The Digital Divide Exacerbates Disparities in Latinx Recruitment for Alzheimer’s Disease and Related Dementias Online Education During COVID-19

Abstract

Latinx adults experience a high burden of dementia. Given that modifiable factors drive dementia disparities, engaging Latinxs in Alzheimer’s disease and related dementias (ADRD) education is critical to address dementia burden among this aging population. Yet, no studies have documented the role of the COVID-19 pandemic on dementia education among Latinxs. This study: (1) elucidates the recruitment and retention processes targeting Latinxs for online educational events during the pandemic; (2) describes facilitators/barriers to participation; and (3) offers lessons learned. We developed online dementia-focused workshops (English and Spanish) and employed a cold-calling approach to invite Latinx participants enrolled in clinical studies ( N = 209). Bivariate tests assessed demographic and cognitive differences between those who recruiters did ( n = 60) and did not ( n = 149) successfully engage. Frequency counts assessed participants’ technological access. Only 8/209 attended the online events; all held university degrees, most reported English as their primary language, and none experienced cognitive impairment. Results underscore how educational attainment, cognitive impairment, language preference, and age intersect to shape recruitment in dementia-focused online education. To promote healthy aging and to ameliorate dementia disparities, barriers to online engagement among older Spanish-speaking Latinxs with cognitive impairment and low educational attainment must be addressed.

A call to address structural barriers to Hispanic/Latino representation in clinical trials on Alzheimer's disease and related dementias: A micro‐meso‐macro perspective

“…When Spanish‐speaking clinical trial staff are available, they may experience work overload, or over‐commitment to multiple research projects with recruitment goals for underrepresented groups within the same center or institution. In sum, sites without sufficient Spanish‐speaking personnel typically fall short of their recruitment goals for monolingual Spanish‐speaking Latino participants, or may recruit them in numbers that are not representative of their respective communities 19 …”

“…The lack of a bilingual/bicultural workforce in clinical trials hampers the language and cultural congruency, and the inclusion needed to facilitate successful outreach, recruitment, and engagement of clinical trial participants. 19 For example, despite recent gains, a 62% majority of US adults ages 25 and older do not have a bachelor's degree, including about eightin-ten Latino adults (79%). 37 Second, potential Latino job applicants have had low exposure to research experience or training during their college education, thus have less knowledge and skills that they can integrate in their job search.…”

“…The need to diversify AD/ADRD trial cohorts is critical and long overdue. Several calls to action have underscored the societal and scientific imperatives for diversifying trial cohorts 8,9,18–21 . In fact, several National Institutes of Health (NIH) scientific initiatives and strategies highlight the importance of increasing the representativeness of trial samples, including funding innovations in science on diversity, recruitment, and retention in aging research 21 .…”

Intersectional Approaches to Minority Aging Research

“…Specifically, intersectionality provides a framework with which to study the specific factors that arise from intersecting social positions. For example, differences in factors such as exposure to social stressors (e.g., discrimination, chronic stress), language barriers, access to socioeconomic and health-promoting resources (e.g., health insurance), health behaviors (e.g., smoking, alcohol consumption), and coping behaviors (e.g., prayer) may arise from the unique constellations of social positions that individuals occupy [1,42,67]. By using an intersectional perspective that first identifies individuals' positionality and conceptualizes the ways that positionality shapes exposure to unique health risks and access to resources across the life course, scholars are better able to move beyond simply describing group differences to identifying potentially modifiable factors and informing more effective and culturally appropriate interventions to improve outcomes for aging minoritized populations.…”

Loneliness Exacerbates the Association Between Bodily Pain and Depressive Symptoms Among Middle-Aged and Older Latinx Adults

“…Prior research shows the centrality of familismo among Latinxs and the value of social programs (e.g., dance programs, support groups) for promoting physical and mental health. Therefore, mobilizing resources to develop culturally-proficient in-person and virtual (Gutierrez et al, 2022) group programs can be an effective strategy to address bodily pain and loneliness among Latinx adults. For instance, in-person and virtual community-based group activities (e.g., Zumba and walking groups) involving family, friends, and community members can tap into familismo and hermandad (solidarity and brotherhood among group) values among Latinxs and can function to reduce loneliness while enhancing social networks, social support, and health.…”