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

 描述(由申请人提供)：老年人面临一系列的医疗决定。有效的决策需要获得可靠的信息，并协调注意力、记忆和推理等认知过程。已观察到与健康有关的决策过程中与年龄有关的下降，并将其归因于对与健康有关的信息不够熟悉和认知能力下降。互联网有潜力满足老年人对各种健康信息的需求。然而，与年龄相关的认知能力下降，以及缺乏与年龄相适应的培训，使得老年人要充分利用这项技术具有挑战性。因此，迫切需要以下干预措施：1)提高老年人获取和评估在线健康信息的能力，2)加强对日常健康相关行为至关重要的认知过程(例如，为知情的健康决策寻求信息)。为了满足这一需求，这项拟议的研究将开发和评估一项为期3个月的干预措施，旨在教老年人如何获取和评估在线健康信息，并改善认知功能。这一干预措施代表了我们团队关于计算机培训的试点研究在理论上的扩展，目的是教老年人如何在互联网上找到可靠的健康信息。建议的干预包括三个关键原则：1)协作学习，2)一系列依赖于认知过程的活动，3)解决现实世界的问题。干预措施将通过2x2x2混合析因设计的随机对照试验进行评估，参与协作学习计划的程度(高敬业度；低敬业度)和认知训练(出席；缺席)为受试者之间的变量，测量时间(Pre；Post；)为受试者内的变量。拟议的研究有以下具体目标：目标1：与老年人合作并在老年人之间制定培训课程(与老年人关于健康的日常生活决定有关的问题集和活动)，以提高老年人获取和评估在线健康信息的能力。目标2：实现 确定在老年人获取和评估在线健康的能力方面，高参与度协作学习和认知训练的组合是否会产生更大或更广泛的改善 信息、认知表现(注意力、工作记忆、推理、回溯记忆和前瞻记忆)和健康决策从干预前到干预后都不是单独的。目的3：确定从干预前到干预后，合作学习项目的参与度(高参与度；低参与度)和/或认知训练(在场、缺席)是否对这些结果有独立影响。

 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.