Preliminary Development of a Multidomain Behavioral Intervention for Primary Prevention of Dementia in Midlife

Abstract

BackgroundAn estimated 40% of global cases of Alzheimer’s disease and related dementias (ADRD) may be prevented through modification of 12 risk factors. Midlife risk reduction is particularly important given the long prodromal period for ADRD. However, population adherence to these health behaviors is low, and large, multidomain behavioral interventions have suffered from poor adherence. The goal of this study was to use qualitative methods to develop a personalized health education intervention (TEACH: Tailored Education for Aging and Cognitive Health), which is grounded in the Health Belief Model.MethodWe conducted six focus groups in which we presented health information about a fictitious person, including images conveying ADRD risk and descriptions of personal health belief factors. Participants provided feedback about the images, their understanding of ADRD risk, and interpretation of the health belief concepts. Results were summarized using a framework matrix.ResultsGroups found the presented risk information to be understandable and relevant to health behaviors. They had strong reactions to presented images and descriptions, and they provided alternative language and suggestions to improve clarity. Participants noted some overlap between health belief constructs but were able to identify connections between health beliefs and personal behaviors.ConclusionsResults guided the TEACH intervention development project, which includes creating an explanatory framework for disclosing individuals’ ADRD risk factors and health belief profile. The long-term goal is to develop a multi-domain intervention to promote sustained health behavior change for primary prevention of ADRD.