Testing a Faith‐based Model to Increase Alzheimer’s Disease Knowledge, Detection and Management in a Rural, Racially/Ethnically Diverse Farmworker Community
Bibliographic record
Abstract
Abstract Background Rural and racially/ethnically diverse residents face multiple disparities that may increase Alzheimer’s disease and related disorder (ADRD) risk, including less formal education, less access to health care information, delayed disease detection, and challenges with management (Liu et al., 2022). Health‐promoting behaviors may reduce ADRD risk in the presence of these and other factors, e.g., environmental exposures (Peritogiannis et al., 2022; Livingston et al., 2020). We hypothesized that providing ADRD‐related education would increase disease knowledge, cognitive screening behaviors, dementia detection, and diagnosis rates in multiculturally diverse field workers in the Lake Okeechobee region of South Florida. Method Schoenberg’s (2009) Faith Moves Mountains framework guided this CBPR descriptive, quasi‐experimental study of 241 primarily African American and Afro‐Caribbeans ≥ age 50. Local church congregants were engaged as health educators and research assistants in recruiting, enrolling, surveying, and screening participants. The Basic Knowledge of Alzheimer’s Disease survey (Wiese et al., 2020) and brief Montreal Cognitive Assessment (MiniMoca) (Nasreddine, 2019) were administered at baseline and one year later. Persons scoring below the MiniMoca score cutoff of 12 were referred to providers for further assessment and potential diagnosis/treatment. Result Positive screen rates were 45.6% at Time 1 and 51.2% at Time 2. Lower pretest BKAD scores [β = ‐0.14, t = ‐3.02, p = .002] and lower years of education [β = ‐0.07, t = ‐1.81, p = .04] were associated with higher referrals. Longer duration of rural residence [β = 0.02, t = 3.09, p = .001], and ethnicity predicted referrals: African American [β = 0.62, t = 3.48, p<.001] or Afro Caribbean [β = 1.04, t = 1.81, p = .04]. Self‐report by participants on follow‐up by the health educators revealed new ADRD diagnoses primarily among African American (47.2%), Afro‐Caribbean (36.1%), White (13.9%) rural residents; Hispanics comprised 2.8%. Rates of new treatments by ethnicity were similar (Table 1). Conclusion Extending Schoenberg’s successful “Faith Moves Mountains” approach beyond the Appalachian setting and chronic illnesses of cancer (2009), smoking cessation (2016), and diabetes (2017) was effective for increasing ADRD knowledge, detection, and management in a unique non‐White rural community. A larger, randomized controlled trial is needed to test if ADRD education among varied faith‐based settings increases health‐seeking behaviors among rural residents experiencing health inequities due to social and medical determinants of health.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".