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Published on: May 7, 2021
Ecological Momentary Intervention for Memory in Chronic Traumatic Brain Injury: Findings From a Mixed-Methods Pilot
Emily L Morrow1, Lyndsay A Nelson, Melissa C Duff
1Author Affiliations: Division of General Internal Medicine & Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (Drs Morrow, Nelson, and Mayberry) and Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Duff).
Objective:
To examine acceptability and feasibility of a technology-delivered memory assessment and intervention tool (MEMI, memory ecological momentary intervention) and its intended delivery schedule for adults with chronic traumatic brain injury (TBI). MEMI introduces new information, cues retrieval, and assesses learning via text messages.
Setting:
Community sample from Vanderbilt Brain Injury Patient Registry in Nashville, TN, USA.
Participants:
20 adults with chronic, moderate-severe TBI and 20 non-injured comparison (NC) participants matched on age, sex, and education.
Design:
In this crossover study, participants used MEMI for two weeks: one in which they completed all learning in a single session to approximate standard memory rehabilitation (Blocked schedule) and one in which retrievals were spaced in short, twice-daily sessions (Spaced, intended delivery schedule).
Main Measures:
The primary pilot outcomes were feasibility (session engagement) and acceptability (Acceptability of Intervention Measure). In a preliminary analysis, we also assessed delayed free recall of trained information. We also report supplementary data on participant surveys and cued recall.
Results:
Participants in both groups were highly engaged and rated the tool as acceptable. On average, the TBI group rated acceptability of the Spaced schedule higher than the Blocked schedule. Both groups remembered more words at the end of the week in the Spaced schedule (TBI: t (17) = 4.37, p <.001, 95% CI [2.79, 7.99]; NC: t (19) = 8.57, p <.001, 95% CI[5.13, 8.46]).
Conclusions:
In this pilot study, spaced retrieval via MEMI was feasible and acceptable for adults with chronic TBI. MEMI has potential as a memory assessment and intervention tool in both therapeutic and research contexts. Future work should include a larger trial to assess MEMI's efficacy, clinical utility, individual differences, and personalizing content.
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