Exploration of an Online Education Program to Support Caregivers' Knowledge Transfer

proportion correct on the immediate (approx. 10 min retention interval) test of near transfer. The test will include 48 questions and will be fill-in-the-blank format. Performance will be explored via percent correct on the test and magnitude of the retrieval practice effect on the test.

proportion correct on the immediate (approx. 10 min retention interval) test to apply examples of symptoms of ADRD. The test will include 8 questions and be short-answer format. Performance will be explored via percent correct on the test and magnitude of the retrieval practice effect on the test.

proportion correct on the final 2-day delayed test of near transfer. The test will include 48 questions and will be fill-in-the-blank format. Performance will be explored via percent correct on the test, magnitude of the retrieval practice effect on the test, and amount of forgetting.

proportion correct on the final 2-day delayed test of transfer to apply examples of symptoms of ADRD. The test will include 8 questions and be short-answer format. Performance will be explored via percent correct on the test, magnitude of the retrieval practice effect on the test, and amount of forgetting.

proportion correct on the final 2-day delayed test of symptoms of ADRD. The test will include 48 questions and will be in multiple-choice format. Performance will be explored via percent correct on the test, magnitude of the retrieval practice effect on the test, and amount of forgetting.

proportion correct on the immediate (approx. 10 min retention interval) test of symptoms of ADRD. The test will include 48 questions and will be in multiple-choice format. Performance will be explored via percent correct on the test, magnitude of the retrieval practice effect on the test, and amount of forgetting.

Participants will complete the Medical Term Recognition Test (METER, Rawson et al., 2010). The METER is completed on paper. A list of 40 medical words and 40 nonwords are presented. Participants read the list of items and select the ones that they recognize as real words. Participants are instructed not to guess and to only select items they are sure were real words. Performance on the METER is calculated as the number of words correctly recognized.

age, gender, education level, race/ethnicity, first generation status, member of an underrepresented group, native language, socioeconomic status, occupation, zip code, relationship with individual living with Alzheimer's Disease or a related dementia (e.g., child, spouse), caregiving status and duration of caregiving, and information seeking about dementia and caregiving.

Caregivers will self-report co-morbid medical conditions for the PLwD, and will report medication use, rating of health, hospitalizations, access to health insurance for the PLwD. Caregivers will be allowed to skip any questions they desire should they prefer not to report responses to any of these questions. No measurement scale will be used for these self-report questions. Instead, these brief questions are intended to obtain general health information. Example questions include, "does the person have other chronic conditions?" "Does the person living with dementia take any prescription medications?" and "Have you gone to the hospital emergency room (ER) about the person living with dementia's health in the past year (12 months)?" Responses to these questions will be used for descriptive purposes to better understand the sample and will not be aggregated into one measure.

The behavioral and psychological symptoms experienced by the person living with dementia will be rated by the caregiver participants using the updated version of the Neuropsychiatric Inventory Questionnaire (NPI-Q; Cummings et al., 1994; Resnick et al., 2024; Resnick et al., 2021). This measure includes 12 items that the participant will rate on presence (yes vs. no), severity (1 = mild, 2 = moderate, 3 = severe), and distress (1 = not distressing at all to 5 = extremely distressing). Perceived symptom severity will be measured twice applying a pre-test post-test design.

Caregivers' performance during learning will be defined as the percent correct on retrieval practice trials. Specifically, caregivers will respond to multiple choice questions during learning when engaging in retrieval practice, and learning progress will be quantified by aggregating responses across items for each block. Each multiple choice question will have 1 correct answer and 3 incorrect lures, and responses will be scored as 1 (correct) or 0 (incorrect) and then aggregated per participant. This is a quantitative measure that is standard in the science of learning and for which no validated scale is available. Performance on retrieval practice trials for the will be evaluated with item-level analysis (to explore content difficulty) and across each learning block to establish participants' rate-of-learning.

Non-verbal fluid intelligence will be assessed with a computerized version of Raven's progressive matrices (Raven, et al., 1998). Participants will complete 18 trials in ascending order in trial normative difficulty (Ariel, Babineau, & Tauber, 2023; adapted from Stanovich & Cunningham, 1993). For each trial, a 3 x 3 array will be displayed with 8 geometric figures. The 9th position in the bottom right-hand corner will be empty. Participants will be given 8 geometric figures from which to choose to correctly complete the array. Participants will be given 10 minutes to complete as many trials as possible. Performance will be calculated as the total number of trials correct.

Verification of ADRD symptoms for each caregiver's person living with dementia (PLwD) is critical to confirm authentic caregiving. We will use the Ascertain Dementia 8 (AD8; Galvin et al., 2005), a validated informant interview sensitive to early cognitive change with strong predictive accuracy (AUC = .83), diagnostic accuracy (AUC = .92; Chen et al., 2018), and cross-cultural validation (Dominguez et al., 2021; Ismail et al., 2021; Meguro et al., 2015). The 3-minute interview will be conducted in-person or via video call. Caregivers answer 8 questions (e.g., Has there been a change in the last several years caused by cognitive (thinking and memory) problems? Have there been problems with judgments (e.g., falls for scams, bad financial decisions, buys gifts inappropriate for recipients) in the last several years?) by responding, yes, no, or N/A (don't know). Scores (0-8) sum affirmative responses; higher scores indicate more impairment. A cutoff ≥ 2 indicates high probability of carin