Instant message-delivered personalised acceptance and commitment therapy (IMPACT) for neuropsychiatric symptoms in persons with mild cognitive impairment: a mixed methods study

Professor Lee, Jung Jae   (Principal Investigator (PI))

Dr Chiu Ka Chun Patrick   (Co-Investigator)

Professor Cuijpers Pim   (Co-Investigator)

Professor Yu Sau Fung Doris   (Co-Investigator)

Dr Lau Esther Yuet Ying   (Co-Investigator)

Professor Chau Pui Hing   (Co-Investigator)

Mrs. YE Fen   (Co-Investigator)

30

2024-01-01

932480

Instant message-delivered personalised acceptance and commitment therapy (IMPACT) for neuropsychiatric symptoms in persons with mild cognitive impairment: a mixed methods study

Language learner strategies, Strategy instruction, Second language listening, English Medium Instruction

PsycholinguisticsNursing

Humanities & Social Sciences (H)

17619223

General Research Fund (GRF) 2023/24

2023

On-going

1. To develop a highly accessible, personalised intervention to provide timely support to persons with mild cognitive impairment (PwMCI) in managing neuropsychiatric symptoms (NPSs).Despite the availability of both private and government-subsidised psychological support services in Hong Kong (HK), PwMCI experience barriers such as social bias in accessing these services, with their psychological distress, including their transdiagnostic NPS condition, often remaining unscreened and unmanaged. Furthermore, existing services for PwMCI focus primarily on improving cognitive functions (e.g. cognitive rehabilitation), with limited psychological support provided to address NPSs. Existing psychological support services are mainly centre-based, and are thus less accessible to PwMCI who work or live in rural areas. Additionally, PwMCI need to pay for access to private psychological support services, while government-subsidised services are limited relative to demand and tend to have long waiting lists. Without timely access to psychological support services, PwMCI’s NPSs go unmanaged, negatively affecting their disease progression (e.g. advancing to the severe dementia stage) and social burden. In this research, the proposed intervention (i.e. an instant message [IM]-delivered psychological intervention) will be delivered according to PwMCI’s preferences. As mobile device penetration in HK is high, most PwMCI will be able to access psychological support as and when they need it, and from any location, thereby minimising the access barriers to psychological support and strengthening the intervention’s practical impact. 2. To conduct a randomised controlled trial (RCT) to determine the effectiveness of the proposed intervention in reducing NPSs among PwMCI.Although the mild cognitive impairment characterising the prodromal stage of dementia remains underdiagnosed, evidence indicates that the number of PwMCI who require care in the community is rising due to population ageing. The WHO Global Action Plan (2017- 2025) highlights the importance of providing support for PwMCI to combat the challenges of ageing populations, and NPSs are among the most prominent symptoms in PwMCI. In HK, where there is a significant ageing population, PwMCI who lack timely support in the community suffer such physical and psychological burdens as financial distress, societal pressure and emotional strain, which can lead to poor health outcomes, resulting in accelerated cognitive decline, physical dependence, poor quality of life, premature institutionalisation and premature death. In this research, PwMCI will receive psychological support and learn how to self-manage their NPSs, thereby enhancing the sustainability of the proposed intervention’s effects. The RCT research design will allow the intervention’s effectiveness in reducing NPSs to be determined by comparing the outcomes of the intervention and control groups. Establishing the effectiveness of the intervention will have implications for practical application in service delivery and facilitate policy development.3. To generate evidence on an innovative personalised acceptance and commitment therapy (ACT) intervention delivered via IMs. IM-based delivery as an intervention framework and ACT as a psychological intervention have both individually been proven to be effective strategies for improving psychological and/or behavioural symptoms, but have rarely been used. The proposed intervention is designed as an innovative brief intervention approach, as recommended by the WHO to ensure intervention scalability. The delivery of brief ACT through IMs will afford PwMCI personalised support for managing NPSs and real-time chat-based support from any location, increasing the ease of access. This will be the first research to investigate and evaluate the delivery of ACT through IMs for PwMCI. We will conduct an RCT of the proposed intervention to produce evidence of its effectiveness. This pioneering research will provide a valuable opportunity to generate evidence of a novel intervention that can be utilised for practical applications and further research.4. To inform the intervention’s future research design through post-trial qualitative interviews. Owing to the novelty of the proposed intervention, we will qualitatively explore the intervention experience of PwMCI, including their compliance with the intervention. The findings will further improve the proposed intervention to maximise its effectiveness. An understanding of how PwMCI adjust and use the IM-delivered NPS intervention (i.e. their intervention compliance) will also inform other mobile intervention projects in HK and globally targeting not only PwMCI but also other populations (e.g. stroke and cancer survivors). As the COVID-19 pandemic has highlighted the significance of telehealth, the proposed intervention will inform and contribute to burgeoning developments in the field as it becomes a mainstay of the new normal in healthcare delivery.