Targeting Lifestyle Behavior to Improve Brain Health: User-Experiences of an Online Program for Individuals with Subjective Cognitive Decline

Background Online programs targeting lifestyle have the potential to benefit brain health. We aimed to develop such a program for individuals with subjective cognitive decline (SCD). These individuals were reported to be at increased risk for dementia, and report both an intrinsic need for brain health information and motivation to participate in prevention strategies. Co-creation and user-evaluation benefits the adherence to and acceptance of online programs. Previously, we developed a prototype of the online program in co-creation with the users. Objectives We now aimed to evaluate the user-experiences of our online lifestyle program for brain health. Design 30-day user test; multi-method. Setting Participants were recruited in a memory clinic and (online) research registries in the Netherlands (Alzheimer Center Amsterdam) and Germany (Center for memory disorders, Cologne). Participants Individuals with SCD (N=137, 65 +/- 9y, 57% female). Measurements We assessed user-experiences quantitatively with rating daily advices and usefulness, satisfaction and ease of use questionnaires as well as qualitatively using telephone interviews. Results Quantitative data showed that daily advices were rated moderately useful (3.5 +/- 1.5, range 1-5 points). Participants (n=101, 78%) gave moderate ratings on the programs' usability (3.7 +/- 1.3, max 7), ease of learning (3.6 +/- 1.9) and satisfaction (4.0 +/- 1.5), and marginal ratings on the overall usability (63.7 +/- 19.0, max 100). Qualitative data collected during telephone interviews showed that participants highly appreciated the content of the program. They elaborated that lower ratings of the program were mainly due to technical issues that hindered a smooth walk through. Participants reported that the program increased awareness of lifestyle factors related to brain health. Conclusions Overall user-experience of the online lifestyle program was moderate to positive. Qualitative data showed that content was appreciated and that flawless, easy access technique is essential. The heterogeneity in ratings of program content and in program use highlights the need for personalization. These findings support the use of online self-applied lifestyle programs when aiming to reach large groups of motivated at-risk individuals for brain health promotion.