JMIR Publications

ABSTRACT

Background:

Rural, low-income African Americans have the highest Alzheimer’s disease and related dementias (ADRD) incidence and prevalence rates but have the least access to formal quality dementia care. To support aging-in-place among individuals living with ADRD, growing evidence suggests remote monitoring technologies can augment existing care by facilitating the completion of activities of daily living and maintaining communication between individuals living with ADRD and their care partners. Despite the success of remote technologies, no studies have investigated the usability, acceptability, and feasibility of remote monitoring technologies among rural, lower-income African Americans living with ADRD and their care partners. Understanding the potential impact of remote monitoring technology on this population can guide the development of tailored aging-in-place interventions for rural, lower-income African Americans living with ADRD and their care partners.

Objective:

Among rural, low-income African Americans living with ADRD and their care partners, our study, ‘Revolutionizing Empowerment of African Americans’ Cognitive Health through Innovative Technology (REAACH-IT), aims to: (1) identify barriers to aging-in-place, current technology use behaviors, and attitudes toward remote monitoring technologies among low-income African Americans living with ADRD and their care partners, and (2) examine the usability, acceptability, and feasibility of deploying a remote monitoring system in the homes of rural low-income African Americans living with ADRD and their care partners for supporting activities of daily living.

Methods:

Ten low-income African Americans living with ADRD and their care partners will be recruited from rural cities and counties in South Carolina. Participants will complete a short online survey to collect demographics and their knowledge, experience, and comfort with using internet-connected devices, followed by 45 to 60-minute in-depth interviews (Objective 1). In the second phase (i.e., Objective 2), ten additional pairs of participants will be recruited to use a remote monitoring system for 18 months. ‘Weekly Health Update’ surveys will measure changes in health and time spent at home for the person living with ADRD. In-depth interviews will be employed at 18 months to examine the usability and acceptability of the system. Feasibility will be determined by the percentage of days data are continuously collected across all remote monitoring sensors.

Results:

Recruitment for Objective 1 began in January 2025 and is ongoing. To date, half of the 10 pairs of persons living with ADRD and their care partners have been recruited, surveyed, and interviewed about their challenges to aging with ADRD or caring for someone with the disease, technology use, and openness to remote monitoring technology. It is anticipated that recruitment for Objective 2 will begin in Fall, 2025.

Conclusions:

Findings from the REAACH-IT study will contribute notably to the development of multi-sensor remote monitoring systems that can support the activities of daily living for low-income, rural-dwelling African Americans living with ADRD. Combining this technological support system with other services may increase the likelihood that this population can age in place while reducing caregiver burden. Clinical Trial: N/A