Innovations in Dementia Empowerment and Action: RCT for Underserved Communities

ABSTRACT Background Research has revealed dementia disparities among underserved older adults. Built upon standard‐Reducing Disability in Alzheimer's Disease (s‐RDAD), Innovations in Dementia Empowerment and Action (IDEA) is designed and culturally tailored for underserved communities through an empowerment stigma‐reduction cognitive‐behavioral intervention and tested with sexual and gender minority (SGM) adults and care partners. Methods The study is a 2‐arm (IDEA and s‐RDAD), single‐blind, randomized controlled trial (RCT) with a staggered multiple baseline design. With 161 dyads (person living with dementia/care partner), the aim of the study is to compare the two arms via between and within group differences on primary (physical activity) and secondary outcomes (e.g., quality of life, physical functioning, and resource literacy) at post‐treatment, and 30 and 56 week follow‐up. Results When comparing the two arm between‐group differences, the IDEA care partners' community resource literacy was significantly higher at 30‐week follow‐up than for s‐RDAD (contrast = 0.10, p = 0.005). While both intervention arms demonstrated efficacy with significant improvement in physical activity (contrast IDEA = 0.10, p = 0.010; contrast s‐RDAD = 0.14, p < 0.001) and quality of life (contrast IDEA = 0.06, p < 0.001; contrast s‐RDAD = 0.03, p = 0.035) for the person with dementia at post‐treatment, positive treatment effects on physical activity (contrast IDEA = 0.09, p = 0.032) and quality of life (contrast IDEA = 0.03, p = 0.040) persisted at 30 weeks for IDEA but not for s‐RDAD. Conclusion While both intervention arms were efficacious, IDEA demonstrated sustained efficacy. The cultural tailoring of interventions is promising to address disparities in dementia care and interventions in underserved communities. Future research is needed for the translation of this efficacious intervention to the larger community. Clinicaltrials.gov identifier: NCT03550131