The presentation of the methodology and results follow the Consolidated criteria for Reporting Qualitative research (28) and the Standards for Reporting Qualitative Research (29) wherever applicable.
Intervention mapping
Intervention mapping process involves six steps. In this study, steps one to three— identification of the problem and needs assessment (Step 1), identification of the target of the program and goals for change (Step 2) and development of the training program (Step 3) —were used to design the program and are described below. The three following steps—testing the efficacy of the program (Step 4), developing strategies for the implementation, adoption, and maintenance of the program (Step 5), and creating an evaluation plan to assess program implementation and efficacy (Step 6)—are still ongoing and will be reported separately.
Step 1: Identification of the problem and needs assessment.
The first step of the process was establishing a detailed understanding of the memory problems and needs of older adults, and identifying the factors that influence the problem that the program should address. This was done by reviewing research articles on memory and normal aging. We were particularity interested in which memory processes impacted by aging the program should target.
The second step of the process was specifying targets of the intervention program and goals for change. This was done, again, by reviewing research articles on memory interventions and techniques known to boost memory performance. We were particularity interested in how the program should target the memory processes identified in Step 1.
Step 3: Development of the training program
The third step of the process was translating the information gathered in steps 1 and 2 into a coherent, relevant and tailored training program. This was achieved by conducting two 2-hour workshops of co-creation, spaced three days apart, with a focus group of six healthy community-dwelling older adults referred to as the co-creators throughout the manuscript.
Co-creators were recruited from the research center participant registry. The inclusion criteria required participants to be age 60 or over, able to ambulate independently, capable of providing informed consent, proficient in writing, with normal or corrected vision and audition, without cognitive impairment, untreated depression, major psychiatric conditions, brain injury or surgery, and fluent in French. Co-creators received financial compensation. The study received ethical approval from the Comité d'éthique de la recherche vieillissement – neuroimagerie (CER VN) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal (CCSMTL) (project number 2022 − 1479, CER VN 21-22-28).
Workshops were facilitated by one of the authors (RP; male; PhD; Postdoctoral researcher at the time of the study) and two research assistants (females; undergraduate students at the time of the study). Nobody was present besides the co-creators and facilitators. No relationship was established between the co-creators and between the co-creators and the facilitators prior to study commencement. The workshops were conducted in a room at the research center, equipped with tables and a projector. The content of the workshops followed a semi-structured format and included a set of activities known to support the co-creation process. This format was informed by a meta-design perspective, as a flexible approach that allows for better adaptation to the unpredictable and ever-changing nature of end-user challenges and needs (30).
The first aim of the workshops was to determine how to adapt the Episodic Specificity Induction technique (ESI) into a training program format and to build a first prototype. The aim was in particular to determine the right number of training sessions, their ideal duration, and the best approach to conduct the training sessions. This was done in consideration of the needs and abilities of the end-users, and of the information gathered from the first two steps of the intervention mapping process. The second aim was to generate relevant content by gathering real-life examples of situations where the ESI technique could be applicable and beneficial for creating meaningful exercises. The workshops activities are detailed below.
Ice breakers, aims and rules. The workshops began with icebreaker activities, where participants paired up to identify five mutual interests (e.g., hobbies, music, or movie preferences) to share with the group. Following the icebreaker, co-creators collectively agreed on the main goal of the co-creation process and the specific goals of the workshop, to increase transparency (31). Then, co-creators agreed to participation rules, aimed to foster co-creator ownership and maintain a positive environment (32, 25, 34). Facilitators did not present any personal goals, reasons for doing the research, bias, assumptions, reasons, or interests in the research topic other than the goals agreed upon.
Psychoeducation and constraints. The next step was to provide psychoeducation on episodic memory and the rationale behind the different forms of ESI technique. The group discussed and commented on the psychoeducational content and its clarity. Moreover, facilitators addressed some limitations that needed to be considered before the prototyping phase, including the content suitable for ESI technique administration, the time required for each ESI administration, the recommended number of sessions based on existing literature, and the budget allocated for financial compensation.
Persona-scenarios. The next activity involved creating several persona-scenarios (34–37). Co-creators developed fictional characters, each with basic traits and a memory challenge. They created storyboards for each character, illustrating how they tackled the challenge using one of the six ESI versions. Storyboards were composed using post-it notes on worksheets to express the challenges, steps to address these challenges using the ESI, and any questions, comments, or ideas to guide the design of the program (Fig. 1). All the created persona-scenarios were approved by the co-creators.
Figure 1.
Storyboarding during the persona-scenario module
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Prototyping. The co-creators then built a short and concrete preliminary version of the program by discussing, providing individual input, and reaching consensus on the activities that should be included in each program session, the ideal number of sessions, their duration, and how different versions of the ESI technique should be practiced. This preliminary version took the form of an "experience prototype" (38, 39) and was documented on a worksheet.
Data collection and analysis. Discussions pertaining to persona-scenarios and the prototype were audio-recorded, transcribed, and analyzed by a member of the research team (RP) to summarize key elements. Storyboards and worksheets were also collected and analyzed. Data collection concluded following the second workshop as data saturation was reached. Collected data were reviewed and discussed among the research team members. Persona-scenarios and the prototype were subsequently approved by the research team following consensus. The format and content of the approved prototype of the training program are presented and justified in the result section (Step 3).