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Online cognitive stimulation therapy for dementia in Brazil and India: acceptability, feasibility, and lessons for implementation

Online cognitive stimulation therapy for dementia in Brazil and India: acceptability, feasibility, and lessons for implementation

Fisher, Emily ORCID: 0000-0002-8110-8405 , Venkatesan, Shreenila ORCID: 0009-0008-6231-9232 , Benevides, Pedro ORCID: 0009-0001-8985-7857 , Bertrand, Elodie ORCID: 0000-0002-8361-8548 , Brum, Paula Schimidt ORCID: 0000-0001-5041-9772 , El Baou, Céline ORCID: 0000-0002-7212-1835 , Ferri, Cleusa P ORCID: 0000-0002-1815-7685 , Fossey, Jane ORCID: 0000-0002-8533-3263 , Jelen, Maria ORCID: 0000-0002-9729-1208 , Laks, Jerson ORCID: 0000-0002-0022-3162 , Liu, Lisa ORCID: 0009-0002-2219-5155 , Mograbi, Daniel C ORCID: 0000-0002-4271-2984 , Natarajan, Nirupama ORCID: 0000-0002-1881-8877 , Naylor, Renata ORCID: 0009-0000-3349-2927 , Pantouli, Despina ORCID: 0009-0003-5216-623X , Ramanujam, Vaishnavi ORCID: 0000-0002-9290-7114 , Rangaswamy, Thara ORCID: 0000-0001-6813-066X , Santos de Carvalho, Raquel L ORCID: 0000-0001-7460-901X , Stoner, Charlotte R. ORCID: 0000-0002-1536-4347 , Vaitheswaran, Sridhar ORCID: 0000-0001-7848-7638 and Spector, Aimee ORCID: 0000-0003-4448-8143 (2024) Online cognitive stimulation therapy for dementia in Brazil and India: acceptability, feasibility, and lessons for implementation. JMIR Aging, 7:e55557. pp. 1-16. ISSN 2561-7605 (doi:https://doi.org/10.2196/55557)

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Abstract

Background: Cognitive stimulation therapy (CST) is an evidence-based, group psychosocial intervention for people with dementia, and it has a positive impact on cognition and quality of life. CST has been culturally adapted for use globally. It was developed as a face-to-face intervention but has recently been adapted for online delivery.
Objective: In this study, we aimed to explore the feasibility and acceptability of online or virtual CST (vCST) delivery in India and Brazil, emphasizing barriers and facilitators to implementation.
Methods: A single-group, multisite, mixed methods, feasibility study was conducted, with nested qualitative interviews. Primary feasibility outcomes were recruitment rate, attendance, attrition, acceptability, and outcome measure completion. Exploratory pre- and postintervention measures, including cognition and quality of life, were assessed. Qualitative interviews were conducted with people with dementia, family caregivers, and group and organizational leaders following intervention delivery, and the data were analyzed using the Consolidated Framework for Implementation Research.
Results: A total of 17 vCST group sessions with 59 participants were conducted for 7 weeks, with 53% (31/59) of participants attending all 14 sessions. Attrition rate was 7% (4/59), and outcome measure completion rate at follow-up was 68% (40/59). Interviews took place with 36 stakeholders. vCST was acceptable to participants and group leaders and enabled vital access to services during pandemic restrictions. While online services broadened geographic access, challenges emerged concerning inadequate computer literacy, poor technology access, and establishing interpersonal connections online. Exploratory, uncontrolled analyses indicated positive trends in quality of life but negative trends in cognition and activities of daily living, but these results were not statistically significant.
Conclusions: vCST demonstrated feasibility and acceptability, serving as a crucial resource during the pandemic but raised challenges related to technology access, computer literacy, and long-term implementation. The study highlights the potential of vCST while emphasizing ongoing development and solutions to address implementation challenges.

Item Type: Article
Uncontrolled Keywords: psychosocial; intervention; technology; COVID-19; LMIC; low and middle income countries
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > R Medicine (General)
T Technology > T Technology (General)
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Mental Health
Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified: 18 Jun 2024 13:05
URI: http://gala.gre.ac.uk/id/eprint/47454

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