Sajatovic M, Herrmann L K, Knebusch C, Sarna K, Lerner A J, Fuentes-Casiano E, Burant C J
Martha Sajatovic, M.D., Professor of Psychiatry and of Neurology, Case Western Reserve University School of Medicine, Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, 10524 Euclid Avenue, Cleveland, Ohio 44106, Tel. 216/844-2808, Fax 216/844-2742, email:
J Prev Alzheimers Dis. 2023;10(4):790-799. doi: 10.14283/jpad.2023.124.
While the U.S. National Institute on Aging has developed a strategy for recruitment of minority populations in dementia research, including increasing awareness and engagement, minority populations remain under-represented, and the evidence-base is limited. We tested a conceptually driven communication approach targeting barriers and facilitators to research participation vs. standard education.
In this 2-phase project, input from the minority advisory board of the Cleveland Alzheimer's Disease Research Center informed development of 2 brief health communication videos which differentially focused on research barriers and facilitators (POWER) versus an education control (Phase 1). In Phase 2, a randomized prospective survey compared POWER vs. an active comparator control on pre/post video change in dementia knowledge, cumulative barriers, and facilitators to dementia research, and change in research readiness measured by the Transtheoretical behavior change model. Changes in outcomes were evaluated using two group by two time points repeated measure analysis of variance (RMANOVA) controlling for age, gender, race, and education.
The pre-video sample (n=242) had mean age of 57.6 (SD17.2) years, mostly female (n=181, 74.8%), 42.6% non-white. The analyzable sample who completed both pre and post assessments comprised n=102 in the POWER and n=105 in the control group. Non-white participants made up 41.1% of the analyzable POWER (n=51) and 44.1% (n= 52) of controls. Adjusted for age, gender, race and education, controls had a greater increase in dementia knowledge (p=0.004). There was a significant reduction in barriers for POWER (p=.044) vs. control. There were no differences in research facilitators and research readiness between POWER vs. control. Among African Americans (n=59, 28.5% of the analyzable sample) there was a trend for improved dementia knowledge (p=.059) favoring control and in research readiness (p=.051), favoring POWER.
Targeting barriers and attitudes towards research could inform development of approaches with potential to improve dementia research participation across diverse communities.
虽然美国国立衰老研究所已制定了一项在痴呆症研究中招募少数族裔人群的策略，包括提高认知度和参与度，但少数族裔人群在研究中的代表性仍然不足，且证据基础有限。我们测试了一种概念驱动的沟通方法，该方法针对研究参与的障碍和促进因素，与标准教育方法进行对比。
在这个两阶段项目中，克利夫兰阿尔茨海默病研究中心少数族裔咨询委员会的意见为两段简短的健康沟通视频的制作提供了信息，这两段视频分别侧重于研究障碍和促进因素（POWER）以及一个教育对照组（第一阶段）。在第二阶段，一项随机前瞻性调查比较了POWER组与一个积极对照对照组在观看视频前后痴呆症知识、累积障碍以及痴呆症研究促进因素的变化，以及通过跨理论行为改变模型测量的研究准备度的变化。使用控制年龄、性别、种族和教育程度的两组两时间点重复测量方差分析（RMANOVA）评估结果的变化。
视频前样本（n = 242）的平均年龄为57.6岁（标准差17.2），大多数为女性（n = 181，74.8%），42.6%为非白人。完成前后评估的可分析样本中，POWER组有n = 102人，对照组有n = 105人。非白人参与者占可分析的POWER组的41.1%（n = 51），占对照组的44.1%（n = 52）。在对年龄、性别、种族和教育程度进行调整后，对照组的痴呆症知识增长更多（p = 0.004）。与对照组相比，POWER组的障碍显著减少（p = 0.044）。POWER组与对照组在研究促进因素和研究准备度方面没有差异。在非裔美国人中（n = 59，占可分析样本的28.5%），存在痴呆症知识改善倾向（p = 0.059），有利于对照组，在研究准备度方面（p = 0.051），有利于POWER组。
针对研究障碍和态度可能为开发有潜力提高不同社区痴呆症研究参与度的方法提供信息。
