Broadening the reach of dementia risk-reduction initiatives: strategies from dissemination models

Abstract

Background: Modifiable risk factors for dementia account for 40% of cases worldwide and exert impacts on risk across the life course. To have maximal public health impact, dementia risk-reduction initiatives need to reach a large and diverse audience, including people from a wide range of ages and socioeconomic backgrounds. Currently, dementia risk-reduction interventions primarily reach a narrow audience, consisting largely of highly educated older adults from high income countries. Methods: In this commentary, we review established dissemination models to identify strategies that could be used to extend and broaden the reach of dementia risk-reduction initiatives. Three potential reach-broadening strategies can be identified from these models: engaging with distinct user groups; focusing on interpersonal communication; and utilising dissemination agents. Results: Engaging with distinct user groups and utilising dissemination agents show promise for broadening the reach of dementia risk-reduction initiatives, while interpersonal communication has received limited attention in this context. Further evaluation of the impact of interpersonal communication may provide avenues to take advantage of this dissemination method. Conclusions: Based on the reviewed models and data from current risk-reduction initiatives, we suggest that utilising all three of these strategies may most effectively broaden the reach of dementia risk-reduction initiatives. This may promote risk reduction among a larger and more diverse audience, more equitably reducing the global impact of dementia.

Interpersonal communication may improve equity in dementia risk education

“…1,7,17,18 These risk-reduction initiatives may be inadvertently increasing health inequities by providing additional risk-reduction opportunities to groups of people who are already likely to have low levels of modifiable dementia risk. 19 The reach of dementia risk reduction initiatives therefore needs to be increased and broadened to include more people from groups that tend to have a higher level of modifiable dementia risk. Interpersonal communication about an initiative may be one way of increasing initiative reach to include these people.…”

“…Interpersonal communication about an initiative may be one way of increasing initiative reach to include these people. 19,20 Similar to other dementia risk reduction initiatives, the Wicking Dementia Centre's globally available Preventing Dementia Massive Open Online Course (MOOC) primarily attracts people aged 50-70, women, health care workers, highly educated people, and people from high-income countries. 19,21 Preventing Dementia MOOC participants frequently report sharing information with others as an outcome of course participation.…”

“…19,20 Similar to other dementia risk reduction initiatives, the Wicking Dementia Centre's globally available Preventing Dementia Massive Open Online Course (MOOC) primarily attracts people aged 50-70, women, health care workers, highly educated people, and people from high-income countries. 19,21 Preventing Dementia MOOC participants frequently report sharing information with others as an outcome of course participation. After completing the MOOC, 99% of responding participants stated that they would recommend the MOOC to others.…”

“…Mass media campaigns and programs that are freely available online also tend to reach a small portion of the global population, primarily reaching highly educated individuals from high income countries 1,7,17,18 . These risk‐reduction initiatives may be inadvertently increasing health inequities by providing additional risk‐reduction opportunities to groups of people who are already likely to have low levels of modifiable dementia risk 19 . The reach of dementia risk reduction initiatives therefore needs to be increased and broadened to include more people from groups that tend to have a higher level of modifiable dementia risk.…”

“…The reach of dementia risk reduction initiatives therefore needs to be increased and broadened to include more people from groups that tend to have a higher level of modifiable dementia risk. Interpersonal communication about an initiative may be one way of increasing initiative reach to include these people 19,20 …”