Journal Article

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

Chen, Rong, Shi, Changmiao, Xue, Erxu, Wang, Ying, Huang, Zishuo, Qiu, Gonghang, Ao, Xinhua, Xu, Dong(Roman), Wang, Ziyi

2026

Overview

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. Highlights This study provides the first systematic application of the updated Consolidated Framework for Implementation Research (CFIR) five‑step methodology (2025) to a community‑based multidomain non‑pharmaceutical interventions (NPIs) implementation study using an embedded mixed‑methods design. Coincidence analysis (CNA) moves beyond isolated factor listings to identify exploratory configurational pathways across multiple CFIR domains. This approach illustrates the principle of equifinality in implementation outcomes, where different combinations of conditions are associated with successful real‑world delivery. A comprehensive implementation landscape of 202 determinants is mapped, systematically distilling six core facilitator themes and six core barrier themes. The analysis further delineates a distinctive “policy–academia–community” synergy alongside observed translation gaps between top‑down policy signals and frontline operational realities. Three actionable, multi‑level implementation strategy bundles are developed and stakeholder‑validated, including Capacity Building, Collaborative Network Building, and a CONSORT‑AI‑aligned AI/LLM‑enabled WeChat mini‑program (“Timi‑Cog”) designed to personalize care, enhance engagement, support sustainable delivery, and bridge the digital divide.

• Publisher: John Wiley & Sons, Inc,Wiley
• Subject: Adaptation / Adults / Aged / Aging / Capacity Building / Capacity building approach / China / cognitive decline prevention / Cognitive Dysfunction - prevention & control / Cognitive impairment / Collaboration / Community / community‐dwelling older adults / Consolidated Framework for Implementation Research (CFIR) / Dementia / Efficacy / Female / Fingers / Health care / Humans / Implementation / implementation science / Independent Living / Intervention / Mixed methods research / multidomain non‐pharmaceutical interventions / Older people / Pharmaceuticals / Prevention / Retrospective Studies / Stakeholders / Strategies / Success