Promoting Brain Health Literacy during Midlife among Hispanic/Latino Adults

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PROJECT SUMMARY The Hispanic/Latino (H/L) population in the U.S. is 1.5 times more likely than non-Hispanic Whites to develop Alzheimer’s disease and related dementias (ADRD). These disparities are likely the result of social determinants of health (SDOH) that include a range of systemic factors, such as lower educational attainment and socioeconomic status, exposure to environmental pollutants, discrimination, stress, and trauma. Yet another determinant of ADRD risk could be limited health literacy – one’s capacity to gather accurate self-care knowledge, make informed health decisions, enact recommended behaviors, and appropriately use health services. Limited health literacy – specifically during middle adulthood – could contribute to later life ADRD, especially among H/L adults. Many known or suspected risk factors manifest and become prevalent in midlife, such as: 1) chronic conditions that often are delayed in their detection, or inadequately managed due to poor treatment adherence; 2) undetected or uncorrected sensory impairments; 3) entrenched lifestyle behaviors; and 4) common psychosocial stressors. Healthy People 2030, which lays forth the public health priorities for the U.S., calls for promoting health literacy as a means to reduce health disparities more broadly. More recently, ‘brain health literacy’ programs have been implemented as a means to increase ADRD awareness, address misperceptions, and empower adults to take action to reduce their later risk through lifestyle modification and healthcare engagement. Yet few brain health literacy initiatives have included H/L adults, and none have explicitly tailored their approach for H/L adults in midlife. A primary reason for this has been a continued lack of understanding of what is known and not known about ADRD awareness, attitudes, beliefs, and related behaviors among H/L middle-aged adults. Therefore, the goal of my F31 proposal is to conduct mixed methods investigations among H/L middle-aged adults in support of a future H/L brain health literacy intervention. Filling this knowledge gap is a needed first step towards developing culturally-appropriate brain health literacy programs with the potential to address ADRD disparities in this community over time. My specific aims are to: 1) synthesize evidence of current ADRD knowledge and perceptions among U.S. H/L adults; 2) explore perspectives on brain health, aging, and risk of ADRD among middle-aged H/L adults; and 3) examine middle- aged H/L adults’ knowledge and beliefs about key risk factors and preventative behaviors pertaining to brain health, and their engagement in related behaviors. For Aim 1, I will conduct a systematic literature review that will inform qualitative interviews with middle-aged H/L adults (Aim 2) and a cross-sectional survey to further investigate brain health knowledge, attitudes, beliefs, and related behaviors among H/L adults in midlife (Aim 3). These F31 mentored activities will help me establish a novel, health services and disparities research agenda focused on brain health and aging, preparing me to successfully transition to post-doctoral fellowship and faculty.