Stigma underlies many health disparities in Kenya, and dementia-related stigma is no different. Preliminary evidence highlights the short-term benefits of a dementia anti-stigma intervention in Kenya. The study aims to ascertain the long-term effectiveness of a locally developed dementia anti stigma intervention in order to establish a community resource that will improve dementia understanding, reduce stigma and improve health behaviours.
In AIM 1, the investigators will assess what public stigma towards people with dementia and their carers looks like in Kenya, through a survey (600). Individual interviews with 20 members of the general public who completed the survey will be conducted to explore what stigmatizing beliefs are held and why they form. Triangulation techniques will then be used to integrate quantitative and qualitative data. Reflecting on AIM 1 findings, the investigators will engage 20 key stakeholders to refine an existing anti-stigma intervention, to better target culturally specific misconceptions and negative beliefs about dementia (AIM2). In AIM 3, the investigators will determine the effectiveness of the intervention among members of the general public (n=184), through a stepped wedge cluster randomized trial (SWT).
Residents of Mbooni Sub county
Aged 18 years and above
Able to speak the local language (Kamba)
Have capacity to consent
Non residents of Mbooni Sub county
Less than 18 years
Do not speak the local language
Have no capacity to consent
Sequential
Dementia anti stigma intervention
BehavioralThe intervention is a train-a-trainer programme contextually developed, for delivery (via demonstrations and role-plays) by lay providers such as community health workers. It includes four sessions that promote: (i) understanding of dementia, (ii) demystifying myths and misconceptions, (iii) empathetic connections using videos of people with dementia and carers (virtual social contact) and (iv) social inclusion through a case vignette and discussions. It is delivered bi-weekly in a group setting and each session ranges between 1.5 to 2 hours.
Change in Dementia attitudes (measured by the Dementia Attitudes Scale (DAS))
Dementia attitudes will be assessed using the Dementia Attitudes Scale (DAS), a validated tool that measures participants' comfort and perceptions when interacting with people with dementia. Scores on the DAS range from 20 to 140, with higher scores indicating more positive attitudes.
Change in Dementia knowledge (measured by the Dementia Knowledge Assessment Scale (DKAS))
Dementia knowledge will be assessed using the Dementia Knowledge Assessment Scale (DKAS), which evaluates knowledge across domains such as causes, symptoms, risk factors, and care of people with dementia. Scores on the DKAS range from 0 to 50, with higher scores reflecting greater knowledge.
Intervention acceptability
Acceptability of the intervention will be assessed through self-reported responses where participants will be asked about their satisfaction, perceived usefulness, and willingness to continue or repeat participation in the dementia anti-stigma sessions. Outcomes will be reported as the proportion of participants indicating that they found the intervention acceptable and would be willing to continue or engage in similar sessions in the future.
Change in Dementia engagement (Behavior)
This will be assessed through self-reported responses where participants will be asked about their willingness to interact with, support, and include people with dementia in community life. Outcomes will be reported as the proportion of participants providing affirmative responses.
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Africa Institute of Mental and Brain Health (AFRIMEB)
Lead sponsor
Alzheimer's Association
Collaborator
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