Understanding How Digital Dementia Risk-Reduction Education Works: A Realist-Informed Mixed-Methods Study of Engagement, Interpretation and Behavioural Readiness in Midlife Adults

Abstract

Peter Carey*

Dementia is a growing global public health concern, with prevention increasingly emphasised through the promotion of modifiable lifestyle and health risk factors. In response, a range of digital dementia risk-reduction education resources has been developed to support public awareness and encourage preventative behaviours, particularly among adults in midlife.

Despite this expansion, improvements in knowledge do not consistently translate into sustained behavioural change, leaving the underlying mechanisms through which digital health education influences behaviour poorly understood. This multi-phase mixed-methods study examines how cognitively unimpaired midlife adults aged 40–65 years engage with and interpret digital dementia risk-reduction education, and how these processes shape behavioural intentions and readiness for behaviour change. Moving beyond outcome-focused evaluation, the study explores the cognitive, emotional, and contextual factors that influence engagement and meaning-making.

A sequential mixed-methods design, underpinned by critical realism and Context–Mechanism–Outcome (CMO) logic will be deployed with a purposive sample of 30–45 participants. Quantitative baseline and post-engagement questionnaires assess changes in knowledge, risk perception, and intentions, while qualitative think-aloud protocols and semi-structured interviews explore real-time engagement and interpretation experiences. The findings will provide a framework for evaluating digital health interventions and inform the design of user-centred dementia risk-reduction programs in real-world settings.

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