Developing Midlife Metacognitive Strategy Training (M-MCST) program: A feasibility study with middle-aged adults to evaluate the design, implementation, and impact of a novel program in fostering healthy cognitive aging
- 1Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
- 2Department of Audiology and Speech Language Pathology, National Institute of Speech and Hearing, Trivandrum, India
- 3Department of Audiology and Speech Language Pathology, Nitte Institute of Speech and Hearing, Deralakatte, Mangalore, Karnataka, India
Abstract
Background: Metacognitive skills mediate the role of cognitive reserves in aging and facilitate effective cognitive abilities. Metacognitive deficits may precede cognitive impairments, making it important to optimize metacognition as early as middle adulthood to promote cognitive communicative well-being. Thus, the present study aimed to develop and evaluate the feasibility of a novel metacognitive strategy training (MCST) program with neurotypical middle-aged adults (MAAs). Method: This study aligns with the initial stage of the National Institutes of Health (NIH) Stage Model for Behavioral Intervention Development. A modified nominal group technique was employed, involving a panel of five healthcare professionals to draft the strategy and execution-related aspects of the M-MCST. The feasibility of the developed protocol was then tested with twenty neurotypical middle-aged adults (MAAs) (Experimental group (EG)- 10; Control group (CG)- 10), on parameters such as recruitment, retention, adherence, changes in their cognitive performance, absolute self-estimation, and self-perception of performance using the Contextual Memory Test (CMT). Additionally, the EG participants provided reflections on the program's design, implementation, and impact to gauge participant acceptability of intervention. Results: The MCST comprises seven sessions incorporating the adapted ‘stop-think-plan-do-check’ metacognitive strategy, client-centered personalized goal selection, and a daily diary method for tracking progress. Feasibility testing revealed 100% recruitment, retention, and protocol adherence along with significant improvements in CMT performance, absolute self-estimation discrepancy, and self-perception of performance among trained MAAs. The participants found the design and implementation aspects of the training program to be promising. Conclusion: The MCST program guides healthcare professionals in the use of metacognitive strategy training with neurotypical adults, embedding it within everyday tasks. It incorporates mechanisms for monitoring strategy use, error awareness, and self-reflection through daily diaries. The findings demonstrate that the program is feasible and acceptable to MAAs and shows potential benefits for improving performance on the CMT and related metacognitive functioning. These findings support further evaluation of the program in large-scale efficacy trials and future investigations examining its potential contribution to broader constructs, such as cognitive reserve and healthy cognitive aging.
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BibTeX
@article{rooha2026developing,
title = {{Developing Midlife Metacognitive Strategy Training (M-MCST) program: A feasibility study with middle-aged adults to evaluate the design, implementation, and impact of a novel program in fostering healthy cognitive aging}},
author = {Aysha Rooha and Sinchana Swamy and Nidhi Lalu Jacob and Gagan Bajaj and Chanchal Chaudhary and Vinitha Mary George and Jayashree S. Bhat},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0358223},
url = {https://doi.org/10.1371/journal.pone.0358223},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Developing Midlife Metacognitive Strategy Training (M-MCST) program: A feasibility study with middle-aged adults to evaluate the design, implementation, and impact of a novel program in fostering healthy cognitive aging
AU - Aysha Rooha
AU - Sinchana Swamy
AU - Nidhi Lalu Jacob
AU - Gagan Bajaj
AU - Chanchal Chaudhary
AU - Vinitha Mary George
AU - Jayashree S. Bhat
PY - 2026
DA - 2026/09/25
JO - PLOS One
DO - 10.1371/journal.pone.0358223
UR - https://doi.org/10.1371/journal.pone.0358223
AB - Background: Metacognitive skills mediate the role of cognitive reserves in aging and facilitate effective cognitive abilities. Metacognitive deficits may precede cognitive impairments, making it important to optimize metacognition as early as middle adulthood to promote cognitive communicative well-being. Thus, the present study aimed to develop and evaluate the feasibility of a novel metacognitive strategy training (MCST) program with neurotypical middle-aged adults (MAAs). Method: This study aligns with the initial stage of the National Institutes of Health (NIH) Stage Model for Behavioral Intervention Development. A modified nominal group technique was employed, involving a panel of five healthcare professionals to draft the strategy and execution-related aspects of the M-MCST. The feasibility of the developed protocol was then tested with twenty neurotypical middle-aged adults (MAAs) (Experimental group (EG)- 10; Control group (CG)- 10), on parameters such as recruitment, retention, adherence, changes in their cognitive performance, absolute self-estimation, and self-perception of performance using the Contextual Memory Test (CMT). Additionally, the EG participants provided reflections on the program's design, implementation, and impact to gauge participant acceptability of intervention. Results: The MCST comprises seven sessions incorporating the adapted ‘stop-think-plan-do-check’ metacognitive strategy, client-centered personalized goal selection, and a daily diary method for tracking progress. Feasibility testing revealed 100% recruitment, retention, and protocol adherence along with significant improvements in CMT performance, absolute self-estimation discrepancy, and self-perception of performance among trained MAAs. The participants found the design and implementation aspects of the training program to be promising. Conclusion: The MCST program guides healthcare professionals in the use of metacognitive strategy training with neurotypical adults, embedding it within everyday tasks. It incorporates mechanisms for monitoring strategy use, error awareness, and self-reflection through daily diaries. The findings demonstrate that the program is feasible and acceptable to MAAs and shows potential benefits for improving performance on the CMT and related metacognitive functioning. These findings support further evaluation of the program in large-scale efficacy trials and future investigations examining its potential contribution to broader constructs, such as cognitive reserve and healthy cognitive aging.
SN - 1932-6203
ER -