A clinician implementation protocol for BetterBrains: An online, person-centred risk factor management program to prevent cognitive decline

Objective: Modifiable risk factors, particularly those in midlife, can contribute to cognitive decline and dementia. Despite this, the 'how' of dementia risk reduction, including the application of interventional and care frameworks to deliver such a program is lacking. Our aim was to describe the 'how' in clinical delivery of a dementia risk reduction program called BetterBrains. Methods: BetterBrains is an online, person-centred risk factor management program designed to prevent or delay cognitive decline in cognitively unimpaired community-dwelling, middle-aged adults with a family history of dementia. This protocol describes the delivery and implementation of BetterBrains using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Results: Procedures for risk factor assessment and tailored management pathways using motivational interviewing, nationwide community linkage mapping and community referral pathways using digital delivery are outlined. Coach training and competency checks for program fidelity measures are also described. Conclusion: Complex, multi-component programs require detailed implementation processes. Clinicians delivering BetterBrains may be better supported through standardised operating procedures, training and monitoring of competencies and implementation fidelity.