An Agile Development Cycle of a Web-Based Memory Intervention Program for Healthy Older Adults

The Memory and Aging Program is an in-person psychoeducation intervention for healthy older adults provided at Baycrest Health Sciences. The program has been shown to significantly increase participants' memory knowledge, strategy use, and satisfaction with their memory, promote healthier lifestyle behaviors, and decrease intentions to seek unnecessary medical attention. To increase outreach, a web-based version of the program was created through an agile development cycle: an iterative process involving end-users feedback. The current thesis outlines this process according to the four translational (T) phases of the Clinical and Translational Research Spectrum. First, an overview of the design phase (T1) is provided. In the T2 phase, 26 older adults participated in piloting of individual modules. Additionally, 20 older adults completed the program in its entirety from their homes (T3). Qualitative feedback, results of memory measures, lessons learned for tailoring the e-learning experience to older adults, and next steps (T4) are discussed

An agile development cycle of an online memory program for healthy older adults

Online interventions for older adults should be tailored to their unique needs to increase the efficacy of and adherence to the intervention. The agile development cycle is a dynamic model to solicit and incorporate feedback from older adults during the design process. We combined this approach with the framework of Harvard University’s clinical and translational phases that provide a clear structure for evaluating new health programs before they are offered in the community. We based our online memory program on the empirically validated in-person Memory and Aging Program. The aim of the present study was to combine the agile development cycle with the clinical and translational phases framework to develop and pilot an online memory program tailored to the unique needs of older adults. Study 1 involved piloting individual program modules on site and integrating participant feedback into the program’s design to optimize usability. Study 2 involved two sequential pilots of the program accessed remotely to evaluate preliminary clinical outcomes and obtain feedback for iterative modifications. Plans for further validation and limitations are discussed. The successful application of the agile development cycle implemented in this series of studies can be adapted by others seeking to offer online content for targeted end users. Les interventions en ligne pour les personnes âgées doivent être adaptées à leurs besoins spécifiques afin d’augmenter leur efficacité et l’adhésion des utilisateurs. Le cycle de développement agile est un modèle dynamique permettant de solliciter et d’intégrer les commentaires des personnes âgées au cours du processus de conception. Nous avons combiné cette approche avec le Cadre des phases cliniques et translationnelles de l’université Harvard qui fournit une structure claire pour évaluer les nouveaux programmes de santé avant qu’ils ne soient proposés dans la communauté. Nous avons élaboré notre programme en ligne sur la mémoire à partir du programme sur la mémoire et le vieillissement qui se donnait en présentiel, et qui avait été validé empiriquement. L’objectif de l’étude était d’associer le cycle de développement agile avec le Cadre des phases cliniques et translationnelles pour concevoir et tester un programme pilote en ligne sur la mémoire qui est adapté aux besoins uniques des personnes âgées. L’étude no 1 a permis de tester dans une phase pilote les modules individuels du programme avec des participants présents sur place, et à intégrer leurs commentaires lors du développement du programme afin d’en optimiser la convivialité. L’étude no 2 a consisté en deux pilotes séquentiels du programme accessibles à distance dans lesquels les résultats cliniques préliminaires ont été évalués et des commentaires ont été collectés pour guider les modifications itératives. Les plans pour une validation ultérieure et les limites des études sont discutés. L’application réussie du cycle de développement agile mis en œuvre dans cette série d’études pourra être adaptée par d’autres équipes souhaitant proposer un contenu en ligne à des groupes d’utilisateurs finaux plus spécifiques

A Self-Guided E-Learning Program Improves Metamemory Outcomes in Healthy Older Adults: A Randomized Controlled Trial

The majority of older adults will experience normal age-related memory changes. Memory programs offer a promising solution to mitigate decline and promote brain health. Memory programs have evolved over time, progressing from single mnemonic techniques to the combination of mnemonics, then to multicomponent programs offering participants a more holistic approach to enhancing their memory and brain health. A large body of literature demonstrates that in-person memory interventions can increase knowledge, support the acquisition of memory strategies, improve metamemory outcomes, and promote healthy lifestyle behaviors among participants. With the advancement of technology and the goal of attaining scalable and accessible solutions, researchers and clinicians are developing online memory programs. Our team developed a self-guided, e-learning program based on the well-validated, in-person Memory and Aging Program®. The objective of this dissertation was to evaluate efficacy of the e-learning program compared to a waitlisted control group through a randomized controlled trial. The trial was registered at clinicaltrials.gov (identifier: NCT03602768). As part of a larger, multi-arm, controlled trial, 115 healthy older adults (ages 60-84, 71% female) were randomized into an intervention or a delayed-start control condition. Team members involved in data collection were masked to participant grouping. Outcome measures were completed by telephone interviews (assessing memory knowledge) and online questionnaires (assessing metamemory and health-promoting lifestyle behaviors) at three time points (pre-program, post-program, and 6- to 8-week follow-up). Reasons for attrition were explored with a brief feedback survey. Improvements over time in memory knowledge, the acquisition of memory strategies and their use in daily life, and memory satisfaction and ability were larger in the group that completed the intervention than the control group. There was no interaction effect for health-promoting lifestyle changes. Attrition was 43%, and the most common participant-reported reasons for attrition included a breakdown in communication, personal circumstances, dissatisfaction with the e-learning program, and technical/instructional issues. Overall, this self-guided, e-learning memory program may be an effective, accessible, flexible, and potentially cost-effective intervention that has the potential to achieve similar metamemory outcomes as the original in-person version in participants that complete the program. This research identified opportunities to design e-learning interventions to better support healthy lifestyle changes and potentially improve participant retention. Findings are discussed in relation to evidence-based practice in psychology