Development of a Theory of Change framework and co-design of an Aboriginal Health Practitioner-led dementia prevention program

Background/Aim: The rates of dementia in Aboriginal Australians are high. Several risk factors for dementia in this population are modifiable (e.g., head injury, hypertension, stroke and poor mobility). However, there is currently no evidence-base on how to delay/prevent cognitive decline in Aboriginal Australians. Therefore, a comprehensive program to target dementia risk factors in this population is required.
Methods: Based on our Theory of Change (ToC) framework and in partnership with Aboriginal Community Controlled Health Services (ACCHS) in Western Australia, we developed an Aboriginal health practitioner-led health program (DAMPAA) to target key dementia risk factors for Aboriginal people over 45yo. The DAMPAA program (and ToC) were co-designed by researchers, Elders and ACCHS. Qualitative data was collected through ACCHS staff workshops, Elders yarning groups and DAMPAA researcher interviews to inform the final program protocol. Additionally, a small pilot study was conducted.
Results: The resources for DAMPAA within the ToC include (not limited to): appropriately trained personnel, culturally safe venue, transport, exercise and education materials and a goal-setting app. The program activities include group and individual exercise programs, education sessions, goal setting and medication management. The expected outcomes within the DAMPAA ToC are: 1) Improved function, 2) Better cardiovascular risk management, 3) Falls reduction, 4) Improved quality of life, and 5) Reduced cognitive decline. The desired program impact is reduced dementia rates in Aboriginal people.
Conclusions: The DAMPAA ToC has informed the development of the program protocol. DAMPAA is being evaluated through a randomised controlled trial and process evaluation using the ToC framework.