Dementia
Conditions
Keywords
Dementia, Schools, Nutrition, Health
Brief summary
The purpose of this research study is to evaluate the knowledge of parents and children with respect to dementia symptoms, risk factors, and response before and after an interactive dementia education program that uses music and dance to enhance a health education curriculum at 1-week and 3-months after the intervention.
Detailed description
Public awareness of cardinal Alzheimer's disease (AD) symptoms remains low. Adults often underestimate personal dementia risk; minority populations are more likely to have low dementia literacy and be unaware of it. Cultural dementia belief in minority groups are complex and pose barriers to diagnosis, with dementia symptoms being considered a part of normal aging, or that discussion may be taboo even when recognized. A key barrier to timely AD diagnosis in African Americans is delayed physician contact, often years-long, following the onset of first symptoms. Despite studies demonstrating that dementia concepts first develop in elementary school periods, apart from our work, no dementia awareness programs focus on children. This intervention therefore addresses a major gap regarding optimal approaches for shifting cultural perceptions of dementia in low-income minority populations and reducing barriers to its timely diagnosis. All R01 aims have been completed in this study.
Interventions
BEHAVIORALOld SCHOOL Hip-Hop
A school-based intervention called Old S.C.H.O.O.L. Hip-Hop (OSHH) or Seniors Can Have Optimal aging and Ongoing Longevity, to educate 4th and 5th grade students (ages 9-11y) about key dementia signs and symptoms, basic pathophysiology of Alzheimer disease, and the importance of early recognition, care-seeking behavior, and preventative measures (lifelong healthy lifestyle decisions). The intervention is delivered in a classroom or school auditorium setting, using an innovative, modular, multimedia program and home-based activities, to increase parental and family dementia literacy.
BEHAVIORALMy Plate
The program selected for the control arm, My Plate, will address nutrition, physical activity, and obesity education. This program was selected because nutrition, physical activity, and wellness programs are now being incorporated into New York City public school curriculums as part of a legislative directive. Trained facilitators will conduct My Plate as an entry point for the USDA's My Plate nutrition program. Students will learn about My Plate across the 3-day one-hour-a-day program.
Sponsors
National Institute on Aging (NIA)
Columbia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
9 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 4th and 5th-grade children (ages 9-11y) and their parents (age \> 20 years). * Selected New York City public schools with similar socio-demographic composition.
Exclusion criteria
* Schools have already received pilot OSHH and the U.S. Department of Health and Human Services (HHS) programming.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7 | Baseline (1 week up to 15 weeks prior to Intervention Day 1), 1-week post-intervention (1 week up to 13 weeks post-Intervention Day 3, but always before 3-month intervention), and 3-months post-intervention (10 to 24 weeks post-intervention Day 1) | OSHH Program effectiveness of educating parents at 1-week post and 3-months post intervention using a 7-item scale: ASK-AD 7 (Assess Symptoms and Knowledge of Alzheimer's Disease - 7 Questions). Minimum value is 0 and maximum value is 7. Higher scores indicate greater number of questions answered correctly, indicating a better outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7 | Immediately before intervention began (On Day 1 of programming), Immediately post intervention (Day 3 of programming), 3-months post intervention (6 up to 20 weeks post Day 1 of programming) | OSHH Program effectiveness of educating students immediately-post and 3-months post the intervention using a 7-item scale: ASK-AD 7 (Assess Symptoms and Knowledge of Alzheimer's Disease - 7 Questions). Minimum value is 0 and maximum value is 7. Higher scores indicate greater number of questions answered correctly, indicating a better outcome. |
Countries
United States
Participant flow
Recruitment details
NYC schools were recruited & enrolled from September 9, 2018 through February 27, 2023. Once each school agreed to participate, parents & students were recruited. Then each school was randomized into either Control or Intervention arm.
Participants by arm
| Arm | Count |
|---|---|
| Control Students School population without the Old SCHOOL Hip-Hop program, but with the My Plate program.
My Plate: The program selected for the control arm, My Plate, will address nutrition, physical activity, and obesity education. This program was selected because nutrition, physical activity, and wellness programs are now being incorporated into New York City public school curriculums as part of a legislative directive. Trained facilitators will conduct My Plate as an entry point for the USDA's My Plate nutrition program. Students will learn about My Plate across the 3-day one-hour-a-day program. | 774 |
| Intervention Students School population with the Old SCHOOL Hip-Hop program.
