "worried well," doubting capacity for behavior change), clinics (limited time and resources), and the larger healthcare system (underemphasis on prevention). Implementation strategies guided by Expert Recommendations for Implementing Change (ERIC) included: developing tailored materials, training staff, obtaining buy-in from leadership, addressing stigmatized language and practices, identifying "champions," and integrating with workflows and resources.
Conclusions:
The results will inform our recruitment, enrollment, and retention procedures to implement the first randomized clinical trial of My Healthy Brain. Our study provides a blueprint for addressing multi-level barriers to the implementation of AD/ADRD prevention for older patients in medical settings.
More Related Videos
11:21Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
Published on: July 27, 2018
12:18A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Related Concept Videos
01:20Lifestyle Factors and Health
Benefits of Physical Activity
Physical activity, whether through structured exercise or casual activities like walking, biking, or dancing, is a cornerstone of a...
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:26Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
01:22Alzheimer's Disease: Treatment
01:24Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation
01:30Preventive Healthcare Services