| Poster | Poster Session 04 Program Schedule
02/15/2024
12:00 pm - 01:15 pm
Room: Shubert Complex (Posters 1-60)
Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology
Final Abstract #45
Preliminary Insights on Usability of a Remote App-Based Assessment of Cognition Among Older Adults with Normal Cognition
Kimberly Halberstadter, Temple University, Philadelphia, United States
Erin Liebenberg, University of Pennsylvania, Philadelphia, United States
Rachel Rovere, University of Pennsylvania, Philadelphia, United States
Valerie Humphreys, University of Pennsylvania, Philadelphia, United States
Dawn Mechanic-Hamilton, University of Pennsylvania, Philadelphia, United States
Category: Teleneuropsychology/ Technology
Keyword 1: neuropsychological assessment
Keyword 2: technology
Keyword 3: aging (normal)
Objective:
Mobile, valid, and engaging cognitive assessments are essential for detecting and tracking change in research participants and patients at risk for Alzheimer’s Disease and Related Dementias (ADRDs). Remote mobile assessments, such as the mobile cognitive app performance platform (mCAPP), may serve as cost-effective, accessible, and sensitive alternatives or adjuncts to paper-and-pencil neuropsychological testing. However, the utility and advantage of app-based measures among older adults relies upon the usability and adoptability of such technology. This study assesses participants’ subjective experiences with mCAPP, including quantitative and qualitative feedback.
Participants and Methods:
The mCAPP platform includes three gamified tasks measuring memory and executive functioning. Sixty older adults (73% female; age=74±4.8; years of education=17±2.4; 48% Black/African American) with normal cognition enrolled in the Penn Alzheimer’s Disease Research Center cohort completed one initial session of mCAPP in-person, followed by two weeks of at-home use. Experience with mobile technology was collected with the Mobile Device Proficiency Questionnaire (MDPQ-16), and usability of mCAPP was measured after participants’ first (T1) and final (TLast) sessions with the IBM Computer Usability Satisfaction Questionnaire (IBM) and the mHealth App Usability Questionnaire (MAUQ) respectively. Feedback on the mCAPP games was collected through questionnaires before and after at-home usage and through a semi-structured interview at the end of study participation. Interview responses were coded for distinct insights and thematically analyzed to determine common experiences among study participants, including successes and challenges with remote at-home testing.
Results:
Participants completed on average 12±5.1 mCAPP sessions over 2 weeks. The average MDPQ-16 total proficiency score was 33±5.7 (8-40 range), and 62% of participants reported experience with playing games on their personal mobile device. mCAPP usability ratings were high at T1 (8.2±1.2, IBM, 0-9 scale) and TLast (6.3±0.7, MAUQ, 1-7 scale), and perceived enjoyment and likelihood to play mCAPP games were high and increased over time. At the end of study participation, 71% of participants indicated a preference for app-based cognitive assessments over in-person testing. In the final semi-structured interview, only 23% of participants reported experiencing difficulties with the mCAPP app and 45% reported technology difficulties, most commonly with connecting the study phone to WiFi, navigating the device interface, or charging the study equipment. Regarding at-home use of mCAPP, 47% of participants expressed ease with integrating game-playing into their daily lifestyle, while the most common challenge mentioned was with scheduling or finding the time to play (27%). Recommendations for improvement included increased availability of game performance feedback and more scheduling flexibility (18% and 12% respectively).
Conclusions:
Participants were willing and able to complete at-home cognitive testing, and ratings of usability and enjoyment indicated high adoptability, and even preference for, such assessment methods. Despite relative ease of mobile app use and successful completion of expected at-home sessions, participants reported a number of challenges utilizing the technology itself and managing an at-home assessment schedule. These insights show preliminary feasibility of mobile app-based assessments and identify targets to improve remote testing in future work: 1) improving competence with at-home technology, 2) offering more flexibility in testing schedules, and 3) providing informative performance feedback.
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