The diffusion of dementia risk education

Abstract

Background The Preventing Dementia Massive Open Online Course (PD‐MOOC) is one of several initiatives aiming to increase dementia risk knowledge and promote risk‐reducing behaviour. These initiatives primarily reach advantaged individuals, increasing health inequities. Previously, thematic analysis of PD‐MOOC participant feedback identified frequent reports of sharing dementia risk information with others. Interpersonal communication often introduces information to people from a broader demographic and may increase the impact of dementia risk education. This study investigated the diffusion of dementia risk reduction knowledge and behaviour beyond PD‐MOOC participants. Method The PD‐MOOC attracted over 99,000 enrolments from 2016 to 2019. Responses to surveys completed by participants before (demographics) and after (course feedback) the PD‐MOOC were analysed. Qualitative statements were characterised using key word filtering and subsequent thematic analysis. Chi‐squared tests of homogeneity with Bonferroni adjustments for multiple comparisons were used to determine significant information sharing patterns. Result Older people, females, health sector workers and people with a post‐secondary education were over‐represented among PD‐MOOC participants. Participants expressed an eagerness to share the MOOC with others, with 98.8% of respondents agreeing they “would recommend the MOOC to others”. 25% of responding participants discussed sharing PD‐MOOC information in their response to the question “If you have already applied your MOOC learning, please tell us how”. Among those who reported sharing information with specific people, family members were mentioned most frequently, followed by friends and colleagues. Significantly more responses discussed sharing information with males than females (p < 0.001) and with people outside the health sector than within (p < 0.001). Some participants reported sharing information about specific risk domains; physical activity was mentioned most frequently, followed by cognitive stimulation and diet. Additionally, some reported that the person with whom they shared information altered their behaviour; increased physical activity was most commonly reported, followed by a general improved lifestyle and a change in diet. Conclusion Information sharing transmits dementia risk information to, and promotes behaviour change among, people who are demographically less represented in the PD‐MOOC, extending the reach and impact of this educational intervention. The PD‐MOOC enables dementia risk reduction beyond those educated.

Island Study Linking Aging and Neurodegenerative Disease (ISLAND) Targeting Dementia Risk Reduction: Protocol for a Prospective Web-Based Cohort Study

“…We anticipate that this targeted and supported recruitment strategy will increase the representation of people who may not otherwise join a web-based research program and whose data will contribute to more population-equivalent distributions across the risk domains (eg, smoking, BMI, diet). A related study [ 67 ] is examining the drivers of reach and resonance of risk reduction messages at community and population level and will inform the ongoing development and dissemination of actionable information about dementia risk reduction. Cultural and linguistic diversity was not included in the initial baseline data but is increasingly recognized as an important determinant of health and health behaviors.…”

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

“…Some participants in dementia risk-reduction initiatives report discussing these initiatives in personal conversations. In the preventing dementia MOOC, 70% of participants reported hearing about the programme through interpersonal communication, which is unsurprising given that 99% of participants stated that they would recommend the MOOC to others [34]. According to the predictions of the reviewed models, these personal conversations may already be broadening the reach of this initiative.…”

“…While empirical data have shown that two of the identified strategies are able to broaden the reach of dementia risk-reduction initiatives, there is no data to suggest that these strategies will promote initiative participation among all members of a global target audience. Interpersonal conversations may transmit information about dementia risk reduction alongside information about risk-reduction initiatives, which may independently increase dementia risk-reduction knowledge and promote risk-reducing behaviour, thereby reducing the importance of direct initiative participation [34]. Interpersonal communication may therefore have the added benefit of enabling people who may never participate in dementia risk-reduction initiatives to access and act on information about dementia risk reduction.…”

Interpersonal communication may improve equity in dementia risk education

“…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.…”

“…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 21 . In MOOC iterations from 2016 to 2018, sharing information from or about the MOOC was one of the most common topics arising in free‐text responses to the broad application question: “if you have already applied your MOOC learning, please tell us how.” 22 This interpersonal communication may be reaching people from a broader range of backgrounds than those directly participating in the course, increasing the population‐wide impact of this initiative.…”