Increasing dementia diagnostic workup participation among at-risk Chinese older adults via risk communication: A quasi-experiment

Fan Yang; Junyao Zheng; Shaowei Liu; Wenjie Li; Yiyan Zhou; Shihan Lu; Bin Tang; Jia'an He; Yifeng Ding

doi:10.1016/j.gerinurse.2025.103432

Increasing dementia diagnostic workup participation among at-risk Chinese older adults via risk communication: A quasi-experiment

Geriatr Nurs. 2025 Jun 27:64:103432. doi: 10.1016/j.gerinurse.2025.103432. Online ahead of print.

Authors

Fan Yang¹, Junyao Zheng², Shaowei Liu³, Wenjie Li⁴, Yiyan Zhou⁴, Shihan Lu⁴, Bin Tang⁵, Jia'an He⁵, Yifeng Ding⁵

Affiliations

¹ School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, PR China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, PR China; China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, PR China; School of Emergency Management, Shanghai Jiao Tong University, Shanghai, PR China. Electronic address: fan_yang86@sjtu.edu.cn.
² School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, PR China; China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, PR China.
³ School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, PR China; School of Emergency Management, Shanghai Jiao Tong University, Shanghai, PR China.
⁴ School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, PR China.
⁵ Shanghai Jian'ai Public Welfare Organization, Shanghai, PR China.

PMID: 40580817
DOI: 10.1016/j.gerinurse.2025.103432

Abstract

This study examines whether structured risk communication strategies based on the Health Belief Model (HBM) and the Social Ecological Model (SEM) can increase participation in dementia diagnostic workups among at-risk older adults. A three-arm quasi-experiment was conducted in urban Shanghai, involving 198 at-risk older adults. Participants were divided into three groups: an unstructured communication group (n = 106), an HBM-based communication group (n = 46), and a SEM-based communication group (n = 46). The primary outcome was participation in dementia diagnostic workups within two months. The logistic regression results indicated that structured communication groups (HBM group and SEM group combined) showed significantly increased odds of participation than the control group. When analysed separately, both HBM- and SEM-based communication approaches effectively encouraged participation. Additionally, the SEM group demonstrated a marginally higher participation than the HBM group. This has highlighted the need for culturally sensitive, multi-level communication strategies in public health initiatives to improve management of dementia.

Keywords: Dementia diagnostic workup; Health belief model; Quasi-experiment; Risk communication; Social ecology model.