How to co-create a multicultural dementia education initiative

Background: Culturally and linguistically diverse (CALD) people affected by dementia have poorer health outcomes and experience greater social exclusion than their non-CALD counterparts. These disparities are worsened by: linguistic barriers; inaccessible and culturally inappropriate education about dementia and relevant support services; and stigma. This is especially prominent in the multicultural South Western Sydney region, where over 12,500 residents are already living with dementia, and dementia prevalence is forecast to increase at the highest rate in NSW by 2050: up to 460 % in some local government areas. Culturally sensitive education about dementia is needed, but no such programs exist here. Objective: We aimed to co-create a dementia education initiative that was accessible, culturally sensitive, and tailored to meet the needs of English, Arabic, Vietnamese, Chinese, and Greek-speaking communities. Methods: We established a Dementia Alliance comprising representatives from the local dementia support group, council, university, and multicultural service providers. Through a series of co-creation workshops with English, Arabic, Vietnamese, Chinese, and Greek-speaking alliance members, we mapped out the education program’s content, structure, format, and evaluation methods to suit all cultural groups. This research discusses the barriers and enablers of disseminating useable and accessible dementia information. Findings: The Dementia Alliance adapted the global Dementia Friends initiative for multicultural delivery. The co-creation workshops revealed the following barriers to uptake of information: the stigmatised translations of ‘dementia’; lengthy duration (>2 hrs); online delivery; and long, high-literacy evaluation surveys. The key enablers were: advertising the education program as a ‘memory information session’; using trained bilingual educators along with an academic co-facilitator; acknowledging stigma; durations <2 hrs; in-person, oral delivery; and using plain language paper-based evaluation surveys with <30 items. Conclusion: Co-creating a multicultural dementia education program with information that is useable and accessible by CALD communities and service providers is feasible through partnerships. This work offers practical insights into knowledge mobilisation in multicultural settings and can be applied to other areas of health where disparities exist

The built environment's role in supporting dementia inclusive communities : a case study of Canterbury‐Bankstown city

Background Inclusive and enabling cities are fundamental to the wellbeing of people impacted by dementia. How we implement these ideals in multicultural communities through the built environment remains understudied. The experience of place must be considered in the context of dementia‐friendly community (DFC) models to fully enable people experiencing dementia to remain autonomous, integrated, and connected. This study aimed to explore how diverse individuals with dementia perceive the built environment and its impacts on everyday activities using a mixed methods approach. Method This study was set in Canterbury‐Bankstown, New South Wales, Australia where a high proportion of people impacted by dementia speak English, Arabic, and/or Vietnamese. Seventeen people experiencing dementia, their care partners, and former carers (English: n = 7; Arabic: n = 5; Vietnamese: n = 5) were recruited for a semi‐structured interview, and two of these dyads (English: n = 1; Vietnamese n = 1) audited a local shopping centre and hospital using the DFC‐environmental assessment tool (DFC‐EAT). Interviews and audits were conducted in‐language with bilingual researchers, who then transcribed the data into English for analysis. Similarities and differences were identified across the interview transcripts and audit data to identify issues with the existing built environment and improvement opportunities. Result We found that participants would limit or avoid going outdoors for everyday activities because of safety concerns (especially when using paths and carparks). Furthermore, overwhelming indoor experiences were characterised by unfamiliar designs and fittings (particularly with bathroom facilities), unsupported movement and way‐finding due to excessive or insufficient signage, poor lighting, and high noise. Participants recommended greater access to door‐to‐door transport that caters to people experiencing dementia, establishing quiet resting areas, and improving navigation through signage that uses standardised symbols (e.g., for toilet facilities). Conclusion People experiencing dementia and carers reported an array of issues concerning built environment design and accessibility features that excluded them from everyday activities. These findings were translated into an implementation plan that informed the City of Canterbury‐Bankstown Council’s community planning efforts and the shopping centre’s facility operations. Critical areas for improvement in the built environment would benefit from co‐design practices that are inclusive and representative of the community