Co‐design of an Aboriginal Health Practitioner‐led dementia prevention program (DAMPAA) using a Theory of Change framework

Abstract

AbstractBackgroundDementia prevalence and incidence in Aboriginal Australians is three to five times that of the general population. Many of the known risk factors for dementia in this population are modifiable (e.g., head injury, hypertension, previous stroke and poor mobility). However, there is currently no evidence‐base on how to delay or prevent cognitive decline and dementia in Aboriginal Australians. Therefore, a comprehensive program to target dementia risk factors in this population is required.MethodIn partnership with three Aboriginal Community Controlled Health Services (ACCHS) in Western Australia, we have developed an Aboriginal health practitioner‐led health program (DAMPAA) to target key dementia risk factors for Aboriginal people over 45 years. The DAMPAA program was co‐designed by the research team, Elders and Aboriginal community‐controlled organisations. Qualitative data to inform the co‐design was collected through ACCHS staff workshops, Elders yarning groups and interviews with DAMPAA Aboriginal and non‐Aboriginal researchers using a Theory of Change framework. Additionally, a small pilot study was conducted in 2020, which included participant exit interviews conducted by Aboriginal researchers. Qualitative data from all data sources was analysed thematically by a qualitative researcher, and member checked by two DAMPAA Aboriginal researchers and the Elders Governance group.ResultThe DAMPAA program includes group physical activity, education, goal setting and medication management. Program enablers identified by ACCHS, research staff and participants include (but not limited to) group Aboriginal community controlled organisation based walking and yarning sessions, with additional activities such as aqua aerobics, tai chi and boot scooting, a buddy system for home exercising, connecting with others, transport, healthy food, being Aboriginal led, and the ACCHS partnership. An additional enabler identified by the Elders governance group include Aboriginal language education sessions. Program barriers identified include (but not limited to) family commitments, caring for grandchildren, travel for funerals and other appointments and participant contact details changed.ConclusionThe barriers and enablers identified from participants, ACCHS and DAMPAA staff have informed the development of the program protocol. DAMPAA will be evaluated through a randomised controlled trial implemented at four sites in Western Australia and process evaluation using a Theory of Change framework.