The research proposed here will evaluate whether a web-based recreation intervention, called
      ArtontheBrain, has positive health benefits to older adult users. ArtontheBrain incorporates
      three basic activities; learning (history of the artwork), play (telling stories, solving
      puzzles) and socializing with other users, either in person or online. It can be used alone,
      with another person, or in a group. It is modeled after participatory arts-based
      interventions which studies have shown are associated with health benefits in older adults,
      such as improved sense of well-being, physical health, decreased risk of dementia, and
      reduced need for health services. Our study will test ArtontheBrain at research sites and
      health agencies in Canada, the U.S., and the U.K. with older adults with and without
      cognitive decline. The study will also examine how well that app can support different user
      play modalities and whether it can effect positive health outcomes similar to face-to-face
      arts interventions.

ArtontheBrain: An Inclusive Evidence-based Cognitive Health App for Older Adults to Promote Aging at Home

Cognitive Impairment

Mild Cognitive Impairment

Dementia

Age-related Cognitive Decline

Aging

Our project seeks to validate the positive health impacts of a mobile health (mhealth)
      intervention, called ArtontheBrain; a web-based application (app) aimed at promoting
      cognitive health in older adults, aging at home, through mentally and socially engaging
      recreation. The app was created in response to research showing: a) older adults with chronic
      health conditions experience reduced access to enjoyable recreation due to various barriers
      (e.g., sensory loss, cognitive decline, mobility limitations, geography and low mood); and b)
      participatory arts-based recreation is associated with health benefits in seniors (e.g.,
      enhanced well-being, improved physical health, decreased risk of dementia, and reduced use of
      healthcare resources). There are limited evidence-based solutions for consumers and this
      clinical validation will provide information about the efficacy of ArtontheBrain in achieving
      positive health outcomes to guide health practitioners and older adult consumers toward
      proven products.

      Based on quality of life (QOL) benefits for older adults, reported from participatory arts
      interventions, we hypothesize that engagement with ArtontheBrain will produce similar
      improvements in QOL in our study participants, driven by specific features of this type of
      intervention e.g., self-directed, flexible level of complexity, driven by the user. Secondary
      outcomes hypothesized for engagement with the intervention, include benefits to: active
      living, aspects of cognition (e.g., attention control, reasoning) and health seeking
      behaviours. These hypotheses are encouraged by findings from our initial pilot testing which
      showed improvement in self-perceived health-related QOL and reduced doctor visits in our
      pilot participants and established proof of principle for the ArtontheBrain with respect to
      positive user feedback on their experience with this recreation app.

ArtontheBrain

Seniors Online Victoria

The EQ-5D-5L comprises five dimensions on subjectively perceived quality of life in areas of: mobility, self-care, usual activities, pain/ discomfort, and anxiety/ depression. Participants report on a five-point scale whether they have no problems (1), slight problems (2), moderate problems (3), severe problems (4), or extreme problems (5). Then, using a visual analog scale from 0 to 100, individuals are asked to assess their momentary health state (100 indicating the best health state and 0 indicating the worst health state they can imagine).

The Short Warwick-Edinburg Mental Well-Being Scale (WEMWBS) is a 7-item scale designed to measure mental well-being over the previous two weeks. Each statement is positively phrased and measured along a 5-point Likert scale ranging from 1(i.e., never) to 5 (i.e., always). Questions include: "I've been feeling optimistic about the future"; "I've been dealing with problems well"; "I've been able to make up my mind about things".

The Short-Form Health Survey (SF-36) is composed of 36-items that measure health across eight domains including physical functioning, role limitations due to physical health, role limitations due to emotional problems, energy/ fatigue, emotional well-being, social functioning, pain and general health.

The Stanford Chronic Disease Questionnaire Medical Care section evaluates individuals of health care utilization occurring in the previous six months. It comprises 4 items of three types of health care utilization: physician visits, emergency room visits, and hospitalization.

Psychologist

The Physical Activity Scale for the Elderly (PASE) is a self-report measure of physical activity in older adults. The PASE comprises 10 items of leisure, household, and occupational activities occurring over the previous seven days. Items on the PASE are scored by multiplying the time spent (i.e., hours per week) or participation (i.e., yes or no) with empirically derived weights. Higher scores indicate higher levels of physical activity.

The Social Engagement Survey evaluates an individual's level of social engagement by their social network size, social activities and social support. In the first section, social network size is measured by asking participants to list the names of people in their lives who meet the following criteria: 1) someone with whom you feel close and can talk about personal matters; and 2) someone you have contact with at least once per month. The next section comprises 6-items of social activities measured along a 5-point Likert scale ranging from 1 (i.e., once a year or less) to 5 (i.e., every day or nearly every day) and participants are to report whether they have engaged in that activity in the past year. In the last section, participants are to respond along a 7-point Likert scale ranging from 1 (i.e., very strongly disagree) to 7 (i.e., very strongly agree) on 4-items pertaining to social support.

The Alternative Uses Task was designed to evaluate divergent thinking abilities by asking participants to generate as many uses as possible for a given item within the span of one minute. The following six items will be selected from: eyeglasses, shoes, keys, button, wooden pencil and automobile tire. Participant's responses will be recorded and scored for standard measures of divergent thinking including: fluency, flexibility, appropriateness, elaboration and originality

The Forward and Backward Digit Span subtests will be used in the present study as they are associated with central executive functioning in older adults, and with arts-related competence and training. In the forward span subtest, the experimenter will read out a sequence of numbers at the rate of 1 digit/s and the participant will be instructed to recall the numbers in the same order. In the backward span sub test, the participant will recall the numbers in reverse order.

The Means-End Problem Solving (MEPS) test is a standardized measure comprising 10 vignettes, each with a social problem. The participants are given the beginning of the problem and the end of the problem and are asked to describe in detail the middle part of the story out loud. Participants are given as much time as they may need to fully describe their solutions and a general probe is given after each solution described (e.g., Can you think of anything else that you would like to add to this story?) to ensure all details are described and recorded.

Engagement in arts-related activities occurring in the previous year will be assessed using the Arts Engagement Survey. Briefly, the survey quantifies art engagement by asking participants questions about participation, learning, work/ volunteering and arts-related membership. For each item, participants are asked whether or not they engaged in that event, and if so, approximately how many days or how many hours they spent engaging in that activity or event.

The Life Space Questionnaire (LSQ) is a brief survey that asks participants to reflect on the extent of their range of travel within and outside the home occurring in the previous three days. It comprises nine items with each item addressing a specific life-space zone. The LSQ is a valid and reliable measure that is useful for establishing the spatial extent for mobility among older adults.

The Autobiographical Interview was designed to assess autobiographical memory using a text- based analysis of transcribed protocols. Participants are asked to provide a detailed description of a significant personal event, for example, from early childhood, teenage years, early adulthood, and the past year. Each memory is assessed across free recall, general probe, and specific probe conditions

ArtontheBrain application for about 30 to 45 minutes twice per week, over 6 weeks.

Senior Online Victoria games for about 30 to 45 minutes twice per week, over 6 weeks (https://www.seniorsonline.vic.gov.au/services-information/games), after which they will participate in the ArtontheBrain intervention.

The waitlist control group will no treatment for 6 weeks, after which they will six weeks of the ArtontheBrain intervention.

ArtontheBrain: An Inclusive Evidence-based Cognitive Health App for Older Adults to Promote Aging at Home

About this trial

Study ID

Status

Type

Phase

Placebo

Accepting

Trial Timing

What is this trial about?

What are the participation requirements?