The "Let's Talk Tech" Tool to Support Decision Making About Technology Use

The goal of this research is to help families understand digital health technology options to support dementia care at home so they can negotiate immediate decisions and future use in an informed way. This is a mechanism-focused trial of Let's Talk Tech (LTT), a single-use, self-administered intervention in the form of a web application. It targets education and interpersonal communication processes to enable informed decision making and planning for technology use that relieves care partners of the burden of making decisions without awareness of the person's preferences. Participants are people living with mild Alzheimer's disease (AD) and AD-related dementias (PLWD) or mild cognitive impairment (MCI) and a care partner. The 120 enrolled dyads (60 per study group) will be randomly assigned to receive either the intervention or usual care control. The intervention is self-administered. All participants will complete measures at baseline and at post-test (2 weeks), and care partners will also complete them 3 months later. Aim 1 will test if LTT compared with usual care improves the hypothesized mechanisms of change that are care partners' technology awareness, understanding, communication satisfaction, and intention to honor the PLWD/MCI's preferences, as well as both care partner- and PLWD/MCI-reported dyadic alignment. Aim 2 will examine if and how those hypothesized mechanisms of change improve the post-test and 3-month primary outcomes of care partner preparedness, decisional conflict, and decision making confidence, and secondary outcomes of PLWD/MCI and care partner sharing of technology preferences beyond the dyad and their confidence that PLWD/MCI's preferences will be honored. Exploratory Aim 3 will examine how, with whom, and for what purpose dyad members share technology preferences and explore factors that vary for those who shared with providers vs. family/friends, with the hope of learning how to expand the reach of this intervention to activate dyads' entire care networks.