Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
Department of Geriatric Medicine, Radboud Institute of Health Science, Radboud University Medical Centre, Nijmegen, Netherlands.
Neuropsychol Rev. 2023 Mar;33(1):238-254. doi: 10.1007/s11065-022-09537-4. Epub 2022 Feb 14.
We aimed to describe behaviour change techniques (BCT) used in trials evaluating computerised cognitive training (CCT) in cognitively healthy older adults, and explore whether BCTs are associated with improved adherence and efficacy. The 90 papers included in a recent meta-analysis were reviewed for information about adherence and use of BCTs in accordance with the Behaviour Change Taxonomy. Studies using a specific BCT were compared with studies not using that BCT on efficacy (difference in Hedges' g [Δg]) using three level meta-regression models and on median adherence using the Wilcoxon test. The median number of BCTs per study was 3 (interquartile range [IQR] = 2-5). 'Feedback on behaviour' (if provided by a person; Δg = -0.19, 95% confidence interval [CI] = -0.31;-0.07) and 'non-specific reward' (Δg = -0.19, CI = -0.34;-0.05) were associated with lower efficacy. Certain BCTs that involve personal contact may be beneficial, although none were statistically significantly associated with greater efficacy. The median percentage of adherence was 90% (IQR = 81-95). Adherence was higher in studies using the BCT 'self-monitoring of behaviour' and lower in studies using the BCT 'graded tasks' than studies not using these BCTs (p < 0.001). These findings provide first evidence that BCTs can influence both adherence to and efficacy of CCT programs in cognitively healthy older adults.
我们旨在描述评估认知健康老年人计算机认知训练（CCT）的试验中使用的行为改变技术（BCT），并探讨 BCT 是否与改善依从性和疗效相关。根据行为改变分类法，对最近一项荟萃分析中包含的 90 篇论文进行了审查，以获取有关依从性和 BCT 使用情况的信息。使用特定 BCT 的研究与未使用该 BCT 的研究在疗效（Hedges'g [Δg] 的差异）上进行了比较，使用三级荟萃回归模型，在中位数依从性上使用 Wilcoxon 检验。每项研究的 BCT 中位数为 3 个（四分位距 [IQR] = 2-5）。“行为反馈”（如果由人提供；Δg = -0.19，95%置信区间 [CI] = -0.31；-0.07）和“非特定奖励”（Δg = -0.19，CI = -0.34；-0.05）与疗效降低相关。某些涉及个人联系的 BCT 可能是有益的，尽管没有一个与更高的疗效有统计学显著关联。依从性的中位数为 90%（IQR = 81-95）。与未使用这些 BCT 的研究相比，使用“行为自我监测”BCT 的研究的依从性更高，而使用“分级任务”BCT 的研究的依从性更低（p < 0.001）。这些发现首次提供了证据，表明 BCT 可以影响认知健康老年人的 CCT 计划的依从性和疗效。
