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Wiese LK, Williams IC, Holt JK, Williams CL, Lingler J, Galvin JE, Schoenberg NE. Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults. Aging Ment Health 2024; 28:943-956. [PMID: 38127408 PMCID: PMC11144567 DOI: 10.1080/13607863.2023.2294062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer's disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment. METHODS An adaptation of Schoenberg's Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later. RESULTS This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ2(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ2(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics. CONCLUSION Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Ishan C Williams
- University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Janet K Holt
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
- Southern Illinois University, Edwardsville, IL, USA
| | | | - Jennifer Lingler
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
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Kjerland TM, Schroeder S, Tofaeono V. Increased community engagement of Indigenous Peoples in dementia research leads to higher context relevance of results. DEMENTIA 2024; 23:643-668. [PMID: 38445447 PMCID: PMC11059836 DOI: 10.1177/14713012241233651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples. METHODS We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review. RESULTS Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement. DISCUSSION There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages.
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Affiliation(s)
- Tonya M Kjerland
- Department of Indigenous Health, University of North Dakota, USA
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Xue B, Luo C, Luo X. Attitudes toward dementia screening and influential factors in older adults in China. Psychogeriatrics 2023; 23:211-221. [PMID: 36457142 DOI: 10.1111/psyg.12918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/29/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Dementia will likely be an ongoing concern for future generations, and according to the World Health Organization, two-thirds of dementia cases are missed diagnoses. We aimed to explore the attitudes of older adults toward dementia screening and the related influencing factors. METHODS A multicentre cross-sectional study was conducted. Data were collected using questionnaires between 2020 December and 2021 June from five provinces in China. The study included older adults aged 60 years or older, living in China. A sociodemographic questionnaire and the Perceptions Regarding Investigational Screening for Memory in Primary Care scale were used to assess attitudes toward and influencing factors of dementia screening. RESULTS A total of 279 participants completed the questionnaires. The results revealed housing status as a positive factor in the acceptance dimension, while high income was the primary positive factor in the benefits of screening dimension. Having religious beliefs, low income, and never participating in social activities were positive factors for the stigma dimension. Widowed marital status and participation in social activities were negative factors for the independence dimension, while having religious beliefs positively influenced the suffering dimension. CONCLUSIONS This study showed that participants held a relatively positive attitude toward dementia screening, although they had concerns about stigma and negative impact on independence. Further studies are required to develop intervention strategies to help older adults improve their attitudes and quality of life, promote cognitive health, and facilitate healthy ageing.
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Affiliation(s)
- Bing Xue
- School of Nursing, Wuhan University, Wuhan, China
| | - Chang Luo
- School of Artificial Intelligence of Jianghan University, Wuhan, China
| | - Xianwu Luo
- School of Nursing, Wuhan University, Wuhan, China
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Bryant J, Freund M, Ries N, Garvey G, McGhie A, Zucca A, Hoberg H, Passey M, Sanson-Fisher R. Volume, scope, and consideration of ethical issues in Indigenous cognitive impairment and dementia research: A systematic scoping review of studies published between 2000-2021. DEMENTIA 2022; 21:2647-2676. [PMID: 36054372 DOI: 10.1177/14713012221119594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION High quality research involving Indigenous people with cognitive impairment and dementia is critical for informing evidence-based policy and practice. We examined the volume, scope and ethical considerations of research related to dementia with Indigenous populations globally from January 2000-December 2021. METHODS Studies were included if they were published in English from 2000 to 2021 and provided original data that focused on cognitive impairment or dementia in any Indigenous population. RESULTS The search yielded 13,009 papers of which, 76 met inclusion criteria. The overall number of papers increased over time. Studies were mostly conducted in Australia with Aboriginal and Torres Strait Islander people (n = 30; 39%). Twenty-six papers directly involved Indigenous participants with cognitive impairment or dementia. Of these studies, ethics approval was commonly required from two or more committees (n = 23, 88.5%). Ethical and legal governance frameworks were rarely discussed. DISCUSSION There is a clear need for further robust studies examining cognitive impairment and dementia with Indigenous populations. Future research should consider the ethical aspects of involving Indigenous participants with cognitive impairment in research.