Old SCHOOL Hip-Hop: A school-based intervention called Old S.C.H.O.O.L. Hip-Hop (OSHH) or Seniors Can Have Optimal aging and Ongoing Longevity, to educate 4th and 5th grade students (ages 9-11y) about key dementia signs and symptoms, basic pathophysiology of Alzheimer disease, and the importance of early recognition, care-seeking behavior, and preventative measures (lifelong healthy lifestyle decisions). The intervention is delivered in a classroom or school auditorium setting, using an innovative, modular, multimedia program and home-based activities, to increase parental and family dementia literacy. | 687 |
| Control Parents Parents of school population without the Old SCHOOL Hip-Hop program, but with the My Plate program.
My Plate: The program selected for the control arm, My Plate, will address nutrition, physical activity, and obesity education. This program was selected because nutrition, physical activity, and wellness programs are now being incorporated into New York City public school curriculums as part of a legislative directive. Trained facilitators will conduct My Plate as an entry point for the USDA's My Plate nutrition program. Students will learn about My Plate across the 3-day one-hour-a-day program. | 401 |
| Intervention Parents Parents of school population with the Old SCHOOL Hip-Hop program. Old SCHOOL Hip-Hop: A school-based intervention called Old S.C.H.O.O.L. Hip-Hop (OSHH) or Seniors Can Have Optimal aging and Ongoing Longevity, to educate 4th and 5th grade students (ages 9-11y) about key dementia signs and symptoms, basic pathophysiology of Alzheimer disease, and the importance of early recognition, care-seeking behavior, and preventative measures (lifelong healthy lifestyle decisions). The intervention is delivered in a classroom or school auditorium setting, using an innovative, modular, multimedia program and home-based activities, to increase parental and familv dementia literacy. | 382 |
| Total | 2,244 |
Baseline characteristics
| Characteristic | Total | Control Students | Intervention Students | Control Parents | Intervention Parents |
|---|---|---|---|---|---|
| Age, Customized 18-64 years | 756 Participants | 0 Participants | 0 Participants | 387 Participants | 369 Participants |
| Age, Customized <18 years | 1461 Participants | 774 Participants | 687 Participants | 0 Participants | 0 Participants |
| Age, Customized >=65 years | 10 Participants | 0 Participants | 0 Participants | 4 Participants | 6 Participants |
| Age, Customized Unknown/Not Reported | 17 Participants | 0 Participants | 0 Participants | 10 Participants | 7 Participants |
| Baseline Alzheimer's Disease Knowledge Using ASK-AD 7 Parents Pre-Test: Before Intervention | 5.18 units on a scale STANDARD_DEVIATION 1.74 | — | — | 5.13 units on a scale STANDARD_DEVIATION 1.77 | 5.24 units on a scale STANDARD_DEVIATION 1.7 |
| Baseline Alzheimer's Disease Knowledge Using ASK-AD 7 Students Pre-Test: Immediately Before Intervention | 2.87 units on a scale STANDARD_DEVIATION 1.95 | 2.98 units on a scale STANDARD_DEVIATION 1.93 | 2.75 units on a scale STANDARD_DEVIATION 1.97 | — | — |
| Race/Ethnicity, Customized Asian | 54 Participants | 17 Participants | 9 Participants | 19 Participants | 9 Participants |
| Race/Ethnicity, Customized Black or African American | 813 Participants | 158 Participants | 214 Participants | 209 Participants | 232 Participants |
| Race/Ethnicity, Customized Hispanic | 408 Participants | 106 Participants | 87 Participants | 118 Participants | 97 Participants |
| Race/Ethnicity, Customized Native Hawaiian or Other Pacific Islander | 6 Participants | 3 Participants | 0 Participants | 3 Participants | 0 Participants |
| Race/Ethnicity, Customized Not Hispanic | 998 Participants | 218 Participants | 245 Participants | 268 Participants | 267 Participants |
| Race/Ethnicity, Customized Unknown | 838 Participants | 450 Participants | 355 Participants | 15 Participants | 18 Participants |
| Race/Ethnicity, Customized Unknown/Not Reported (Other) | 1184 Participants | 544 Participants | 426 Participants | 116 Participants | 98 Participants |
| Race/Ethnicity, Customized White | 187 Participants | 52 Participants | 38 Participants | 54 Participants | 43 Participants |
| Region of Enrollment United States | 2244 Participants | 774 Participants | 687 Participants | 401 Participants | 382 Participants |
