Cognitive Aging Progress in Understanding and Opportunities for Action (2015) / Chapter Skim
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7 Public Education and Key Messages
7 Public Education and Key Messages
Pages 257-294
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; how the public currently receives and could receive information about cognitive aging; and effective public health messaging. The chapter concludes with key messages to be disseminated on cognitive aging and recommendations for next steps.
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When trying to influence health behavior change, such as the adoption of behaviors that protect and enhance cognitive health, it is important to understand the motives that people have for their actions, their perceptions about the efficacy of the actions and their ability to perform them, and the environmental factors that support or hinder the behaviors (Ajzen, 1991; Bandura, 1986; Fisher and Fisher, 2002; Sallis et al., 2008)
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. The relatively high level of worry among older Americans about maintaining their own and their loved one's cognitive health as they age gives public education campaigns a motivator for behavior change that they should be able to tap into.
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Third, the preventive actions that people should take to preserve or enhance their cognitive function are often misunderstood. Many people mistakenly believe that vitamins and supplements are effective in maintaining cognitive health (Friedman et al., 2013; Roberts et al., 2014)
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have the strongest research evidence indicating that they improve cognitive health and preventing declines; or (2) have scientific evidence indicating that they are likely to be beneficial for cognitive health and also are proven to be beneficial for health overall.
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. Other differences in beliefs about prevention behaviors, including beliefs that particular foods and supplements promote cognitive health, may need to be addressed in public communication efforts aimed at promoting evidence-based behavior (Friedman et al., 2011; Laditka, J
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. Summary The knowledge and motivation to engage in behavior that promotes cognitive health may vary by gender, ethnicity, income, and education level, and thus educational strategies and materials need to be relevant to the needs of specific target groups.
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A content analysis of articles in the top eight women's and men's magazines in 2006–2007 found an average of four messages related to cognitive health per magazine in 2006, and three in 2007, with the most common recommendations for maintaining cognitive health relating to diet, followed by vitamins and supplements, cognitive exercises, physical activity, and social interactions (Friedman et al., 2010)
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found that large health systems were more likely to promote cognitive health than were senior centers, but promotion of physical activity represented only 20 percent of the website content. Although active monthly Twitter users are predominantly younger (only 3 percent of adults who are 65 years and older use Twitter regularly)
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Although some messages and materials are relevant -- as reviewed below -- there remains a strong need for campaigns that focus squarely on healthy cognitive aging. In addition to its goals relevant to people diagnosed with dementia and their caregivers, the Healthy Brain Initiative seeks to improve the cognitive health of the American population (Alzheimer's Association and CDC, 2013)
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. Using workshops, events, and mass media, the CDC and the Alzheimer's Association ran a demonstration project through local Alzheimer's Association chapters in Atlanta and Los Angeles aimed at increasing awareness of cognitive health, physical activity, and cardiovascular health among African American baby boomers.
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. project showed that community partners can be engaged within a relatively short period of time to promote cognitive health and that workshops on cognitive health designed with local partners and targeted to a specific age and ethnicity can affect knowledge and some behavioral intentions, a greater media presence will be necessary to reach large numbers of people.
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Physical Activity Physical activity is recommended for all age groups because of its health benefits in a variety of domains, including cognitive health (see Chapter 4A)
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. Individually tailored programs: Programs can be individualized to teach skills related to the increase and maintenance of physical activity, such as goal setting and self monitoring, building social support, self-rewards and positive self-talk, and problem solving to maintain behavior change and prevent relapses (Kahn et al., 2002; Task Force on Community Prevention Services, 2002)
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. Such interventions also have the advantage of promoting social engagement, which may further contribute to cognitive health (see Chapter 4A)
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Interventions targeting adherence plus another behavior had the same impact as interventions targeting adherence alone, which suggests that cognitive aging campaigns could focus on adherence alone or adherence and other goals, such as physical activity. Neither the mode of delivery (e.g., media, face-to-face counseling, or both)
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In terms of financial decision making, surveys show a gap between people's estimates of their ability to make financial decisions and their actual financial literacy, and this gap widens with age (Lusardi and Mitchell, 2011)
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Families may benefit from messages suggesting strategies for communicating with their older relatives about specific decisions and decision making in general. CHALLENGES FOR PUBLIC EDUCATION CAMPAIGNS Combating Stigma and Prejudice Studies have shown that in many countries, the United States included, cognitive impairment is stigmatized, and this stigma has been a barrier to early detection and treatment (Wahl, 2012; WHO, 2012)
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. This can reduce older adults' opportunities to engage in some of the recommended behaviors that are useful in maintaining cognitive health.
