Exploring the qualitative experiences of administering and participating in remote research via telephone using the Montreal Cognitive Assessment-Blind: cross-sectional study of older adults

Abstract

Background: The COVID-19 pandemic caused a drastic shift in the practice of research and clinical services. It has been noted that cognition measured via in-person versus remote methods differ substantially, and it is possible that subjective and experiential differences exist between modalities.

Objective: The aim of the study is to explore the perceptions of both researchers and older adult participants on the experience of remotely conducted research using a cognitive screener.

Methods: We conducted a thematic analysis of the experience of engaging in remote research from both the participant (n=10) and researcher (n=4) perspectives. The research interaction was framed through teleadministration of the Montreal Cognitive Assessment-Blind (suitable for telephone administration) and administration of a subsequent semistructured debriefing interview. Participant perspectives were garnered during debriefing interviews, while researcher insights were collected via self-reported qualitative field notes completed following each research session.

Results: Data aggregated into themes of barriers and facilitators from the lenses of both participants and researchers. Participants noted facilitators including short instrument length, convenience, and presession contact; barriers included the length of the interaction, some tasks being more challenging on the phone, and the potential for participant dishonesty. Research assistants noted several facilitators: instrument length, rapport building, ability to prepare for and record sessions, and comfort with the protocol; barriers were items with too many response options, telephone issues (eg, response delays), and concerns about participant comprehension.

Conclusions: These results suggest remote telephone-delivered cognitive screening tools as a feasible and acceptable method of research inquiry. The findings provide a starting point for the inclusion of diverse populations in research to capture underrepresented groups whose input would immensely benefit our understanding of remotely delivered cognitive screening measures. Further, we offer materials (eg, checklists), which can be used in future investigations to promote future inclusive research and increase generalizability.

Plain Language Summary

The pandemic has led many researchers and service providers to using remote methods for providing tests and care. The telephone remains one of the most commonly used communication technologies that are available, especially in the households of older adults. However, not everyone is comfortable with communicating by phone for memory and cognitive testing. This study explored the experience of older adults when participating in a cognitive screening test over the phone. We compared this experience with the reports of the research assistants who administered the tests. Our participants liked several aspects of the telephone interaction, including the fact that they did not need to travel in order to participate. They also felt more at ease because they answered questions from the comfort of their own home. However, they found the consent procedure for a research project over the phone rather long and tedious. Meanwhile, research assistants enjoyed that telephone administration of the tests was often simpler to prepare, and less stressful than in-person testing. However, sometimes participants could not hear well, or found it tricky to answer based on too many response options. Even though the telephone-administration of our testing procedure was possible and, overall, a good experience for everyone, there are still a few things to improve. Telephone testing is a useful alternative especially for participants where travel may be an access barrier. Inclusion of such participants can ensure that our data remain more representative of the population overall.