Collaborative co‐design of an active and healthy ageing program using mobile technology to reduce dementia risk in older Aboriginal Australians

Abstract

AbstractBackgroundHigh rates of dementia have been observed in Aboriginal Australians and dementia risk reduction is a priority in this population. The Koori Active and Healthy Ageing Project aimed to develop new, effective, culturally appropriate healthy brain ageing approaches in collaboration with older Aboriginal people and partner communities in regional and urban Australia.MethodInitially, 34 semi‐structured interviews and 2 yarning (focus) groups were conducted with older Aboriginal participants to understand perceptions regarding community health priorities, preferences for healthy ageing programs and acceptability of technology as a platform for program delivery. Following consultation and development, a pilot randomised control trial (RCT) was conducted over 16 weeks, to evaluate the feasibility of a new program versus a health education control condition in 30 Aboriginal people aged 45+ years. The primary outcome included dual‐task walking. Trial registration ID: ACTRN12619001130156.ResultQualitative interviews identified key health concerns including memory loss, mobility, depression, and access to healthcare services. Using self‐directed technology for healthy ageing was widely supported, however, the importance of maintaining social group connections was emphasised. StandingTall is an unsupervised balance exercise program delivered using mobile technology for older people and was the preferred option selected in yarning groups. With further consultation, this program was redeveloped to provide a culturally inclusive interface, and incorporate cognitive‐motor (dual‐task) activities to boost potential benefits for healthy brain ageing and maintaining functional independence. Eighteen participants were enrolled and completed the RCT (8 intervention, 10 control). Users rated the StandingTall program as easy and enjoyable to use. There was no significant effect of intervention observed on dual‐task walking in intention to treat analysis (F(1,16)=0.14, p=0.71). However, adherence was highly variable and likely affected outcomes; three participants did not engage with the program and five reached a median of 33.4 minutes per week (max=130.7).ConclusionBy implementing a technological platform, this program has strong potential to improve access to dementia prevention strategies, enable low‐cost individualised program tailoring and facilitate transferability across diverse community settings. Understanding the factors related to program adherence is critical and a larger trial is needed to examine the effectiveness of the program in this population.