| Sex/Gender, Customized Female | 1415 Participants | 362 Participants | 374 Participants | 354 Participants | 325 Participants |
| Sex/Gender, Customized Male | 697 Participants | 334 Participants | 274 Participants | 42 Participants | 47 Participants |
| Sex/Gender, Customized Unknown/Not Reported | 132 Participants | 78 Participants | 39 Participants | 5 Participants | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 774 | 0 / 687 | 0 / 401 | 0 / 382 |
| other Total, other adverse events | 0 / 774 | 0 / 687 | 0 / 401 | 0 / 382 |
| serious Total, serious adverse events | 0 / 774 | 0 / 687 | 0 / 401 | 0 / 382 |
Outcome results
Primary
OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7
OSHH Program effectiveness of educating parents at 1-week post and 3-months post intervention using a 7-item scale: ASK-AD 7 (Assess Symptoms and Knowledge of Alzheimer's Disease - 7 Questions). Minimum value is 0 and maximum value is 7. Higher scores indicate greater number of questions answered correctly, indicating a better outcome.
Time frame: Baseline (1 week up to 15 weeks prior to Intervention Day 1), 1-week post-intervention (1 week up to 13 weeks post-Intervention Day 3, but always before 3-month intervention), and 3-months post-intervention (10 to 24 weeks post-intervention Day 1)
Population: Parents whose children participated in either Control Arm (MyPlate Program) or Intervention Arm (Old School Hip Hop Program) and who consented to participate in the survey.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Control | OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7 | Pre-Test (1 week prior to intervention) | 5.14 score on a scale | Standard Error 0.09 |
| Control | OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7 | Post-Test (1-week post intervention) | 5.41 score on a scale | Standard Error 0.08 |
| Control | OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7 | Delayed Post-Test (3-months post intervention) | 5.68 score on a scale | Standard Error 0.09 |
| Intervention | OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7 | Pre-Test (1 week prior to intervention) | 5.28 score on a scale | Standard Error 0.08 |
| Intervention | OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7 | Post-Test (1-week post intervention) | 5.62 score on a scale | Standard Error 0.07 |
| Intervention | OSHH Program Effectiveness of Educating Parents at 1-week and 3-months After the Intervention Using ASK-AD 7 | Delayed Post-Test (3-months post intervention) | 5.95 score on a scale | Standard Error 0.09 |
Secondary
OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7
OSHH Program effectiveness of educating students immediately-post and 3-months post the intervention using a 7-item scale: ASK-AD 7 (Assess Symptoms and Knowledge of Alzheimer's Disease - 7 Questions). Minimum value is 0 and maximum value is 7. Higher scores indicate greater number of questions answered correctly, indicating a better outcome.
Time frame: Immediately before intervention began (On Day 1 of programming), Immediately post intervention (Day 3 of programming), 3-months post intervention (6 up to 20 weeks post Day 1 of programming)
Population: Students randomized into either Control Arm (My Plate program) or Intervention Arm (Old School Hip Hop program)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Control | OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7 | Pre-test (Immediately Before Intervention) | 3.13 score on a scale | Standard Error 0.18 |
| Control | OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7 | Post-Test (Immediately Post Intervention) | 3.67 score on a scale | Standard Error 0.17 |
| Control | OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7 | Delayed Post-Test (3-months post intervention) | 4.21 score on a scale | Standard Error 0.18 |
| Intervention | OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7 | Pre-test (Immediately Before Intervention) | 3.36 score on a scale | Standard Error 0.18 |
| Intervention | OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7 | Post-Test (Immediately Post Intervention) | 5.02 score on a scale | Standard Error 0.17 |
| Intervention | OSHH Program Effectiveness of Educating Students at Immediate-post and 3-months Post the Intervention Using ASK-AD 7 | Delayed Post-Test (3-months post intervention) | 6.69 score on a scale | Standard Error 0.18 |