Table 2 Barriers and facilitators to multi-domain lifestyle intervention participation.
Obstacle factors | Reason | Facilitating factors | Preferences or needs | TDF components |
|---|---|---|---|---|
Insufficient interest and do not believe that the interventions presented in the study are effective and/or necessary | Lack of awareness about the benefits and effectiveness of the interventions, leading to disinterest and disbelief in their necessity | Provide clear and compelling information about the effectiveness and importance of the intervention through motivational interviewing and engaging educational materials | Reading materials should be well illustrated and text-based, and the font size should be large | Knowledge, Intentions |
Don’t know the importance of daily and long-term persistence | Lack of understanding regarding the significance of consistent engagement in lifestyle interventions over time | Offer educational sessions or materials emphasizing the long-term benefits of consistent participation | Knowledge, Beliefs about consequences | |
Low self-efficacy, lack confidence in being able to adhere to behavior change long-term | Feelings of inadequacy and doubt in one’s ability to sustain lifestyle changes over an extended period | Implement motivational strategies, such as goal-setting and gradual progression, to boost self-confidence and provide personalized support and encouragement | Accumulate points and display the overall points ranking in real-time | Beliefs and capabilities |
Inconvenient access to intervention (external challenges such as distance, bad weather, and lack of equipment) | Obstacles related to physical access and environmental factors hindering participation in interventions | Offer flexible intervention delivery options, such as online platforms or home-based programs, and provide support to overcome logistical challenges | Apps to deliver interventions are easily available and accessible | Environmental context and resources |
Competing priorities (such as childcare and household responsibilities) that are make individuals too busy to properly follow lifestyle interventions | Conflicting obligations and time constraints preventing individuals from prioritizing lifestyle interventions | Offering schedule flexibility and integration into daily life, to help individuals balance competing responsibilities | Hope to carry out remote intervention, which can be completed at home | Environmental context and resources |
Worry about too many interventions and fear of learning new things | Anxiety about the complexity or volume of interventions and reluctance to engage in unfamiliar activities | Break down intervention tasks and provide clear instructions and support, to reduce fear and promote learning through the gradual introduction of new activities | The tasks in different modules are clearly distinguished or indicated | Reinforcement, Environmental context and resources |
Lack of affordability of healthy lifestyles (e.g., food) | Financial constraints limiting access to resources necessary for maintaining healthy behaviors | Provide affordable alternatives, such as increasing healthy food variety options | Don’t want to be forced to eat a certain “health food” | Environmental context and resources |
Dementia remains stigmatized and associated with negative attitudes and preconceptions | Persistent societal stigma and misconceptions surrounding dementia discourages engagement in interventions | Launch educational campaigns aimed at reducing stigma and increasing awareness about dementia, emphasizing the importance of early intervention and support | De-stigmatization; the words “dementia” and “cognitive impairment” do not appear in the name and content modules of the application | Environmental context and resources, Social influences |
If coaching isn’t personalized, people won’t be motivated | Lack of personalized support and guidance leading to diminished motivation and engagement | Offer individualized coaching and support tailored to the specific needs and preferences of participants to enhance motivation and adherence | Set personalized points goals | Goals, Reinforcement |
Not familiar with mobile phone functions and don’t know what to do when encountering problems | Limited technological proficiency and uncertainty in troubleshooting issues with mobile devices | Provide user-friendly technology platforms with intuitive interfaces and offer ongoing technical support and guidance to address any difficulties | Professional staff available for consultation | Environmental context and resources |
Lack of supervision and often forget to complete intervention tasks | Absence of regular oversight and reminders, resulting in forgetfulness and incomplete adherence to intervention tasks | Implement strategies for monitoring and feedback, including regular check-ins and automated reminders, to enhance accountability and task completion | Posting tasks at fixed times each week or day can help establish a routine | Environmental context and resources |
The intervention content is not very interesting and can easily become boring | Lack of engagement due to unstimulating or monotonous intervention content | Enhance intervention content with interactive elements, gamification elements, and personalized experiences, to sustain interest and motivation over the long term | Intervention tasks have a high degree of autonomy and personalization | Environmental context and resources |
