Abstract Background Multidomain interventions may reduce the risk of cognitive decline among older adults with modifiable risk factors, but most existing programs are resource-intensive and difficult to scale. To address this barrier, we developed and pilot-tested Brain Health Together (BHT), a 12-week, virtual group program to reduce dementia risk by targeting modifiable risk factors in older adults with subjective cognitive decline. Methods We used two phases to develop (Phase 1), pilot-test, and refine (Phase 2) the BHT program. During Phase 1, we collected semi-structured interview data and used an iterative human-centered design approach to identify program opportunities, user needs, and guiding design principles to develop the virtual BHT program. In Phase 2, we refined the BHT program based on participant feedback and assessed preliminary BHT feasibility and acceptability through measures of participant retention, session attendance, and survey-based perceived usefulness of program elements, educational content, and subjective changes since starting the program. We also explored participant experiences with the BHT program through semi-structured interviews. Results In Phase 1, our iterative human-centered design identified four opportunities for BHT development (e.g., holistic support for participants, personalized feedback) and three user archetypes that informed the development of the 12-week BHT framework. In Phase 2, six of seven participants attended > 90% of sessions during weeks 1–4. At week 4, BHT program delivery was adapted based on participant feedback (e.g., education was simplified and covered a larger range of topics). During weeks 5–12 of Phase 2, 7 enrolled participants (6 retained, 1 new) attended 86% of sessions. Participants reported the most useful program elements were individual brain health coaching sessions (mean ± SD: 4.9 ± 0.4, max score: 5), sharing progress with group (4.3 ± 0.8). All participants self-reported feeling “somewhat” or “much” better compared to baseline. Participant qualitative data suggest subjectively beneficial effects of BHT classes, brain health education, and brain health coaching on confidence and motivation. Conclusions The BHT program, a multidomain intervention with virtual brain health coaching, was developed to address cognitive decline risk reduction among those with cognitive impairment. Our 12-week pilot suggests that BHT is feasible and acceptable among older adults with cognitive decline. Trial Registration This study was retrospectively registered as a clinical trial at ClinicalTrials.gov (NCT06914947) on 04/04/2025.
Miller et al. (Mon,) studied this question.