Connectedness, feeling At home, and joyful Play (CAP): A place-based wellness model for cognitive health promotion in the community by the community

ABSTRACT

As populations age, leveraging community resources to reduce dementia risk is increasingly vital for brain health. Using community-based participatory research methods, we co-developed and tested a pilot program with older adults in Metro Vancouver, Canada, to better understand and address brain health needs in community settings. Over 12 focus groups, older adults provided input which led to a place-based wellness model ‘Connectedness, feeling At home, and joyful Play’ (CAP). The CAP model was incorporated into an 8-week feasibility study, testing various components of a multi-domain realist controlled trial (n = 78). Older adults were recommended various existing activities in the community based on their CAP profiles. A ‘Finding Meaning in Aging’ mindful discussion program was added in response to older adults’ feedback on current gaps. Path analysis of preliminary data suggests that total attendance (β = .196, p = .070) improved brain health at week 8 by increasing a sense of playfulness at week 4 (β = .284, p = .002). Mindfulness (β = .215, p = .046) improved brain health by increasing a sense of at-homeness (β = .227, p = .025). Both pre- and post-implementation feedback from older adults centred the importance of friendship in late life, specifically to address late-life losses. The community-generated CAP model shows promise for place-based cognitive health promotion.

KEYWORDS:

• Social cohesion
• participatory design
• older adults
• cognitive health
• dementia
• aging in place

Acknowledgements

This research is funded by a Canadian Institute of Health Research (CIHR) Fellowship in Urban Housing and Health, the Community Engagement Initiative (CEI), and the Community-Engaged Research Initiative (CERi) of Simon Fraser University (SFU), awarded to DG. We are grateful for the Brain Health in Community (BHIC) Steering Committee members, mentors, community staff, and research assistants. Special mention goes to Cylia Wong and Don Orr Martin, two valued members of the BHIC Steering Committee who shaped crucial decisions early on in the project. We would also like to thank our community partners, including Frog Hollow Neighbourhood House, MOSAIC, the Jewish Seniors Alliance, South Vancouver Neighbourhood House, and Britannia Community Resource Centre for their guidance, input, and continued support. A complete list of community partners can be found on our webinar recording, which is available here: https://youtu.be/ot_DbCG7vpk.

Parts of this research were presented at various conferences, including Putting Patients First by Michael Smith Health Research BC, American Congress of Rehab Medicine (ACRM), and the Canadian Consortium on Neurodegeneration in Aging (CCNA) webinar. This research won the 2023 Canadian Institutes of Health Research (CIHR) Institute of Musculoskeletal Health and Arthritis (IMHA) Inclusive Research Excellence Prize for Patient (Community) Engagement.

Disclosure statement

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

Additional information

Notes on contributors

Claire Wang

During data collection, this study was held at Simon Fraser University (with DG, CW, and EO). By integrating the insights and expertise of the Brain Health in Community (BHIC) committee members in and outside of the institution (within the broader community), this project seeks to contribute to the development of tailored practical, evidence-based interventions that promote mental health, social connectedness, and improved quality of life among aging populations.