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Objectives Spousal caregivers of patients with dementia are in need of interventions to bolster their quality of life. Computer-based, self-administered cognitive training is an innovative approach to targeting spousal caregiver distress and coping. We tested the feasibility of administering one such intervention with minimal clinician intervention. Methods Twenty-seven elderly adults (> 64 years old), who each were the primary caregiver for a spouse with dementia, were recruited through the Memory Disorders Clinic of the Alzheimer Disease Research Center in Pittsburgh, PA. Spousal caregivers were instructed to use a handheld computer version of the Adaptive Paced Visual Serial Attention Task (APVSAT) at least three times per week for 4 weeks as part of a larger caregiver intervention trial (P01 AG020677). Feasibility was explored by examining the frequency of APVSAT usage. Results Results suggest that self-directed cognitive training is feasible for spousal caregivers of dementia patients. The mean usage of the APSVAT was 42 (SD = 28.58). Performance increased from the beginning to the end of the trial, and usage was not affected by stress, worry, or poor sleep quality. Conclusion Findings suggest the potential utility of cognitive training via handheld computer for spousal caregivers of dementia patients to improve problem solving, coping and adaptation, planning, and persevering with goal-directed tasks.

Background Despite the proliferation of health technologies, descriptions of the unique considerations and practical guidance for evaluating intervention fidelity of technology-based behavioral interventions are lacking. Objectives To: (a) discuss how technology-based behavioral interventions challenge conventions about how intervention fidelity is conceptualized and evaluated, (b) propose an intervention fidelity framework that may be more appropriate for technology-based behavioral interventions, and (c) present a plan for operationalizing each concept in the framework using the intervention fidelity monitoring plan for Pocket PATH®, a mobile health technology designed to promote self-care behaviors after lung transplantation, as an exemplar. Method The literature related to intervention fidelity and technology acceptance was used to identify the issues that are unique to fidelity of technology-based behavioral interventions and thus important to include in a proposed intervention fidelity framework. An intervention fidelity monitoring plan for technology-based behavioral interventions was developed as an example. Results The intervention fidelity monitoring plan was deemed feasible and practical to implement, and showed utility in operationalizing the concepts such as assessing interventionists’ delivery and participants’ acceptance of the technology-based behavioral intervention. Discussion The framework has the potential to guide the development of implementation fidelity monitoring tools for other technology-based behavioral interventions. Further application and testing of this framework will allow for a better understanding of the role that technology acceptance plays in adoption and enactment of the behaviors that technology-based behavioral interventions are intended to promote.