A Systematic Review of Communication-Focused Dementia Interventions for Indigenous Communities.

Abstract

Dementia is a significant challenge for many Indigenous peoples who face inequities in risk factors, prevalence, progression rates, and access to quality healthcare. Culturally relevant interventions are needed across the care pathway, however, little evidence exists to guide culturally relevant communication support. This systematic review aims to understand dementia communication interventions developed for Indigenous populations and explore factors relating to their effectiveness. A systematic search of databases, repositories, and search engines was conducted. We took a comprehensive approach to communication, considering the communication skills and abilities of people with dementia, their communication partners, healthcare providers, and community-level information sharing. Studies were required to evaluate an intervention targeting communicative skills, communicative ability, or health communication and include a cultural focus on one or more Indigenous communities. Quality was appraised using an adapted Well Living House Quality Appraisal Tool. Six studies met inclusion criteria, with most studies (n = 5) conducted from 2019 onwards. No studies evaluated an intervention targeting communicative skills and abilities for people with dementia, their communication partners, or healthcare providers. All included studies evaluated a health communication intervention. Interventions utilised various resources, including storybooks, videos, flipcharts, posters, handouts, worksheets, fact sheets, and training modules, tailored towards Indigenous communities across Canada, the United States, and Australia. Content about dementia and dementia management varied across interventions. Analysis identified key benefits of the interventions and three factors influencing their effectiveness: (1) representation of Indigenous people, cultures, and languages in resources, (2) methods and settings for knowledge sharing, and (3) communication, connection, and collaboration. While content within resources and methods for information sharing should be tailored to local communities, common elements may support health communication developments across Indigenous contexts. Further research is needed to develop interventions specifically targeting communication skills and conduct methodologically strong evaluations.