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Accepted for/Published in: JMIR Formative Research

Date Submitted: Oct 6, 2025
Open Peer Review Period: Oct 7, 2025 - Dec 2, 2025
Date Accepted: Dec 20, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

A Telehealth-Based Behavioral Intervention for Cancer-Related Cognitive Decline in Older Adults Undergoing Systemic Therapy for Breast Cancer: Development and Usability Testing

Kelly JM, Berkhof L, Franco-Rocha OY, Mustian L, Targia V, Bauer J, Mortimer J, DiGIovanni G, Millstein D, Scioli K, DAurizio H, DeCaporale-Ryan L, Mohile S, Janelsins M, Ferguson RJ, Huston A, Magnuson A

A Telehealth-Based Behavioral Intervention for Cancer-Related Cognitive Decline in Older Adults Undergoing Systemic Therapy for Breast Cancer: Development and Usability Testing

JMIR Form Res 2026;10:e85140

DOI: 10.2196/85140

PMID: 41603881

PMCID: 12850034

A Telehealth-based Behavioral Intervention for Cancer Related Cognitive Decline in Older Adults Undergoing Systemic Therapy for Breast Cancer: Development and Usability Testing

  • J. MacLaren Kelly; 
  • Lucia Berkhof; 
  • Oscar Y. Franco-Rocha; 
  • Lewis Mustian; 
  • Valerie Targia; 
  • Jessica Bauer; 
  • Jessica Mortimer; 
  • Grace DiGIovanni; 
  • Daniel Millstein; 
  • Kassandra Scioli; 
  • Heidi DAurizio; 
  • Lauren DeCaporale-Ryan; 
  • Supriya Mohile; 
  • Michelle Janelsins; 
  • Robert J. Ferguson; 
  • Alissa Huston; 
  • Allison Magnuson

ABSTRACT

Background:

Cancer-related cognitive decline (CRCD) is a significant problem; interventions are needed to mitigate CRCD for older adults.

Objective:

Our objective was to develop Memory and Attention Adaptation Training-Geriatrics (MAAT-G), a CRCD intervention for older adults, and evaluate MAAT-G usability.

Methods:

MAAT-G, is a cognitive behavioral therapy-based intervention delivered by a health professional over the course of ten weekly individual workshops via videoconferencing. To develop MAAT-G, the Contextual, Cohort-based, Maturity, Specific Challenge (CCMSC) framework was used for preliminary adaptations. Patient advocate collaborators guided further refinement, reviewing MAAT-G workshop content, participant workbook, and intervention delivery via videoconferencing to optimize relevance and usability for older adults. The usability of MAAT-G and its video-conferencing delivery was subsequently evaluated in 4 older adults with breast cancer using the System Usability Scale (SUS; score range 0-100, >67 above average) and through semi-structured qualitative interviews.

Results:

Numerous adaptations were made to address the unique needs of older patients using CCMSC framework and patient advocate feedback. Usability testing included four female patients with breast cancer; mean age 73.3 years (range 67-77). Patients were receiving systemic therapy (two adjuvant, two advanced stage disease). One patient had less than a high school education; three had some college education or more. Two patients identified as low-comfort with technology; one patient required a mobile Wi-Fi hotspot due to limited internet access. All four patients completed study procedures, including 10 MAAT-G workshop sessions (100% intervention adherence). Mean SUS score was 85.6, indicating good usability.

Conclusions:

MAAT-G is a behavioral intervention developed to mitigate CRCD. It is designed specifically for older adults and showed above average usability in this population.


 Citation

Please cite as:

Kelly JM, Berkhof L, Franco-Rocha OY, Mustian L, Targia V, Bauer J, Mortimer J, DiGIovanni G, Millstein D, Scioli K, DAurizio H, DeCaporale-Ryan L, Mohile S, Janelsins M, Ferguson RJ, Huston A, Magnuson A

A Telehealth-Based Behavioral Intervention for Cancer-Related Cognitive Decline in Older Adults Undergoing Systemic Therapy for Breast Cancer: Development and Usability Testing

JMIR Form Res 2026;10:e85140

DOI: 10.2196/85140

PMID: 41603881

PMCID: 12850034

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