PROspective MEmory Training to improve HEart failUre Self-care: a randomised controlled trial

Restorative memory training (Virtual Week) HF patient participants randomly allocated to receive the computer based restorative memory training strategy (Virtual Week), will be contacted by a research assistant (RA) who is blinded to their baseline neuro-psychological assessment. The RA will organize to meet face-face with the HF patient participant at a convenient time at their home or a clinic, to begin the training. It is anticipated the first training session will take 40-45 mins. At the training session the patient participant will be provided with a USB version of Virtual Week to use on their home computer over six weeks. They will be advised to use the training program four times per week over six weeks. Each training session will take approximately 20 to 30 minutes to complete each day. On insertion of the USB into the participant’s computer, it will bring up prompts to begin the training at the appropriate level and limit the number of sessions that can be completed on each day. The training version of Virtual Week has the critical factor of adaptive difficulty where the task starts at a relatively easy level and then is progressively more difficult, adapting to the performance level achieved by the participant. Another key feature of this program is the distributed practice of the cognitive training, in this case over six weeks, rather than massed practice in one or two long sessions. A final key training feature, is that Virtual Week has provision to provide feedback at the conclusion of each 'virtual day' (which will occur twice per session) so that participants are aware of their performance on each day and of their progression through the difficulty levels. The program also has provision to record performance. At the first training session the RA will provide face-to-face support to the patient participant in using the computer program. An automatic emailing system will also be set up by the RA to send participant's training data automatically at the completion of each session so that the participant’s involvement in the restorative memory training program can be monitored. In addition, the RA will make contact with participants by telephone twice a week to offer support and monitor progress. The RA will also be accessible to participants by telephone four days a week, during business hours to answer queries or resolve issues relating to the program. Face-to-face support will be arranged where needed. After six weeks of using the memory training program the RA will arrange for the USB to be returned.