Design and evaluation of a cognitive health education pilot program according to the RE-AIM framework

PLoS One. 2021 Dec 3;16(12):e0260934. doi: 10.1371/journal.pone.0260934. eCollection 2021.

Abstract

Objective: Most formats of currently used community-based health education for cognitive impairment prevention are limited to one-way communication, such as distributing leaflets, pasting posters, or holding a lecture, and they lack comprehensive evaluation. Here we aim to design, test, and evaluate a novel pilot cognitive health education program combined with psychosocial interventions (CHECPI).

Methods: We designed the CHECPI program and tested it among adults aged 60 and over in an aging-friendly community in 2018. Multidimensional cognitive functions were measured by the Montreal Cognitive Assessment (MoCA) before and three months after the CHECPI program. Quantitative and qualitative analyses were performed based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. Wilcoxon signed-rank tests were used to assess changes in multidimensional cognitive functions.

Results: The CHECPI program was comprised of 12 courses and introduced 5 kinds of psychosocial interventions. Reach: 28 older adults participated in the program, of whom most were female (n = 22) and younger elderly with an average age of 65.32 years. Effectiveness: 19 participants finished≥6 courses as well as the follow-up survey. Although their MoCA scores did not improve significantly, they had increased their visuospatial ability significantly (with the average score increasing by 0.42). Adoption: the community officers, lecturers, and participants highly recommended the program, but they agreed that the lack of professional instructors may hinder its popularization. Implementation: the program was implemented in full accordance with the pre-program design. Maintenance: three months after the program, 17 participants had maintained at least one of the seven healthy behaviors that were introduced in the program.

Conclusions: Younger female elderly were more willing to participate in the program. It enhanced participants' visuospatial ability, but a sufficient number of professional instructors are crucial for large-scale promotion.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aging*
  • Case-Control Studies
  • Cognition / physiology*
  • Female
  • Health Behavior / physiology*
  • Health Education / methods*
  • Health Plan Implementation*
  • Health Promotion / methods*
  • Humans
  • Male
  • Pilot Projects
  • Research Design

Grants and funding

This work was supported by the National Natural Science Foundation of China (81573257 and 81973144) (URL: http://www.nsfc.gov.cn/) awarded to Ya Fang, Education and scientific research project of young and middle-aged teachers in Fujian Education Department (grant number JT180007) (URL: http://jyt.fujian.gov.cn/) awarded to Manqiong Yuan, and the Natural Science Foundation of Fujian Province (grant number 2016J01408) (URL: http://kjt.fujian.gov.cn/) awarded to Ya Fang. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.