Feasibility and Pilot Testing of Mobile Health Apps to Supplement 2 Healthy Lifestyle Interventions in Chronic Traumatic Brain Injury.

OBJECTIVES: To determine the feasibility of mobile health (mHealth) apps for enhancing participation of people with chronic traumatic brain injury (TBI) in the Group Lifestyle Balance (GLB-TBI) weight loss intervention and Brain Health Group (BHG-TBI) active control intervention. SETTING: Community. PARTICIPANTS: n = 56 overweight/obese adults with moderate-severe TBI. DESIGN: The GLB-TBI is a 12-month group- and community-based program to promote healthy eating and physical activity. The BHG-TBI is a 12-month group- and community-based program to promote general brain health, designed as an active control condition matched on time, structure, and perceived benefit to the GLB-TBI. In a randomized controlled trial testing the efficacy of the GLB-TBI for weight loss, participants used a group-specific mHealth app providing daily tips customized according to their intervention allocation. MAIN MEASURES: Compliance (percentage of daily prompts read and completed) and participant-reported satisfaction and usability. RESULTS: In conjunction with relevant stakeholders, we developed the content and structure of the GLB-TBI and BHG-TBI apps based on core curriculum components. We incorporated cognitive strategies (app notifications) to address potential cognitive impairment common after TBI. Both apps delivered brief daily educational and motivational "tips" derived directly from their respective curricula. Daily use of the apps varied greatly across participants, with most participants who used the apps completing 10% to 50% of daily content. Participants found the apps to be easy to use, but only some found them helpful. App use was substantially different for those who participated in the intervention during (2020) versus before (2019) the COVID-19 pandemic. CONCLUSIONS: Although enhancing an intensive lifestyle intervention with mHealth technology may be helpful, further refinement is needed to optimize the frequency and delivery methods of mHealth content. Although one might expect remote app use to have been higher during the pandemic, we observed the opposite, potentially due to less hands-on training and ongoing support to use the app and/or general technology fatigue with social distancing.

Reliability of the Oral Trail Making Test in a Teleneuropsychology Testing Environment

Objective Despite the growing interest and literature supporting the validity and reliability of teleneuropsychology during the COVID-19 pandemic, little research exists on the reliability of the Oral Trail Making Test (OTMT) administered via videoconference. Previous work examining telephone administration of OTMT found good reliability across formats for Part B, but not Part A, suggesting further reliability studies on OTMT are needed. Method 119 healthy aging controls and 84 individuals with mild cognitive impairment or dementia (M age = 68.37, SD = 9.57;63% female;M education = 14.08, SD 2.73 years) were administered a brief neuropsychological battery including OTMT in counterbalanced face-to-face (FF) and videoconference (VC) conditions. T-tests and intraclass correlations (ICC's) were used to compare results between testing conditions across groups. Results Among controls, the mean differences (MD) between conditions on OTMT-A (MD = -1.6, SD = 1.96) and B (MD = 1.6, SD = 54.77) were small, but statistically significant for OTMT-A;p < 0.001 but not OTMT-B (p = 0.749). ICC's reflected good (0.85) and moderate (0.66) agreement on OTMT-A and B, respectively. Within the cognitively impaired group, mean differences across conditions on OTMT-A (MD = 22.74, SD = 155.44) and OTMT-B (MD = 46.87, SD = 240.65) were nonsignificant (p = 0.18 and 0.08, respectively). ICC's showed moderate agreement on OTMT-A (0.66) and B (0.53). Conclusions While similar mean OTMT scores were seen across test conditions, SD's were large. ICC's were only moderate, and scores on OTMT-A were even more variable than OTMT-B, similar to previous reports. Results support the utility of using the OTMT in teleneuropsychological assessment, but suggest cautious interpretation of findings given the variability in scores seen. [ABSTRACT FROM AUTHOR] Copyright of Archives of Clinical Neuropsychology is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)