Testing the Implementation Framework for Behavioral and Lifestyle Interventions in Alzheimer's Disease (MOBILIZE) via the ACT Randomized Controlled Trial
Bibliographic record
Abstract
BACKGROUND: Implementing multi-site behavioral intervention trials in Alzheimer's disease (AD) has many unique challenges, leading to substantial variations in delivered intervention doses and cognitive findings. These issues can be addressed by the IMplementation Framework fOr Behavioral and LIfestyLe Interventions In AlZheimer's DiseasE (MOBILIZE) that was developed to guide the design and implementation of behavioral interventions in AD. METHOD: This study systematically evaluated the implementation outcomes of the 3-site aerobic exercise and cognitive training (ACT) trial that employed MOBILIZE. Sites included University of Minnesota (UMN], University of Rochester (UR], and Arizona State University (ASU]. Building on the person-centered care principle, MOBILIZE includes three implementation outcomes (screening, intervention adherence, and safety) with corresponding team processes to guide trial implementation. Screening was defined as time to complete the 4-step screening phase and baseline testing. Intervention adherence included: attendance, session dose adherence, and days required to complete the prescribed 72 sessions. Exercise session dose was considered compliant if (1) the session's average heart rate or rating of perceived exertion was in prescribed zone of the session and (2) session length was met. Cognitive session dose was considered compliant if participant completed the prescribed length of cognitive training. Safety was operationalized as the number of study-related adverse events (AEs). RESULT: The sample (n = 146) was 73.8±5.7 years in age and 23.4±2.1 on Montreal Cognitive Assessment score, with 48.0% female and 91.8% White. The median days of screening-to-enrollment averaged 98 days. For the entire sample, the mean average attendance was 76.7±28.6% (UMN: 79.7±32.3%; UR: 79.5±22.5%; ASU: 65.7±32.1%) (F=2.79, p = 0.07). Adherence to exercise session dose was 71.7±30.8% (UMN: 76.6±30.6%; UR: 70.5±30.5%; ASU: 60.1±30.1%) (F=1.98, p = 0.07). Adherence to cognitive session dose was 51.5±26.2% (UMN: 73.3±21.6%; UR: 39.6±32.8%; ASU: 35.7±20.3%) (F=21.24, p <0.01) respectively. The median length of the 6-month intervention period was 188.0 (173.5-197.3) days (UMN: 185.0 [170.0-196.0] days; UR: 190.0 [182.0-199.0] days; ASU: 184.0 [127.5-207.5] days) (H(2)=4.50, p = 0.11). There were 10 study-related adverse events and didn't differ across sites (p = 0.76). CONCLUSION: MOBILIZE helped the ACT Trial achieve high intervention attendance and safety and may be particularly important for early-stage and multi-site trials in AD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.191 | 0.165 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.006 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".