Implementing multidomain non-pharmaceutical interventions for preventing cognitive decline in community-dwelling older adults in China: An embedded mixed-methods implementation study of determinants and strategies

Abstract

Introduction: The WW-FINGERS network has demonstrated the efficacy of multidomain non-pharmaceutical interventions (NPIs) but left their real-world implementation largely unexplored, prompting this study in Changxing County to identify key determinants and develop actionable strategies for community-based delivery.

Methods: An embedded mixed-methods retrospective evaluation using the Consolidated Framework for Implementation Research (CFIR) was conducted. Data from 42 stakeholders across six communities were analyzed via a hybrid deductive-inductive approach and coincidence analysis (CNA). Strategies were matched using the ERIC compendium and refined by a stakeholder panel.

Results: We identified 202 determinants, revealing six core facilitator themes (e.g., policy-academia-community synergy) and six barrier themes(e.g., unsustainable funding). CNA delineated potential pathways. Three strategy bundles were finalized: Capacity Building, Collaborative Network Building, and an AI-enabled digital platform.

Discussion: This study provides a practical, theory-informed framework for implementing complex NPIs, bridging the science-to-practice gap in dementia prevention. The AI-enabled platform offers a forward-looking approach for sustained delivery.

Keywords: Consolidated Framework for Implementation Research (CFIR); cognitive decline prevention; community‐dwelling older adults; implementation science; multidomain non‐pharmaceutical interventions.