Optimizing the social engagement of persons with mild cognitive impairment: insight from a process evaluation of an empowerment‐based psycho‐behavioral program

Abstract Background Enhancing social engagement has been suggested as a promising approach to enhance the quality of life and prevent the progression to dementia among older adults with mild cognitive impairment (MCI). However, their cognitive deficits and the concomitant neuropsychiatric symptoms, particularly depression and apathy, may not only mass their incompetency and inadequacy to engage in social events, but also lead to withdrawal from leisure activities and social interaction. Therefore, a randomized controlled trial of an empowerment‐based psycho‐behavioral program was conducted among persons with MCI, and its process evaluation may provide insight into optimizing social engagement among this preclinical cohort. Method A qualitative process evaluation was conducted for a 13‐week, group‐based, psycho‐behavioral program focused on promoting knowledge enhancement, cognitive coping, and stress adaptation among persons with MCI and was guided by empowerment model through a goal‐setting approach. A purposive sample of 22 participants who reported differential changes on NPS after completing the program attended an individual, semi‐structured, face‐to‐face interview from December 2020 to October 2021. A semi‐structured interview guide was developed to elicit their views on the engagement experience and perceived effects of the program. All interviews were audio‐taped, transcribed verbatim, and analyzed by thematic analysis. Result Three themes emerged: (1) barriers to social engagement, (2) environmental factors to increase social engagement, and (3) psychosocial context to increase social engagement. The participants identified fear of social rejection, lack of available social activities, and perceived difficulties in keeping appointments as barriers to social engagement. As supported by the empowering environment of the program, the participants received a clear roadmap and protocol to overcome their cognitive deficits and enhance their participation in social activities. The memory aids provided by the program, such as whiteboards and memos, were highly useful in tracking upcoming appointments and social events. The program also offered them a platform to develop new friendships and interact with peers facing similar challenges. Conclusion This study highlighted the effects of a psycho‐behavioral program on improving cognitive and psycho‐social well‐being among persons with MCI. The findings also underscored the potential of the empowerment approach to optimize cognitive coping and social engagement in this preclinical cohort.