Table 1.

Session outline for the Active Brains-Fitbit and health enhancement program for older adults with chronic pain and cognitive decline.

Session	AB-Fa topic	AB-F skills and session content	HEPb topic	HEP skills and session content
1	CPc and CDd: the disability spiral	Myths about pain, unhelpful pain alarm, disability spiral, mind-body connection, deep breathing, and gratitude practice	Program overview and CP and CD	Understanding CP and CD, connection between CP and CD, and impact of stress
2	“Walk All Over” the disability spiral	Quota-based walking, choosing meaningful activities, setting a walking plan, education on increasing daily walking, self-compassion, and barriers to using the Fitbit	The connection between CP, CD, and physical wellness	Connection between CP and CD
3	Mindfulness and pain	Mindfulness, breathing meditation, body scan, mindful moments, and pain awareness	Sleep and wellness	Sleep hygiene, cognitive and physical health
4	Mindfulness of pain sensations	Noticing unhelpful alarms, mindfulness of pain meditation, mindful walking, and overcoming barriers to walking	Exercise and wellness	Physical exercise, maintaining healthy weight, and tips for getting active
5	Building cognitive reserve	Education on cognitive abilities, CP-CD connection, coping with cognitive difficulties, engaging your intellect, and cognitive mindful moments	Nutrition I: the basics	Basic nutrition, portion size and calories, and understanding food labels
6	Strengthening social support for CP and CD	Social support and the pain cycle, types of social support, reducing loneliness: get active together, social support in CP and CD, and effective communication	Nutrition 2: healthy weight and weight loss	Eating healthier meals and snacks, eating out healthy, and weight loss and BMI
7	Coping skills to get back on track	CP, CD, and values; why we walk; getting back on track with walking; and stop and breathe, reflect, and choose	Managing your health care for CP and memory-related problems	Communicating with doctors, health diary, medical emergencies, and medication adherence
8	Staying on track and maintaining your progress	The powerful self, staying on track, reflecting on Active Brains skills, and resiliency plan	Review of Active Brains 2	Overview of program skills

^aAB-F: Active Brains-Fitbit.

^bHEP: health enhancement program.

^cCP: chronic pain.

^dCD: cognitive decline.