There is no one size fits all: Elements of implementing virtual bike rides to address loneliness in people living with dementia

Objective: This study aimed to identify factors that hinder or facilitate the implementation of an exergaming technology, SilverFit Mile, which offers virtual cycling, for nursing home residents with dementia in and its potential impact on feelings of loneliness. Methods: The study followed a descriptive qualitative approach using semi structured interviews with eight care professionals in nursing homes in the Netherlands and based on the Consolidated Framework for Implementation Research (CFIR). Thematic text analysis was used to analyze the interviews. Results: We identified three main themes and twelve subthemes based on the CFIR. The main themes were residents’ personal characteristics, implementation factors, and loneliness. SilverFit Mile was more suitable for those familiar with cycling and those who enjoyed more solitary activities. Organizational factors such as staff's low digital literacy, lack of time, and need for training were found barriers to implementation, while facilitators included fostering social interaction. Conclusions: SilverFit Mile was considered positively by care staff based on observations of persons living with dementia. We identified loneliness as a relevant outcome of SilverFit Mile implementation. We argue that SilverFit Mile can foster social interaction between residents and staff through reminiscence or the physical aspect of cycling. However, a better understanding of the connection between loneliness and the use of SilverFit Mile is needed. Overall, our research provides initial ideas about how exergaming technology might address loneliness in dementia.