Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK.
UCL Division of Psychiatry, London, UK.
Int J Geriatr Psychiatry. 2018 Aug;33(8):1048-1056. doi: 10.1002/gps.4891. Epub 2018 May 9.
We evaluated the feasibility and acceptability of a tailored evidence-based intervention, consisting of a leaflet and a letter, to encourage timely help-seeking for dementia in Black elders.
Participating GP surgeries were randomised to send either the intervention or a control leaflet about ageing well to Black patients aged ≥50 years old without known dementia. We interviewed patients 2 weeks later about the intervention's acceptability using closed and open-ended questions, and they completed a Theory-of-Planned-behaviour questionnaire about what they would do if they developed memory problems, which they also completed 4 months later.
Five of 26 surgeries approached agreed to invite patients. Sixty-five patients responded, of whom 61 (93.8%) agreed to participate. At 2 weeks, we consented and interviewed 47/61 (77%), of whom 24 received the intervention, and at 4 months we followed up 43/47 (91.5%). At 2 weeks, 44/47 (93.6%) found either intervention acceptable to receive by post, including 23/24 of the intervention. Nineteen of 24 (79.2%) reported reading the intervention leaflet compared with 13/23 (56.5%) controls. The intervention leaflet made 16/24 (66.7%) think about visiting their doctor for memory problems and led 4 to help-seeking behaviour. We calculated that 191 patients and 24 surgeries are required for an efficacy trial.
Given the intervention is acceptable, inexpensive, and unlikely to cause harm, we judge it appropriate to disseminate it without a full-scale trial. Recruitment attainment, retention, and projected sample size calculation indicated feasibility for a larger trial.
我们评估了一项定制的基于证据的干预措施的可行性和可接受性，该措施包括一份传单和一封信，以鼓励黑人老年人及时寻求痴呆症的帮助。
参与的全科医生手术被随机分配发送干预措施或控制传单给年龄在 50 岁及以上、没有已知痴呆症的黑人患者。我们在 2 周后通过封闭和开放式问题对患者进行了干预措施的可接受性访谈，并让他们填写了一份关于如果出现记忆问题他们会怎么做的计划行为理论问卷，他们还在 4 个月后再次填写了该问卷。
26 家诊所中只有 5 家同意邀请患者。共有 65 名患者做出了回应，其中 61 名（93.8%）同意参与。在 2 周时，我们同意并采访了 47/61 名患者（77%），其中 24 名接受了干预措施，在 4 个月时，我们随访了 43/47 名患者（91.5%）。在 2 周时，47/47 名患者（93.6%）认为通过邮寄方式接受干预措施是可以接受的，其中包括 24 名干预组的患者。24 名干预组中有 19 名（79.2%）报告说阅读了干预传单，而 23 名对照组中有 13 名（56.5%）。干预传单让 24 名患者中的 16 名（66.7%）考虑去看医生治疗记忆问题，并导致 4 名患者寻求帮助。我们计算得出，需要 191 名患者和 24 家手术才能进行疗效试验。
鉴于干预措施是可接受的、廉价的且不太可能造成伤害，我们判断在没有全面试验的情况下传播它是合适的。招募的实现程度、保留率和预计的样本量计算表明了进行更大规模试验的可行性。
