Discerning rural Appalachian stakeholder attitudes toward memory screening

Abstract

Objective:The aim of this descriptive study was to examine Appalachian stakeholder attitudes toward routine memory screening, and to compare and contrast results from a similar study conducted in an ethnically diverse rural Florida cohort. Determining perceptions about memory screening is essential prior to developing culturally relevant programs for increasing early dementia detection and management among rural underserved older adults at risk of cognitive impairment. Benefits of early detection include ruling out other causes of illness and treating accordingly, delaying onset of dementia symptoms through behavior management and medications, and improving long-term care planning (Dubois, Padovani, Scheltens, Rossi, & Dell'Agnello, 2016). These interventions can potentially help to maintain independence, decrease dementia care costs, and reduce family burdens (Frisoni, et al., 2017).Method: Researchers applied a parallel mixed method design (Tashakkori & Newman, 2010) of semi-structured interviews, measurements of health literacy (REALM-SF) (Arozullah, et al., 2007), sociodemographics, and cognitive screening perceptions (PRISM-PC) (Boustani, et al., 2008), to examine beliefs and attitudes about memory screening among 22 FL and 21 WV rural stakeholders (residents, health providers, and administrators).Results: Findings included that > 90% participants across both cohorts were highly supportive of earlier dementia detection through routine screening regardless of sample characteristics. However, half of those interviewed were doubtful that provider care or assistance would be adequate for this terminal illness. Despite previous concerns of stigma associated with an Alzheimer's disease diagnosis, rural providers are encouraged to educate patients and community members regarding Alzheimer's disease and offer routine cognitive screening and follow-through.

Overcoming the COVID-19 Pandemic for Dementia Research: Engaging Rural, Older, Racially and Ethnically Diverse Church Attendees in Remote Recruitment, Intervention and Assessment

“…Researchers have previously shown that providing information regarding AD can increase AD knowledge in long-term care settings (Dassel et al, 2020) and in rural communities (Wiese et al, 2017(Wiese et al, , 2020a(Wiese et al, , 2020b(Wiese et al, , 2020c. Providing education regarding AD has been shown to increase racially/ethnically diverse faith-based participants in memory screenings (95%; Daccarett et al, 2021) and completed provider referrals (84-95%; Wiese et al, 2021).…”

“…It has been tested in over 600 rural older adults, with a pre-post effect size of r = 0.81, indicating a large effect size (Lakens, 2013). However, tests for reliability and validity have been favorable, including Cronbach's alpha = .84 and overall Rasch item analysis of .94 (Wiese et al, 2017(Wiese et al, , 2020a(Wiese et al, , 2020b(Wiese et al, , 2020c(Wiese et al, , 2021.…”

“…To address this need for early dementia detection in rural underserved communities, our research has focused on increasing cognitive screening rates following educational outreach efforts. We previously examined basic knowledge of Alzheimer’s disease (BKAD; Wiese et al, 2017 , 2019 ), stakeholder willingness to screen ( Wiese, Williams, and Galvin, 2018 , Wiese, Williams, Galvin, et al, 2020a , 2020b , 2020c ), and rates of follow-through after referral after positive screens ( Wiese, Williams, Galvin, et al, 2020a , 2020b , 2020c ). We observed that faith-based settings are a potentially robust avenue in which dementia screening and educational programs can be successfully implemented.…”

Telehealth in Response to the COVID‐19 Pandemic in Rural Veteran and Military Beneficiaries

“…Furthermore, rural residents not only may be more accustomed to self-isolation and cohesive family interdependence, but they may actively cultivate these lifestyle qualities. 48,49 Thus, sheltering in place may not feel as constricting as it would to an urban or suburban resident. We may be able to discern much from the rural community about how to effectively adjust and live so as to successfully weather this pandemic and minimize related adverse mental health sequelae.…”

“…The reason that individuals in rural communities are at diminished risk is merely a matter of density: the same reason why state governors and local municipalities initially banned gatherings of over 50 people, subsequently reduced them to 10, and in some cases as few as 2. Furthermore, rural residents not only may be more accustomed to self‐isolation and cohesive family interdependence, but they may actively cultivate these lifestyle qualities 48,49 . Thus, sheltering in place may not feel as constricting as it would to an urban or suburban resident.…”