The Effect of Health Belief Model-Based Education on Knowledge and Behavioral Changes Regarding Dementia in Older Adults

N/AEnrolling By InvitationNCT07505693

Hasan Kalyoncu University60 enrolled

Overview

While age is one of the strongest known risk factors for the onset of dementia, dementia is not an inevitable consequence of aging. Several modifiable risk factors, such as physical inactivity, obesity, diabetes, hypertension, smoking, excessive alcohol consumption, depression, and social isolation, increase the risk of developing dementia (WHO, 2025). Positive health beliefs and attitudes toward preventing or reducing the risk of dementia can encourage individuals to adopt healthy lifestyle behaviors (Vrijsen et al., 2021). Many studies in the literature have investigated the effects of lifestyle interventions on dementia prevention and reported that adhering to a healthy lifestyle can improve cognitive function and reduce or delay the risk of dementia (An et al., 2025; Siette 2023; Lee et al., 2022). The Health Belief Model argues that individuals' health behaviors are influenced by their beliefs, values, and attitudes (Gözüm \& Çapık, 2014). Considering individuals' beliefs and attitudes towards health, the education and treatment offered can be tailored to the individual and their benefit can be ensured (Gözüm \& Çapık, 2014; Li et al., 2022). Within the framework of the Health Belief Model, it has been stated that reducing the perceived barriers in individuals in the intervention process aimed at preventing dementia is a fundamental factor in strengthening their beliefs about dementia prevention and encouraging the development of healthy behavioral habits (Li et al., 2022). Therefore, it is thought that Health Belief Model-based education applied to the elderly may have an effect on individuals' level of knowledge about dementia and their motivation to change behaviors to reduce the risk of dementia.

While age is one of the strongest known risk factors for the onset of dementia, dementia is not an inevitable consequence of aging. Several modifiable risk factors, such as physical inactivity, obesity, diabetes, hypertension, smoking, excessive alcohol consumption, depression, and social isolation, increase the risk of developing dementia (WHO, 2025). Positive health beliefs and attitudes toward preventing or reducing the risk of dementia can encourage individuals to adopt healthy lifestyle behaviors (Vrijsen et al., 2021). Many studies in the literature have investigated the effects of lifestyle interventions on dementia prevention and have reported that adhering to a healthy lifestyle can improve cognitive function and reduce or delay the risk of dementia (An et al., 2025; Siette 2023; Lee et al., 2022). One of the models underlying research on the prevention or reduction of symptoms of dementia is the Health Belief Model (Lee et al., 2022). The Health Belief Model provides an effective guide in evaluating factors affecting health-protective and health-promoting behaviors, as well as individuals' adherence to treatment (Gözüm \& Çapık, 2014). However, a review of the literature indicates that intervention and education studies based on the Health Belief Model for dementia prevention need to be increased (Lee et al., 2022; An et al., 2025). Therefore, it is thought that Health Belief Model-based education applied to the elderly may have an effect on individuals' knowledge level regarding dementia and their motivation to change behaviors to reduce the risk of dementia.

Interventions

1. Introduction Session: Increasing Perceived SensitivityBEHAVIORAL

SESSION 1: Do We Know Dementia? (Perceived Awareness) In this session, we will learn what dementia is and its symptoms. • What is Dementia? Dementia means "loss of the mind"; it is not simply forgetfulness, but an impairment of thinking and understanding abilities. • Symptoms: It manifests itself with symptoms such as difficulty finding words, getting lost in familiar places, or forgetting recent events. • Prevalence: As the elderly population increases worldwide and in Turkey, dementia cases are also rapidly increasing.

Session 2: Increasing the Perception of Seriousness/ImportanceBEHAVIORAL

Severity and Stages of the Disease (Perceived Severity) In this session, we will discuss how the disease progresses and what happens in each stage. • Stages: Dementia progresses in three stages: Mild, Moderate, and Advanced. • Mild Stage: The person is usually independent but frequently loses belongings and begins to forget names. • Moderate and Advanced Stages: Assistance is needed for daily tasks, time/space perception is confused, and in the advanced stage, the person may become completely dependent on others. • Early Diagnosis: The earlier the disease is detected, the more possible it is to preserve the quality of life.

Session 3: Increasing the Perception of BenefitBEHAVIORAL

What Can We Change? In this session, we will focus on the tools we have to reduce the risk. • Modifiable Factors: Factors such as physical inactivity, high blood pressure, smoking, and social isolation increase the risk of dementia. • Protective Steps: Taking brisk walks at least 1-2 days a week, keeping blood pressure under control, and using a hearing aid if you have hearing loss protects the brain. • Mental Activity: Learning new things, reading books, and solving puzzles are the strongest shields for brain health.

Session 4: Addressing the Perception of BarriersBEHAVIORAL

Overcoming Obstacles: In this session, we will identify the obstacles to developing healthy habits. Recognizing the Obstacles: Why don't we exercise enough? What challenges are we facing in our diet? Why are we socializing? Self-Assessment: Smoking addiction, sleep problems, or the use of multiple medications can make lifestyle changes difficult.

Session 5: Raising Awareness and Enhancing Self-Efficacy of ImplementersBEHAVIORAL

Taking Action In this session, we plan how to incorporate what we've learned into our lives. Goal Setting: We will take concrete steps such as keeping blood pressure below 140/80 mmHg, ventilating the room for quality sleep, and maintaining regular communication with loved ones. Belief: It's important to start with small goals by saying, "I believe I can do this." Suggestion: If you're out of breath while walking, you're at the right pace.

Eligibility

Sex: ALLMin age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Individuals who are: * 60 years of age and older, * Registered with the Active Living Center and actively using its services, * Not diagnosed with dementia, * Not visually and/or hearing impaired, * Possessing reading comprehension skills, * Possessing Turkish speaking and comprehension skills, * Not having a psychiatric diagnosis, * Not taking psychiatric medication, * Not having previously participated in a dementia-related training program, and who volunteer to participate in the study will be included. Exclusion Criteria: * Individuals who do not meet any of the research inclusion criteria, * Individuals who have not attended at least two sessions of the Training Program, * Individuals who refuse to participate in/wish to withdraw from the Training Program will be excluded from the research by the researcher.

Outcomes

Primary Outcomes

Dementia Knowledge Scale

The scale, originally developed by Annear, M. J., Toye, C., Elliott, K. E. J., McInerney, F., Eccleston, C., \& Robinson, A. (2017), was adapted into Turkish by Akyol, M. A., et al. in 2021. The scale consists of 17 items and is unidimensional. Each item is scored as indicated. The total score is obtained by summing the scale items. The lowest possible score is 0 and the highest is 34. A higher score indicates that participants have a higher level of knowledge about dementia. The scale has no cutoff point. Cronbach's α is 0.836, and all fit indices are above 0.90.

Time frame: Up to 8 weeks

Secondary Outcomes

Behavioral Modification Motivation Scale for Reducing Dementia Risk

The Turkish adaptation of the scale, developed by Kim, S., Sargent-Cox, K., Cherbuin, N., \& Anstey, K. J. (2014), was done by Akyol, M. A., et al. in 2022. The scale consists of 10 items and 2 sub-dimensions (Positive Cues for Action, Negative Cues for Action). Positive Cues for Action: M1, M2, M3, M4, M5; Negative Cues for Action: M6, M7, M8, M9, M10. A 5-point Likert-type rating scale is used: strongly disagree, disagree, undecided, agree, strongly agree. The lowest possible score is 10 and the highest is 50. Cronbach's α value is (total α = 0.78, positive cues for action = 0.81 and negative cues for action = 0.70).