Effectiveness of a Dementia Anti-Stigma Intervention in Rural Kenya
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 184
- 主要终点
- Change in Dementia attitudes (measured by the Dementia Attitudes Scale (DAS))
研究概览
简要总结
Stigma underlies many health disparities in Kenya, and dementia-related stigma is no different. Preliminary evidence highlights the short-term benefits of a dementia anti-stigma intervention in Kenya. The study aims to ascertain the long-term effectiveness of a locally developed dementia anti stigma intervention in order to establish a community resource that will improve dementia understanding, reduce stigma and improve health behaviours.
In AIM 1, the investigators will assess what public stigma towards people with dementia and their carers looks like in Kenya, through a survey (600). Individual interviews with 20 members of the general public who completed the survey will be conducted to explore what stigmatizing beliefs are held and why they form. Triangulation techniques will then be used to integrate quantitative and qualitative data. Reflecting on AIM 1 findings, the investigators will engage 20 key stakeholders to refine an existing anti-stigma intervention, to better target culturally specific misconceptions and negative beliefs about dementia (AIM2). In AIM 3, the investigators will determine the effectiveness of the intervention among members of the general public (n=184), through a stepped wedge cluster randomized trial (SWT).
详细描述
The overall aim of this research is to refine and evaluate a dementia stigma reduction intervention tailored to meet the needs of people in Kenya, in preparation for future implementation and adoption within existing policies.
This will be achieved through the following three specific aims. i) AIM 1: To adapt dementia-related knowledge and attitudes tools and develop a representative dementia stigma profile of the general public in Kenya.
ii) AIM 2: To refine an existing anti-stigma intervention to better target culturally specific misconceptions and negative beliefs about dementia.
iii) AIM 3: To determine the effectiveness of the anti-stigma intervention through a stepped wedge cluster randomized trial (SWT) among members of the general public.
Study site is in Makueni County in rural Kenya AIM 1: Adapting a dementia-related knowledge and attitudes tools and developing a representative dementia stigma profile of the general public in Kenya A survey of 600 adults (18 years and older) will be conducted in Makueni County, a rural setting in Kenya. Individuals in rural communities have higher rates of dementia, experience more health disparities and additional challenges with cultural belief systems, and utilization of care compared to their urban counterparts. Participants will be recruited from three geographically defined areas served by six Community Health Workers (CHWs), and ensure a diverse demographic profile based on age, sex and socio-economic status. The three geographically selected rural areas are representative of other rural regions in Kenya due to their similar settings. Participants will complete measures of knowledge (Dementia Knowledge Assessment Scale (DKAS)) and attitudes (Dementia Attitudes Scale (DAS)). DKAS is a reliable and valid tool for assessing dementia knowledge across a range of participants including members of the general public. It has been used among older adults in Africa. DAS is based on the tripartite model of attitude, has been validated for members of the general public and has a high Cronbach's alpha coefficient ranging from 0.83 to 0.85. To ensure that the measures are suitable for use within Kenya, they will undergo cross-cultural adaptation (forward and backward translations will be conducted, inconsistencies checked, and then pilot tested (n=24 general public members). Up to twenty individual interviews will also be held with a convenient sample of members of the general public who completed the survey to better explore what stigmatizing beliefs are held in the communities and why they form.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Other
- 盲法
- Double (Participant, Outcomes Assessor)
盲法说明
Randomization to receive the intervention will be conducted by a blinded independent researcher.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Residents of Mbooni Sub county
- •Aged 18 years and above
- •Able to speak the local language (Kamba)
- •Have capacity to consent
排除标准
- •Non residents of Mbooni Sub county
- •Less than 18 years
- •Do not speak the local language
- •Have no capacity to consent
结局指标
主要结局
Change in Dementia attitudes (measured by the Dementia Attitudes Scale (DAS))
时间窗: Assessments will be collected at baseline during enrollment of participants, then every 3 months up until 6 months after switch points of the intervention.
Dementia attitudes will be assessed using the Dementia Attitudes Scale (DAS), a validated tool that measures participants' comfort and perceptions when interacting with people with dementia. Scores on the DAS range from 20 to 140, with higher scores indicating more positive attitudes.
Change in Dementia knowledge (measured by the Dementia Knowledge Assessment Scale (DKAS))
时间窗: Assessments will be collected at baseline during enrollment of participants, then every 3 months up until 6 months after switch points of the intervention.
Dementia knowledge will be assessed using the Dementia Knowledge Assessment Scale (DKAS), which evaluates knowledge across domains such as causes, symptoms, risk factors, and care of people with dementia. Scores on the DKAS range from 0 to 50, with higher scores reflecting greater knowledge.
次要结局
- Intervention acceptability(Immediately post-intervention (within 2 weeks after completion of the 4-session program).)
- Change in Dementia engagement (Behavior)(From baseline during enrollment of participants, then every 3 months up until 6 months after switch points of the intervention.)