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Affiliation(s)
- Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Megan Freund
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nola Ries
- Faculty of Law, 1994University of Technology Sydney, Sydney, NSW, Australia
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Alexandra McGhie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alison Zucca
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Hana Hoberg
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Megan Passey
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Lee S, Kim D, Lee H. Examine Race/Ethnicity Disparities in Perception, Intention, and Screening of Dementia in a Community Setting: Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148865. [PMID: 35886711 PMCID: PMC9321249 DOI: 10.3390/ijerph19148865] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/07/2022] [Accepted: 07/14/2022] [Indexed: 12/24/2022]
Abstract
Background: Delayed detection and diagnosis of Alzheimer’s Disease and related dementia (ADRD) can lead to suboptimal care and socioeconomic burdens on individuals, families, and communities. Our objective is to investigate dementia screening behavior focusing on minority older populations and assess whether there are ethnic differences in ADRD screening behavior. Methods: The scoping review method was utilized to examine ADRD screening behavior and contributing factors for missed and delayed screening/diagnosis focusing on race/ethnicity. Results: 2288 papers were identified, of which 21 met the inclusion criteria. We identified six dimensions of ADRD screening behavior: Noticing Symptoms, Recognizing a problem, Accepting Screen, Intending Screen, Action, and Integrating with time. Final findings were organized into study race/ethnicity, theoretical background, the methods of quantitative and qualitative studies, description and measures of ADRD screening behavior, and racial/ethnic differences in ADRD screening behavior. Conclusions: A trend in ethnic disparities in screening for ADRD was observed. Our findings point to the fact that there is a scarcity of studies focusing on describing ethnic-specific ADRD screening behavior as well as a lack of those examining the impact of ethnicity on ADRD screening behavior, especially studies where Asian Americans are almost invisible.
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Wiese LK, Williams IC, Schoenberg NE, Galvin JE, Lingler J. Overcoming the COVID-19 Pandemic for Dementia Research: Engaging Rural, Older, Racially and Ethnically Diverse Church Attendees in Remote Recruitment, Intervention and Assessment. Gerontol Geriatr Med 2021; 7:23337214211058919. [PMID: 34825019 PMCID: PMC8609097 DOI: 10.1177/23337214211058919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Access to cognitive screening in rural underserved communities is limited and was further diminished during the COVID-19 pandemic. We examined whether a telephone-based cognitive screening intervention would be effective in increasing ADRD knowledge, detecting the need for further cognitive evaluation, and making and tracking the results of referrals. METHOD Using a dependent t-test design, older, largely African American and Afro-Caribbean participants completed a brief educational intervention, pre/post AD knowledge measure, and cognitive screening. RESULTS Sixty of 85 eligible individuals consented. Seventy-percent of the sample self-reported as African American, Haitian Creole, or Hispanic, and 75% were female, with an average age of 70. AD knowledge pre-post scores improved significantly (t (49) = -3.4, p < .001). Of the 11 referred after positive cognitive screening, 72% completed follow-up with their provider. Five were newly diagnosed with dementia. Three reported no change in diagnosis or treatment. Ninety-percent consented to enrolling in a registry for future research. CONCLUSION Remote engagement is feasible for recruiting, educating, and conducting cognitive screening with rural older adults during a pandemic.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | | | | | - James. E. Galvin
- Professor of Neurology, University of Miami Miller School of
Medicine, Miami, FL, USA
| | - Jennifer Lingler
- School of Nursing, Health & Community
Systems, University of Pittsburgh, Pittsburgh, PA, USA
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Shura RD, Brearly TW, Tupler LA. Telehealth in Response to the COVID-19 Pandemic in Rural Veteran and Military Beneficiaries. J Rural Health 2020; 37:200-204. [PMID: 32402128 PMCID: PMC7273091 DOI: 10.1111/jrh.12454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Robert D Shura
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham, North Carolina.,Salisbury VA Medical Center, Salisbury, North Carolina.,Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Larry A Tupler
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham, North Carolina.,Durham VA Medical Center, Durham, North Carolina.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
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