Community Input for Addressing Dementia Health Disparities: Richmond Brain Health Initiative.

Background: The development of the Richmond Brain Health Initiative (RBHI) was guided by the need to address local brain health service gaps to improve Alzheimer's/Dementia health disparities in racially diverse communities. This paper describes the establishment of RBHI through 1) community and provider stakeholder input and 2) community brain health screening/intake development and testing.

Methods: Phase 1 involved provider and community stakeholder questionnaires to gather feedback as part of the Plan-Do-Study-Act cycle. Subsequently, stakeholder findings directed the RBHI structure and screening/intake registration testing in the community.

Results: Based on the stakeholder responses from fifteen providers and twenty community members, there was strong consensus in the need for local brain health services. The most highly recommended screening needs were for caregiving, cognitive status, and lifestyle risks. Thereafter the RBHI screening/intake was developed and completed by 45 community participants. Participants showed hypertension (62%) as the most prevalent brain health risk factor, followed by depression/anxiety (56%), and loneliness (44%). The intake also indicated cognitive and functional deficits, with the Montreal Cognitive mean equaling 18.4 and the Functional Activities mean equaling 14.9. Additionally, 73% of participants reported experiencing subjective cognitive decline.

Conclusions: This study showcases a model for promoting brain health in racially diverse communities to improve access to Alzheimer's disease and related dementia resources and services.