Boosting Older Adults' Cognition by Training Real-World eHealth Skills



 DESCRIPTION (provided by applicant): Older adults face a range of medical decisions. Effective decision-making requires access to reliable information and the coordination of cognitive processes such as attention, memory, and reasoning. Age-related declines in health-related decision-making processes have been observed and attributed to insufficient familiarity with health-related information and declines in cognition. The Internet has the potential to meet older adults' needs for a diverse range of health information. Yet, age-related declines in cognitive abilities and a lack of age-appropriate training make it challenging for older adults to take full advantage of the technology. Thus, there is a dire need for interventions that can 1) improve older adults' ability to obtain and evaluate online health information, and 2) strengthen cognitive processes that are key to daily health-related behaviors (e.g., information seeking for informed health decision-making). To address this need, the proposed study will develop and evaluate a 3-month intervention designed to teach older adults how to obtain and evaluate online health information and improve cognitive function. This intervention represents a theoretically motivated extension of our team's pilot research on computer training to teach older adults how to find reliable health information on the Internet. The proposed intervention incorporates three key principles: 1) collaborative learning, 2) a range of activities that depend on a combination of cognitive processes, and 3) real world problem solving. The intervention will be evaluated via a randomized controlled trial with a 2 x 2 x 2 mixed factorial design, with degree of engagement in a collaborative learning program (high engagement; low engagement) and cognitive training (present; absent) as the between-subjects variables and time of measurement (pre; post;) as the within-subjects variable. The proposed study has the following specific aims: Aim 1: To develop training curricula (problem sets and activities that are relevant to older adults' everyday life decisions regarding health) collaboratively with and among older adults to promote older adults' ability to obtain and evaluate online health information. Aim 2: To determine if the combination of high engagement in collaborative learning plus cognitive training yields larger or broader improvements in older adults' ability to obtain and evaluate online health information, cognitive performance (attention, working memory, reasoning, retrospective memory and prospective memory), and health decision-making from pre- to post-intervention than either alone. Aim 3: To determine if there are independent effects of the degree of engagement (high engagement; low engagement) in a collaborative learning program and/or cognitive training (presence; absence) on these outcomes from pre- to post-intervention.