Perceptions About Dyadic Physical Activity Intervention for Rural-Dwelling People With Cognitive Impairment

Rural populations face an elevated risk of Alzheimer's disease and related dementias partially attributed to modifiable risk factors such as physical inactivity. The study gathered key community partners' perspectives about (a) feasibility of implementing the telerehabilitation physical activity behavioral (TPAB) intervention, a virtual program aimed at increasing daily stepping with sensor-based monitoring, and (b) necessary adaptions for implementation for rural-dwelling people with cognitive impairment and care partners (dyads).

Eleven rural-dwelling individuals (three medical providers, four older adults, and four care partners of individuals with mild cognitive impairment) in Nebraska were recruited for a focus group via fliers and word of mouth. The person-based approach was used to gain the perspectives of participants during a 1-hr group discussion regarding six dimensions of feasibility. Session transcriptions were analyzed using thematic analysis.

Participants highlighted the need to improve physical activity in the community and supported care partners receiving TPAB alongside individuals with mild cognitive impairment. Suggested modifications to TPAB included, establishing a local champion, integrating local resources, involving primary care providers, setting recruitment deadlines, using participant testimonies for recruitment, and emphasizing program individualization.

Overall, participants perceived TPAB was practical, feasible, and necessary for rural-dwelling participants with cognitive impairment and their care partners; however, several adaptations and the creation of the Cognitive Impairment Rural Community-TPAB are required to optimize rural implementation. Significance/Implications: There is an identified need for the TPAB intervention with outlined redesign approaches to facilitate intervention development and rural implementation.