ORCID

Abstract

INTRODUCTION: This study describes the implementation outcomes and evaluation of DEM-SKY, a community-based dementia screening program developed in rural Kenya with the support of community health care workers (CHWs). METHODS: DEM-SKY was delivered to 3546 older adults in Makueni County, Kenya, over a 6-month period. Using a mixed-methods design, we explored implementation outcomes with stakeholders through surveys and interviews. RESULTS: The program demonstrated good acceptability, adoption, and fidelity and was effective in instigating behavior change. Individuals who screened positive for dementia were 28.7 times more likely to intend to speak to a doctor. Qualitative data showed that participants valued the program but indicated scope for improvement, particularly further down the diagnostic pathway. DISCUSSION: DEM-SKY was successful across several implementation metrics. Although the program demonstrates that community-based screening can be conducted effectively with minimal resources, future research needs to explore the long-term benefits of dementia screening in Kenya. Highlights: Community-based dementia screening is feasible in rural Africa. Involving community health workers strengthens trust in health care systems. Empowering community health workers enhances the community capacity to address dementia Screening promotes proactive health seeking among older adults.

Publication Date

2025-01-14

Publication Title

Alzheimer's and Dementia

Volume

21

Issue

2

ISSN

1552-5260

Acceptance Date

2024-12-06

Deposit Date

2025-01-23

Funding

The authors would like to thank Makueni County for the support provided during the research period, including the provision of health care professionals and CHWs as well as creating a supportive environment. The authors would also like to thank the Africa Institute of Mental and Brain Health for serving as the host institution for the study. This research was funded by the Davos Alzheimer's Collaborative.

Keywords

acceptability, community, community health workers, DEM-SKY, dementia, fidelity, Kenya, mixed-methods, older adult, screening, Community Health Workers, Humans, Middle Aged, Male, Dementia/diagnosis, Rural Population, Aged, 80 and over, Female, Aged, Program Evaluation, Mass Screening/methods, Community Health Services

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