Utilizing the Precede-Proceed Model as a framework for understanding
cognitive impairment among homeless older adults in King County
Anita M. Souza, PhD(c)1; Susan M. McCurry, PhD1; Francesca Martin, PhD2; Robert M. Bowery, MA2; Susan Rogel, MEd2
1University
of Washington; 2Compass Housing Alliance
Background
Community Based Participatory Framework
In King County over 10,000 individuals are living
without permanent housing. It is estimated 24% of
those individuals are older adults. The extent of
cognitive impairment within this population is not yet
quantified but it is recognized as a growing area of
concern by housing providers and homeless advocates
in King County. These members of our community are
vulnerable, invisible, and in desperate need of support.
Aims:
1) To better quantify the extent of cognitive
impairment among homeless older adults.
2) To articulate the challenges of cognitive impairment
within the homeless housing network.
3) To quantify the dementia knowledge of direct
service providers.
4) Formation of a community advisory board. (CAB).
Procedures
From Lawrence W. Green and Shawna L.
Mercer. "Precede-Proceed Model."
Encyclopedia of Public Health. Ed. Lester
Breslow. Vol. 3. Gale Cengage, 2002.
Results
MEAN / %
Methodology: Mixed methods. One hour, in-person,
semi-structured interviews with direct support staff in
shelters, day centers, transitional and permanent
supportive housing in King County.
Measures: Dementia Knowledge Assessment Scale,
27 True/False Questions, 2 domains: dementia
symptoms and progression, support and care.
Age
39 years
% Female
42% (n=5)
English as first language
Have had a formal dementia education course or workshop
92% (n=11)
0%
Immediate family member with dementia diagnosis (yes)
17% (n=2)
Provided professional care to a person experiencing dementia (yes) 17% (n=2)
Provider Questionnaire: 26 Questions, Demographics,
Service Population, Physical Health, Mental Health,
Community and Agency Collaboration.
Next Steps
1) Stage 2: Epidemiological diagnosis.
2) Identify staff development strategies to strengthen
service delivery and positively impact quality of life
for service recipients.
3) Engage CAB to identify stakeholders and champions
that can inform systems level and policy level
decision making.
4) Attend CBPR Partnership Academy July 2016
University of Michigan Detroit Center for Urban
Research.
Participant Profiles (N=12)
Self Rating of dementia knowledge
1 = no knowledge
2
3
4
5 = high level of knowledge
17%
42%
33%
8%
0%
Race
Black/African-American
White
27% (n=3)
73% (n=8)
Acknowledgements:
This project was conducted with the support of
the de Tornyay Center for Healthy Aging.
Annear, M. J., Toye, C. M., Eccleston, C. E., McInerney, F. J., Elliott, K. E. J., Tranter, B. K., ... & Robinson, A. L. (2015). Dementia
Knowledge Assessment Scale: Development and Preliminary Psychometric Properties.Journal of the American Geriatrics
Society, 63(11), 2375-2381.
(n=2)
(n=5)
(n=4)
(n=1)