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Lee, Abigail Rebecca (2023) Promoting Independence in Dementia – Changing Lifestyles & Improving Outcomes: RE-AIM Study of The PRIDE Self-Management App. PhD thesis, University of Nottingham.

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Abstract

Introduction: The ever-increasing prevalence of dementia globally is placing significant demands on health and social care sectors and on families. Given the progressive nature of dementia, self-management can support people and their families to optimise the level of autonomy and independence they are capable of and reduce excess disability. Incorporating technology into self-management interventions could help remove geographical barriers and enable services to deliver to a wider-reaching audience.

Aims: To explore how the PRIDE-app online intervention could promote and support self-management in those living with mild dementia.

Methods: This study employed a mixed methods approach and incorporated the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. The app was subject to two development sprints to produce a version suitable for the main study. In the main study, we recruited 28 people diagnosed with dementia, although 17 completed the intervention. Participants completed the PRIDE-app intervention over 8 weeks with support from a dementia adviser facilitator. Measures exploring mood, physical well-being, and quality of life were collected at baseline and at follow-ups at 3 and 6 months. Eight post-intervention interviews were conducted with participants and facilitators. An additional online questionnaire was completed by 110 people living with dementia and supporters which explored attitudes to and use of computer technology, to better understand the low recruitment rate for the main study.

Results: Data collection began in June 2021 and ceased end of September 2022. Although the PRIDE-app appeared to have no significant improvements on participants’ dementia symptoms or independence, interview data highlighted PRIDE’s impact in encouraging people to carry out more activities. Although participants and facilitators identified areas for improvements to the app interface and delivery format, overall qualitative data showed that the PRIDE-app motivated people to reconnect socially and set individual goals.

Conclusions: This study evaluated the PRIDE-app’s reach, effectiveness and adoptability in the independence and quality of life of those with lived experience of dementia, as well as how it could be implemented and maintained within services. Although pre- and post-intervention scores were inconclusive, the degenerative nature of dementia could have affected PRIDE’s effect on the measured constructs. Interviews provided positive feedback on the influence of the app on peoples’ activities and mood. Knowledge generated will help with any future developments to the app, with the aim of improving its uptake and implementation in services.

Item Type:	Thesis (University of Nottingham only) (PhD)
Supervisors:	Orrell, Martin McDermott, Orii
Keywords:	Dementia; Self-management; Online intervention; App
Subjects:	W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools:	UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID:	73473
Depositing User:	Lee, Abigail
Date Deposited:	31 Jul 2023 04:40
Last Modified:	31 Jul 2023 04:40
URI:	https://eprints.nottingham.ac.uk/id/eprint/73473

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