The Community-Engaged Dementia Education Program for the Houston Vietnamese American Community

Background and Purpose. Following the Fall of Saigon in 1975, three distinct waves of Vietnamese refugees/immigrants arrived in many U.S. cities. Currently, 2.2 million Vietnamese live in the U.S. and the number is growing. Vietnamese refugees arrived with adverse life-long experiences (e.g., war-time traumas, life-threatening migration journeys, low socioeconomic status, low English language proficiency). Despite these backgrounds, their health data are scarce. To fill this knowledge gap, we developed the Vietnamese Aging and Care Survey and collected the health data of community-dwelling older Vietnamese (≥65 years) and their family caregivers (≥18 years) in Houston, Texas in 2021 (N=204). Houston is the 2^nd largest Vietnamese-populated metropolitan area in the U.S. The results showed a high prevalence of cognitive impairment in older Vietnamese, however, no families seemed to be aware of the health risk of cognitive impairment due to their low health literacy. We proposed a Community-Engaged Dementia Education Program to assess and improve the community’s literacy on dementia and develop educational materials appropriate for the Houston Vietnamese American (VA) community.

Methods. We used the Cultural Exchange Model as a conceptual framework. Based on Edwards’ 9-stage Community Readiness Model, 14 Vietnamese key informants were interviewed and assessed the dementia literacy level of the VA community (Aim 1). We explored the key informants’ and the Houston VA community’s perceived knowledge about dementia, cultural factors such as stigma associated with dementia, and perspectives on the community educational materials. To develop dementia educational materials for the community (Aim 2), all key informants participated in focus group discussions. With the participants’ permission, all interviews were recorded and transcribed verbatim. We used thematic analysis and analyzed key informants’ and the community’s knowledge as well as understanding of dementia for Aim 1, and used member-checking techniques to validate the findings. For Aim 2, we developed and refined the educational materials.

Results. The participants were on average 58 years old. All except one informant were Vietnam-born. The vast majority were women (86%), married (79%), full-time employees (79%), and highly educated (71% >college). Their average immigration age was 20 years. They had lived in the U.S. for an average of 40 years and in Houston for 30 years. Several themes (e.g., the Houston VA community’s low dementia literacy level, dementia as a normal part of aging, how to introduce dementia conversations to the community) emerged from the interviews. During the focus group meetings, we developed the one-pager as educational material, discussed its contents using culturally- and linguistically-appropriate translation, and finalized the English and Vietnamese versions of the one-pager.

Conclusions and Implications. We developed a culturally- and linguistically-tailored dementia education one-pager for the Houston VA community that includes a photo of the target population, warning signs of dementia, and encouraging messages to see their doctors for cognitive check-ups based on the community’s opinions. The next steps include utilizing the local ethnic social media and promoting the one-pager, as well as, training Social Work students and offering a “Brain Booth” at various Vietnamese health fairs, advocating for this underserved community.