CULTURAL RELEVANCY FOR SUSTAINING OLDER AFRICAN AMERICAN ENGAGEMENT IN COGNITIVE HEALTH RESEARCH

摘要

African Americans have higher risk of Alzheimer’s disease, yet culturally engaging approaches addressing this disparity are lacking. Failure to design culturally relevant approaches contributes to low African American research participation. The Sharing History through Active Reminiscence and Photo-Imagery (SHARP) study aims to improve brain health among older African Americans through a culturally celebratory framework. We examined whether SHARP achieved its engagement and cultural relevancy goals, significant for sustaining engagement. African Americans aged >55 (n=31; 7 with mild cognitive impairment) walked in triads 3x/week for 6 months in Portland’s historically Black neighborhoods. A tablet guided triads on GPS-routed 1-mile walks. Location-triggered historical images of local African American culture prompted conversational reminiscence. Conversations were recorded for a digital oral history archive and for community health learning sessions. Surveys and focus groups evaluated cultural relevance of study design, content, and implementation. Transcribed discussion was coded using thematic analysis. Ninety-two percent rated historical neighborhood images as helpful to starting and sustaining walking conversations. One-hundred percent rated walking routes as good or great. Pairing an Afrocentric lens with historical fact-driven prompts motivated participant engagement, and recording reminiscence was culturally significant because it preserved neighborhood history lost to gentrification. Connecting personal and community history to future generations was a particular draw for enrollment and sustained engagement. Participants felt the study was for them and the community, rather than for the researchers. For sustained engagement, cultural relevancy should be interwoven through design, implementation, and deliverables to give participants a sense of ownership and service to their community.