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Evaluations of these first-person campaigns will provide valuable information on the influence of media coverage. Portray Older Adults Positively in Entertainment To combat the stigma of cognitive aging, entertainment media can provide stories featuring older adults, incorporate accurate portrayals of people with various levels of cognitive health, and depict respectful interactions between people with and without cognitive impairments.
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Public education messages should encourage the use of appropriate technologies to correct for impairments (e.g., hearing aids, glasses) so that people may continue to participate in social interactions, have an easier time learning new things, and move about more safely.
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. Thus, programs to support cognitive health will need to take health literacy of their target populations into account.
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. Given that the terminology for cognitive aging is new, initial campaigns might set intermediate knowledge goals focused on increasing the understanding of what cognitive aging is and is not and on ways to promote cognitive health.
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Campaign designers map out the pathways and barriers to change and maintenance for each behavior. Logic models based on behavior change theories and research with the target groups may clarify this process, and many useful theories have been applied successfully across a wide range of health behaviors and populations (for a review, see Glanz et al., 2008)
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. Behavior change across a population is more likely when a combination of channels is used and when media can be selected so as to maximize the number of people in the target population who are reached (Hornik, 2002; Snyder and Hamilton, 2002)
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with a focus on the wide variation among individuals in the nature and extent of cognitive changes with age. Additionally, people across the life span should be informed about the actions they can take in childhood, youth, young adulthood, middle age, and older age to preserve and enhance their cognitive health.
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or other neurological diseases. • ctions can be taken by individuals to help maintain cognitive health.
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population with campaigns and pro grams targeted to all relevant groups; • Be sensitive to existing differences in knowledge, literacy, health literacy, perceived risk, cognitive aging–related be havior, communication practices, cultures and beliefs, speech and hearing declines, and skills and self-efficacy among tar get groups; • Include evaluation components to assess outreach efficacy in the short and long term, and research the optimal com munication strategies for the key messages among the target groups; • Be updated as new evidence is gained on cognitive aging; • Emphasize a lifelong approach to cognitive health; • Promote succinct and actionable key messages that are un derstandable, memorable, and relevant to the target groups; • Focus on sustaining changes in behaviors that promote cog nitive health; and • Promote effective evidence-based tools for maintenance of cognitive health and cognitive change assessment, as well as the information gateway on cognitive aging (see Recom mendation 8)
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2009. The public's perceptions about cognitive health and Alzheimer's disease among the U
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New research explores perceptions of cognitive health among diverse older adults. http://www.cdc.gov/aging/pdf/perceptions_of_cog_hlth_fact sheet.pdf (accessed January 5, 2015)
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2010. Cognitive health messages in popular women's and men's magazines, 2006-2007.
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2006. The effectiveness of urban design and land use and transport policies and practices to increase physical activity: A systematic review.
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2009. Promoting cognitive health: A formative research collabora tion of the Healthy Aging Research Network.
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2012. Promoting cognitive health: A web site review of health systems, public health departments, and senior centers.
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2011. Older adults' perceptions of physical activity and cognitive health: Implications for health communication.
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2007. Physical activity and cognitive functioning: translat ing research to practice with a public health approach.
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2002. Recommendations to increase physical activity in communities.
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2009. Gender differences in views about cognitive health and healthy lifestyle behaviors among rural older adults.
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