Developing a Culturally Adapted Intervention to Improve Cognitive Functioning in British South Asians with Dementia: A Protocol

Problem

The WHO states, ‘Dementia is a global public health challenge.’ Non-pharmacological interventions such as Cognitive Stimulation Therapy and Reminiscence Therapy are recommended by NICE to support individuals living with dementia. However the ‘one size fits all’ approach does not allow all individuals living with dementia to benefit from these interventions. The proposed project will be focused on the Urdu speaking British South Asian population. According to the ONS, Urdu is the fourth most spoken language in the UK, with 269,000 Urdu speaking individuals in residing in England and Wales. The aim of the project is to select and culturally adapt the appropriate treatment (Cognitive Stimulation Therapy or Reminiscence Therapy) for Urdu speaking British South Asians with dementia using previously conducted systematic reviews and qualitative methods.

Approach

The study will be based on the MRC (2008) guidelines on developing and evaluating complex interventions. This project will be based on the first phase of the MRC guidelines which is the development stage. The study is based on qualitative research methods. The research methods will include background research using previously conducted systematic reviews, focus groups, a consensus process meeting and a PPIE group. The first step of the project is to conduct background research on both therapies. This will include systematic reviews on the recommended interventions, literature on patient priorities and patient preferences. The second step is to conduct a focus group. Focus group 1 will aim to select the appropriate therapy. The third step is the cultural adaptation of the manual for the appropriate therapy using results from the first focus group and background research. The fourth step is the consensus process meeting and PPIE Group. The aim of the meeting is to finalise the changes and solutions for the culturally adapted manual. The PPIE group will be asked to give their opinion on the activities, format and translations of the culturally adapted manual. Lastly, another focus group will be conducted that will aim to evaluate the appropriateness, deliverability and acceptability of the culturally adapted intervention for Urdu speaking British South Asians with dementia.

Findings

Background research has shown that Cognitive Stimulation Therapy provides improvement in cognition and Reminiscence Therapy provides improvement in psychological and behavioural symptoms, quality of life and depression.

Consequences

There is a need for culturally appropriate and acceptable interventions for the ethnic minority community in the UK. The top five spoken languages in England and Wales are dominated by South Asian languages. Important risk factors for dementia such as stroke, diabetes, heart disease (including blood pressure, hypertension) are more prevalent in the South Asian community in comparison with the white population. These risk factors increase the susceptibility of South Asians developing dementia however South Asians have been neglected in dementia research.