Testing the ‘Faith Moves Mountains model’ to increase Alzheimer’s disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults

Abstract

Objectives

Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer’s disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment.

Methods

An adaptation of Schoenberg’s Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later.

Results

This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ²(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ²(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics.

Conclusion

Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.

Keywords:

• Rural
• racially and ethnically diverse
• Alzheimer’s disease and related dementias
• faith-based
• community-based participatory research

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Lisa Ann Kirk Wiese was funded by National Institutes of Aging, K01AG064047 and the Florida Department of Health, Ed and Ethel Moore Alzheimer’s Disease Research Program 22A02, during this work and manuscript preparation.

Ishan Williams is funded by OT2OD032701: A Patient-focused collaborative hospital repository uniting standards (CHoRUS) for Equitable AI (MPI; Overall PI: Eric Rosenthal), the Geriatrics Workforce Enhancement Program (Co-investigator; PI: Leland Waters) R1081668: The Faith Care Family Project (Co-investigator; MPI: Fields and Xu), and FP00417617: Collaborative relationships and partnerships in the geriatric workforce across Virginia (PI: Williams)

Christine L. Williams is funded by National Institute on Aging, 5R56AG064094.

Jennifer Lingler is a consultant for Biogen and Genentech.

Her active studies as PI include an investigation of the impact of disclosing amyloid imaging results in mild cognitive impairment (R01 AG046906) and a study of recruitment innovations to enhance diversity in research on Alzheimer’s disease (R01 AG054518).

James E. Galvin is funded by grants from the National Institutes of Health, R01 NS101483, R01 NS101483S1, R01 AG071514, R01 AG071514S1, R56 AG074889, P01 AG066584, R01 AG071643, R01 AG069765, R01 AG057681, P30 AG059295, RF1 AG075901, and R01 AG078214.

He is an investigator in clinical trials with CND Life Sciences, Cognition Therapeutics, and EIP Pharma. He serves as Chief Scientific Officer for Cognivue, Inc. He is the creator of the AD8 and Quick Dementia Rating System. He is a consultant for Alpha Cognition, Biogen, Bristol Myers Squibb, Eisai, Eli Lilly, GE Healthcare, Genentech, and Roche.

Nancy E. Schoenberg is funded as:

Co-Investigator, (10%) ‘Researching Equitable Sleep time in Appalachia’ National Institutes of Health, R01 MD016236. (Moloney, M, Badour, C. MPIs). total costs $3,788,475; direct costs $2,500,375. 9/01/2021—8/30/2026.

Co-Investigator, (10%) ‘Appalachian STAR Trial.’ (Pediatric telehealth outreach) National Institutes of Health, U01OD033247. (Emmett, S. Bush, M., MPIs). total costs $1,818,981; direct costs $1,343,641. 9/01/2021–8/30/2026.

Multiple Principal Investigator, (10%) National Institutes of Health, (1T32 CA261786). (Dignan/Schoenberg) Addressing Rural cancer Inequities through Scientific Excellence (ARISE). total costs $764,390; direct costs $711,000. 08/01/2021–07/30/2026.

Principal Investigator, (20%) ‘Implementing an evidence-based mHealth energy balance intervention for a rural, Appalachian population,’ National Institutes of Health, R01HL152714. (Schoenberg/Spring) total costs $3,765,605; direct costs $2,775,907. 8/01/2020–03/31/2026.

Co-Investigator, (10%) ‘Communities Helping the Hearing of Infants by Reaching Parents: The CHHIRP Navigator Trial’ National Institutes of Health, R01DC017770-01. (M. Bush) total costs $3,172,743; direct costs $2,137,131. 04/01/2019–03/31/2024.

Principal Investigator, (20%) ‘Community to Clinic Navigation to Improve Diabetes Outcomes.’ National Institutes of Health, R01 DK112136-01A1 (Schoenberg). Total costs $3,068,390; $2,036,660 direct costs. 08/01/2017–06/30/2024.

Co-investigator (2%) ‘Center for Appalachian Research in Environmental Science.’ National Institutes of Health, 1P30ES026529-01A1 (PI: Hahn). $11,250,000, total costs. 5/01/2017–3/31/2023.

Associate Director, (10%), Kentucky Center for Clinical and Translational Science (Kern: PI) National Institutes of Health CTSA 1UL1TR001998. $3,645,338, annual costs. 08/15/2016–06/30/2027.