Introducing the Adherence Promotion with Person-centered Technology (APPT) trial: Rationale, methods, and baseline...

Home-based cognitive training programs delivered via computers and tablets hold promise as cost-effective, population-level interventions to prevent or mitigate age-related cognitive decline. However, adherence to such programs is often low. Using message-tailoring techniques and an adaptive algorithm, we developed a person-centered reminder smart system that delivers motivational messages at times when participants are predicted to be available for training activities. This paper presents the background, study design, methodology, and baseline data for a randomized controlled trial examining the system's efficacy in supporting adherence to cognitive training. A total of 199 cognitively normal, community-dwelling older adults aged 62 to 88 were randomly assigned (1:1) to either the smart reminder or the control condition. Participants were instructed to engage in training activities for 30 min per day, five days per week, for 18 consecutive weeks. Those in the smart reminder condition received personalized messages, delivered at optimized times, and with targeted content, while those in the control condition received generic messages at a fixed time. Adherence rate will be the primary outcome measure, calculated and compared across conditions. Findings from this study will have implications not only for adherence support in cognitive training but also for broader applications of technology-mediated smart reminder systems, including physical exercise, nutrition, medication management, telehealth, and social connectivity. By enhancing intervention engagement, these systems have the potential to improve the health and well-being of older adults on a large scale.