Implementing cognitive training in primary health care for older adults with MCI: study protocol for a type 3 hybrid effectiveness-implementation cluster-randomized factorial trial.
5 affiliations
- 1Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 3 Yabao Road, Chaoyang District, Beijing, China, 100020.
- 2Chuiyangliu Hospital Affiliated to Tsinghua University, No. 2 Chuiyangliu South Street, Chaoyang District, Beijing, 100028, China.
- 3China National Health Development Research Center, No. 9 Chegongzhuang Street, Xicheng District, Beijing, China.
- 4Chuiyangliu Hospital Affiliated to Tsinghua University, No. 2 Chuiyangliu South Street, Chaoyang District, Beijing, 100028, China. [email protected].
- 5Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 3 Yabao Road, Chaoyang District, Beijing, China, 100020. [email protected].
Abstract
Background
Dementia prevention is an urgent global health priority in aging populations. Mild cognitive impairment (MCI) presents a key window for intervention, where cognitive training can effectively slow progression to dementia. There remains a need for implementation strategies that activate primary healthcare providers (the first point of contact) to deliver such interventions. This study aims to evaluate a multi‑component implementation strategy (enhanced training, financial incentives, and leadership engagement) to promote the delivery of cognitive training for elderly with MCI by family doctor teams in primary care.Methods
This study employs a hybrid type 3 effectiveness-implementation cluster-randomized trial. Guided by the Multiphase Optimization Strategy (MOST) framework, a 2 × 2 × 2 factorial design is used to examine the main effects and interactions of three intervention components (enhanced training, financial incentives, and leadership engagement), thereby generating empirical evidence for optimizing the implementation strategy. It will be conducted across 16 community health centers (CHCs) in Beijing, targeting family doctor teams as the primary intervention units. The active intervention will last 6 months, followed by a 6‑month observational follow‑up to assess sustainability. The primary outcome is the initiation of cognitive training delivery by primary healthcare providers (change from non‑delivery to delivery). Secondary outcomes include providers' self‑efficacy, patients' cognitive function, beneficiary coverage, and implementation‑related measures.Discussion
This study will inform the integration of cognitive training into routine primary care, support the design of community-based dementia prevention strategies, and contribute to promoting healthy aging. The findings will provide actionable evidence for policymakers engaged in active dementia prevention and control globally.Trial registration
The study was registered with the Chinese Clinical Trial Registry ChiCTR2600116108. Registered 05 Jan 2026.
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BibTeX
@article{yuan2026implementing,
title = {{Implementing cognitive training in primary health care for older adults with MCI: study protocol for a type 3 hybrid effectiveness-implementation cluster-randomized factorial trial.}},
author = {Shasha Yuan and Jiayi Diao and Peng Liang and Shuping Wang and Fusong Peng and Xinhe Man and Hui Liu},
journal = {BMC geriatrics},
year = {2026},
month = jul,
doi = {10.1186/s12877-026-07967-w},
url = {https://europepmc.org/article/MED/42902222},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Implementing cognitive training in primary health care for older adults with MCI: study protocol for a type 3 hybrid effectiveness-implementation cluster-randomized factorial trial.
AU - Shasha Yuan
AU - Jiayi Diao
AU - Peng Liang
AU - Shuping Wang
AU - Fusong Peng
AU - Xinhe Man
AU - Hui Liu
PY - 2026
DA - 2026/07/01
JO - BMC geriatrics
DO - 10.1186/s12877-026-07967-w
UR - https://europepmc.org/article/MED/42902222
AB - Background Dementia prevention is an urgent global health priority in aging populations. Mild cognitive impairment (MCI) presents a key window for intervention, where cognitive training can effectively slow progression to dementia. There remains a need for implementation strategies that activate primary healthcare providers (the first point of contact) to deliver such interventions. This study aims to evaluate a multi‑component implementation strategy (enhanced training, financial incentives, and leadership engagement) to promote the delivery of cognitive training for elderly with MCI by family doctor teams in primary care.Methods This study employs a hybrid type 3 effectiveness-implementation cluster-randomized trial. Guided by the Multiphase Optimization Strategy (MOST) framework, a 2 × 2 × 2 factorial design is used to examine the main effects and interactions of three intervention components (enhanced training, financial incentives, and leadership engagement), thereby generating empirical evidence for optimizing the implementation strategy. It will be conducted across 16 community health centers (CHCs) in Beijing, targeting family doctor teams as the primary intervention units. The active intervention will last 6 months, followed by a 6‑month observational follow‑up to assess sustainability. The primary outcome is the initiation of cognitive training delivery by primary healthcare providers (change from non‑delivery to delivery). Secondary outcomes include providers' self‑efficacy, patients' cognitive function, beneficiary coverage, and implementation‑related measures.Discussion This study will inform the integration of cognitive training into routine primary care, support the design of community-based dementia prevention strategies, and contribute to promoting healthy aging. The findings will provide actionable evidence for policymakers engaged in active dementia prevention and control globally.Trial registration The study was registered with the Chinese Clinical Trial Registry ChiCTR2600116108. Registered 05 Jan 2026.
SN - 1471-2318
ER -