Rural stakeholder perceptions about cognitive screening

Abstract

Objectives: The study aims were to explore stakeholder perceptions about cognitive screening in a rural, ethnically diverse, underserved setting, and to examine whether perceptions varied by years lived in a rural area, career, health literacy, willingness to be screened, ethnicity, education, or age. Methods: Twenty-one rural, ethnically diverse stakeholders completed an open-ended interview of five questions and a measure regarding perceptions about cognitive screening (PRISM-PC, Boustani, et al., 2008 ). Open coding using the in vivo process (Saldaña, 2015 ) to "derive codes from the actual participant language" (p. 77) was used to analyze the qualitative data. We used Pearson correlation to examine relationships between the PRISM-PC and sociodemographics including age, years of education, health literacy, years lived in rural areas, and willingness to participate in cognitive screening. Results: Eight codes and two themes were identified from the in vivo analysis. The eight codes were "a sentence being pronounced over the lives", "keep everybody at home", "Education is big", the trust issues is everything here", "identify support systems", "access to care", and "there is a cost to do that". The two themes were "Trust is the essential component of connecting with Community", and (2) "The Community recognizes the importance of knowledge in improving care. PRISM-PC results added new information in that persons were concerned about the emotional and financial burden on their families. Overall, regardless of age, careers, care involvement, health literacy, or education, 81% of stakeholders indicated they would seek annual cognitive screening. Discussion: It is important for rural health professionals to consider that contrary to previous stigma concerns, stakeholders may support earlier dementia detection.

Keywords: Screening and diagnosis; beliefs/attitudes; cultural aspects; mild cognitive impairment; psychological and social aspects.

Figure 1.

The Sociocultural Health Belief Model for dementia care-seeking*. Note: from Sayegh and Knight (p. 518, 2013): Though the model we present here includes only key variables, demographic variables (e.g. age, education) should be included as background variables in any analysis plan. It should also be noted that acculturation only applies to immigrants and certain minority ethnic individuals (e.g. those with fewer generations of US residency). All variables need not be examined at once in any individual analysis or study. In addition, the correlations among the endogenous variables should be examined before running any analyses; the relations presented in this model are hypothesized based on prior research and theory. Finally, this model can also be adapted for conditions other than dementia for which the key variables may be relevant. *Sayegh P, Knight BG. (2013). Cross-cultural differences in dementia: the Sociocultural Health Belief Model. International psychogeriatrics/IPA. 2013;25:517. doi:10.1017/S104161021200213X