Raising awareness for dementia risk reduction through a public health campaign: a pre-post study

Abstract

Objectives: Evaluate the effect of a health promotion campaign aimed at increasing awareness about dementia risk reduction in middle-aged community-dwelling individuals in the Netherlands.

Design: A 10-month public health campaign using mass media and community participation, supported by eHealth. Population-level difference in awareness before and after the campaign, including variation between demographic groups, was assessed in two independent cross-sectional samples from the same target population.

Setting: The public health campaign was launched in the Province of Limburg, the Netherlands, targeting all inhabitants aged 40-75 years old. Three specific districts within the Province were chosen for an additional community participation approach, in which local stakeholders were invited to support the campaign.

Results: No pre- (n=590) post- (n=602) difference was observed in people agreeing to the statement that dementia risk reduction is possible (X²(1)=1.27, p=0.260). For the individual lifestyle factors, physical activity (7.6% increase (X²(1)=7.48, p=0.006)) and healthy diet (10.5% increase (X²(1)=12.37, p≤0.001)) were identified more often as being protective against dementia after the campaign. Of all risk/protective factors assessed, cognitive activity was identified most often at both preassessment (79.4%) and postassessment (80.4%), but there was no increase in awareness (X²(1)=0.17, p=0.677). Self-reported exposure to the campaign was associated with greater awareness and motivation for behavioural change (X²(1)=6.52, p=0.011). Compared with mass media only, the addition of community participation resulted in better recognition of campaign material and the eHealth platform.

Conclusions: This study was not able to reach a population-level increase of awareness of dementia risk reduction. Two out of the three lifestyle factors that formed the foundation of the campaign were identified more often after the campaign. Those reported having been exposed to the campaign were more aware and more inclined towards behavioural change.

Keywords: dementia; preventive medicine; public health.

Figure 1

Precampaign (n=590) and postcampaign (n=602) comparison of the total sample. Percentage agreeing with the statement that dementia risk reduction is possible, and percentage identifying the three target risk factors/themes of the campaign. Maximum values and percentages do not count up due to missing values. ¹Original statement presented to participants: ‘There is nothing I can do to reduce my dementia risk’. **p<0.01; ***p<0.001.

Figure 2

Level of awareness by self-reported general knowledge of dementia in the postassessment sample (n=602). The percentages reflect the percentage of participants who agreed that a particular factor is a risk or protective factor for dementia. Maximum values and percentages do not count up due to missing values. ¹Original statement presented to participants: ‘There is nothing I can do to reduce my dementia risk’. ²Self-reported knowledge of dementia, divided into ‘Insufficient knowledge’ (answering options ‘I don’t know’, ‘Nothing at all’ and ‘Not very much’) and ‘Good knowledge’ (‘Some’, ‘Quite a lot’ and ‘A great deal’). *P<0.05; **p<0.01.