Common Sense Model Factors Affecting African Americans' Willingness to Consult a Healthcare Provider Regarding Symptoms of Mild Cognitive Impairment

Abstract

Objective While at increased risk for developing dementia compared to whites, older African Americans are diagnosed later in the course of dementia. Using Common Sense Model (CSM) of Illness Perception, we sought to clarify processes promoting timely diagnosis of mild cognitive impairment (MCI) for African Americans. Design, Setting, Participants In-person, cross-sectional, survey data were obtained from 187 African Americans, mean age 60.44 years. Data were collected at social and health-focused community events in three southern Wisconsin cities. Measurements The survey represented a compilation of published surveys querying CSM constructs focused on early detection of memory disorders, and willingness to discuss concerns about memory loss with healthcare providers. Derived CSM variables measuring perceived causes, consequences and controllability of MCI were included in a structural equation model (SEM) predicting the primary outcome: Willingness to discuss symptoms of MCI with a provider. Results Two CSM factors influenced willingness to discuss symptoms of MCI with providers. Anticipation of beneficial consequences and perception of low harm associated with an MCI diagnosis predicted a person’s willingness to discuss concerns about cognitive changes. No association was found between perceived controllability and causes of MCI, and willingness to discuss symptoms with a provider. Conclusions These data suggest that allaying concerns about the deleterious effects of a diagnosis, and raising awareness of potential benefits could influence an African American’s willingness to discuss symptoms of MCI with a provider. The findings offer guidance to design culturally congruent MCI education materials, and to healthcare providers caring for older African Americans.

<p>Illness representations of dementia: a scoping review</p>

“…Overall, the IR dimensions examined in most previous studies were identity, causes, cure/control, consequences, timeline (chronic/acute/cyclical), coherence, and emotional representations. Four studies19–22 assessed other dimensions such as preventability, responsibility, and social comparison.…”

“…It should be noted that little work has been carried out to examine dementia IRs among different ethnic groups 19,36. The findings of these studies suggest that despite a potential shift in dementia IRs such as the believing that early recognition of MCI is beneficial, there are still misconceptions in regard to dementia among minority ethnic groups, such as believing that people living with dementia are unhygienic, aggressive, and have the same needs as children 36…”

“…Three of the studies examining formal caregivers assessed physicians, social workers, and nurses 23,31,32. Finally, seven studies were conducted among students or the lay public 19,33–38…”

“…As can be seen in Table 2, most quantitative studies used a revised or brief version of the Illness Perception Questionnaire (IPQ)2 with adaptations. The most common adaptations referred to the cause dimension, which was measured in some studies with an open item asking for “the three most important factors that you believe cause AD,”37 while in other studies the cause dimension was measured with a multiple item including different causes such as stress, worry, aging, heredity, and abnormal brain changes.19,22,27,28,31–33,35,38,39 In addition, six studies19–22,26,37 used dimensions that are not specifically included in the original IPQ and IPQ-Revised (eg, distress, perceived threat).…”

Understanding determinants of patients’ decisions to attend their family physician and to take antibiotics for upper respiratory tract infections: a qualitative descriptive study

“…While the CS-SRM model has mainly been applied to study chronic diseases (e.g. diabetes, Alzheimer's Disease, epilepsy, asthma) [19,[21][22][23], it has been used to explore how general public in the UK managed their respiratory tract infections [24]. URTIs have an acute course and are typically resolved within a few days but people can experience them many times during their lifetime, which may be similar to symptom presentation of some chronic illnesses.…”