初级保健就诊前老年人认知筛查工具的远程自我管理:MyCog移动筛查应用程序可靠性和可用性的试点横断面研究

Remote Self-Administration of Cognitive Screeners for Older Adults Prior to a Primary Care Visit: Pilot Cross-Sectional Study of the Reliability and Usability of the MyCog Mobile Screening App.

作者信息

Young Stephanie Ruth, Dworak Elizabeth McManus, Byrne Greg Joseph, Jones Callie Madison, Yao Lihua, Yoshino Benavente Julia Noelani, Diaz Maria Varela, Curtis Laura, Gershon Richard, Wolf Michael, Nowinski Cindy J

机构信息

Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.

Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.

出版信息

JMIR Form Res. 2024 Feb 7;8:e54299. doi: 10.2196/54299.

Abstract

BACKGROUND

Routine cognitive screening is essential in the early detection of dementia, but time constraints in primary care settings often limit clinicians' ability to conduct screenings. MyCog Mobile is a newly developed cognitive screening system that patients can self-administer on their smartphones before a primary care visit, which can help save clinics' time, encourage broader screening practices, and increase early detection of cognitive decline.

OBJECTIVE

The goal of this pilot study was to examine the feasibility, acceptability, and initial psychometric properties of MyCog Mobile. Research questions included (1) Can older adults complete MyCog Mobile remotely without staff support? (2) Are the internal consistency and test-retest reliability of the measures acceptable? and (3) How do participants rate the user experience of MyCog Mobile?

METHODS

A sample of adults aged 65 years and older (N=51) self-administered the MyCog Mobile measures remotely on their smartphones twice within a 2- to 3-week interval. The pilot version of MyCog Mobile includes 4 activities: MyFaces measures facial memory, MySorting measures executive functioning, MySequences measures working memory, and MyPictures measures episodic memory. After their first administration, participants also completed a modified version of the Simplified System Usability Scale (S-SUS) and 2 custom survey items.

RESULTS

All participants in the sample passed the practice items and completed each measure. Findings indicate that the Mobile Toolbox assessments measure the constructs well (internal consistency 0.73 to 0.91) and are stable over an approximately 2-week delay (test-retest reliability 0.61 to 0.71). Participants' rating of the user experience (mean S-SUS score 73.17, SD 19.27) indicated that older adults found the usability of MyCog Mobile to be above average. On free-response feedback items, most participants provided positive feedback or no feedback at all, but some indicated a need for clarity in certain task instructions, concerns about participants' abilities, desire to be able to contact a support person or use in-app technical support, and desire for additional practice items.

CONCLUSIONS

Pilot evidence suggests that the MyCog Mobile cognitive screener can be reliably self-administered by older adults on their smartphones. Participants in our study generally provided positive feedback about the MyCog Mobile experience and rated the usability of the app highly. Based on participant feedback, we will conduct further usability research to improve support functionality, optimize task instructions and practice opportunities, and ensure that patients feel comfortable using MyCog Mobile. The next steps include a clinical validation study that compares MyCog Mobile to gold-standard assessments and tests the sensitivity and specificity of the measures for identifying dementia.

摘要

背景

常规认知筛查对于早期发现痴呆症至关重要,但基层医疗环境中的时间限制常常制约临床医生进行筛查的能力。MyCog Mobile是一款新开发的认知筛查系统,患者在基层医疗就诊前可在智能手机上自行操作,这有助于节省诊所时间,鼓励更广泛的筛查实践,并提高对认知衰退的早期检测率。

目的

本试点研究的目的是检验MyCog Mobile的可行性、可接受性和初步心理测量特性。研究问题包括:(1)老年人能否在无工作人员支持的情况下远程完成MyCog Mobile?(2)这些测量方法的内部一致性和重测信度是否可接受?(3)参与者如何评价MyCog Mobile的用户体验?

方法

65岁及以上的成年人样本(N = 51)在2至3周的间隔内两次在智能手机上远程自行操作MyCog Mobile测量方法。MyCog Mobile的试点版本包括4项活动:MyFaces测量面部记忆,MySorting测量执行功能,MySequences测量工作记忆,MyPictures测量情景记忆。在首次操作后,参与者还完成了简化系统可用性量表(S-SUS)的修改版和2个定制调查项目。

结果

样本中的所有参与者都通过了练习项目并完成了各项测量。结果表明,移动工具箱评估能很好地测量这些结构(内部一致性为0.73至0.91),并且在大约2周的延迟后保持稳定(重测信度为0.61至0.71)。参与者对用户体验的评分(S-SUS平均得分73.17,标准差19.27)表明老年人认为MyCog Mobile的可用性高于平均水平。在自由回答反馈项目中,大多数参与者提供了积极反馈或根本没有反馈,但一些人表示某些任务说明需要更清晰,担心参与者的能力,希望能够联系支持人员或使用应用内技术支持,以及希望有更多练习项目。

结论

试点证据表明,MyCog Mobile认知筛查器可由老年人在智能手机上可靠地自行操作。我们研究中的参与者通常对MyCog Mobile体验给予积极反馈,并对该应用的可用性给予高度评价。根据参与者的反馈,我们将进行进一步的可用性研究,以改进支持功能,优化任务说明和练习机会,并确保患者在使用MyCog Mobile时感到舒适。下一步包括一项临床验证研究,将MyCog Mobile与金标准评估进行比较,并测试这些测量方法在识别痴呆症方面的敏感性和特异性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a0c/10882476/cf96fbd38090/formative_v8i1e54299_fig1.jpg

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