# Acceptability and fidelity of the multidomain ‘Brain Bootcamp’ dementia risk reduction program: a mixed-methods approach

## TL;DR

This study evaluated a dementia risk reduction program called Brain Bootcamp, finding it acceptable to participants despite low completion rates and identifying ways to improve it.

## Contribution

The study provides new insights into the acceptability and fidelity of a multidomain dementia prevention program using a mixed-methods approach.

## Key findings

- 79.1% of participants felt the program improved their dementia risk factor awareness.
- 92.4% intended to maintain brain-healthy behaviors after the program.
- Qualitative analysis revealed themes on education, motivation, and sustainability for behavior change.

## Abstract

Interventions targeting dementia prevention typically lack comprehensive exploration of feasibility, acceptability, and long-term translation factors prior to deployment. Our study aimed to explore the acceptability, fidelity and participants’ experiences with Brain Bootcamp, a multi-domain behaviour change intervention targeting reduced dementia risk and increased dementia risk factor awareness for older adults.

Conducted in New South Wales, Australia, from January to August 2021, our concurrent single-group mixed-methods feasibility study involved post-intervention surveys and qualitative interviews with community-dwelling older adults. Descriptive statistics were used to assess acceptability of the methods, outcome measures, and fidelity to the program components. Thematic analysis of semi-structured interviews explored participant experiences, preferences, barriers, and recommendations.

Out of 853 enrolled participants, only 355 completed the program (41.6%). Among these participants, 79.1% agreed that the intervention improved their awareness of dementia risk factors, and 92.4% expressed intent to continue maintaining brain healthy behaviours post- program. Participants typically set 2–4 modifiable risk factor lifestyle goals, which were most often related to physical activity (83.7%). A majority (91.5%) successfully achieved at least one brain health goal. Qualitative analyses (n = 195) identified three overarching themes on the role of education on behaviour modification (i.e., the transformative role of the program in enhancing knowledge about dementia prevention and fostering behavioral modifications), psychological considerations (e.g., intrinsic versus extrinsic motivation on their engagement and perception of the program) and future directions (e.g., sustainability concerns and the need for tailored strategies for specific demographics).

While Brain Bootcamp had low completion rates, those who completed the program reported high acceptability. Future refinements, incorporating targeted strategies and enhanced participant support and communication, will facilitate pragmatic initiatives.

ACTRN12621000165886.

The online version contains supplementary material available at 10.1186/s12889-025-21641-7.