Farina Nicolas, Musyimi Christine W, Onuonga Kevin, Ndetei David M
Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, Devon, UK.
Department of Research, Africa Institute of Mental and Brain Health, Nairobi, Kenya.
Alzheimers Dement. 2025 Feb;21(2):e14513. doi: 10.1002/alz.14513. Epub 2025 Jan 14.
This study describes the implementation outcomes and evaluation of DEM-SKY, a community-based dementia screening program developed in rural Kenya with the support of community health care workers (CHWs).
DEM-SKY was delivered to 3546 older adults in Makueni County, Kenya, over a 6-month period. Using a mixed-methods design, we explored implementation outcomes with stakeholders through surveys and interviews.
The program demonstrated good acceptability, adoption, and fidelity and was effective in instigating behavior change. Individuals who screened positive for dementia were 28.7 times more likely to intend to speak to a doctor. Qualitative data showed that participants valued the program but indicated scope for improvement, particularly further down the diagnostic pathway.
DEM-SKY was successful across several implementation metrics. Although the program demonstrates that community-based screening can be conducted effectively with minimal resources, future research needs to explore the long-term benefits of dementia screening in Kenya.
Community-based dementia screening is feasible in rural Africa. Involving community health workers strengthens trust in health care systems. Empowering community health workers enhances the community capacity to address dementia Screening promotes proactive health seeking among older adults.
本研究描述了在肯尼亚农村地区,在社区卫生工作者(CHW)的支持下开发的基于社区的痴呆症筛查项目DEM-SKY的实施成果及评估情况。
在6个月的时间里,DEM-SKY项目在肯尼亚马库埃尼县的3546名老年人中开展。采用混合方法设计,我们通过调查和访谈与利益相关者探讨了实施成果。
该项目显示出良好的可接受性、采用率和保真度,并且在促使行为改变方面是有效的。痴呆症筛查呈阳性的个体与医生交谈的意愿是其他人的28.7倍。定性数据表明,参与者重视该项目,但也指出了改进的空间,尤其是在诊断流程的后续环节。
DEM-SKY在多个实施指标上取得了成功。尽管该项目表明,以社区为基础的筛查可以在资源极少的情况下有效开展,但未来的研究需要探索肯尼亚痴呆症筛查的长期益处。
基于社区的痴呆症筛查在非洲农村地区是可行的。让社区卫生工作者参与可以增强对医疗保健系统的信任。赋予社区卫生工作者权力可提高社区应对痴呆症的能力。筛查可促进老年人积极寻求健康。