This study addresses a James Lind Alliance research gap: translating best dementia care research-to-practice in South Asian minority ethnic populations. The proposed research will inform future roll-out of evidence-based approaches to improving quality of care for people living with dementia from minority ethnic groups, a population that is growing exponentially and is underserved by current care provision. The lack of evidence translatable to minority ethnic communities is a barrier to delivering on policies of inclusion. ARC-NT has the populations and ambition to deliver leading culturally competent dementia care programmes for national roll out.
ARC-NT serves some of the UK’s most diverse populations. Our researchers have highlighted health inequalities experienced by people living with dementia from minority ethnic backgrounds (reference Bhanu et al). We highlighted that dementia services are not culturally competent and that the pandemic worsened access to health and social care (references Giebel et al and Liu et al).
We demonstrated excellent adherence to remotely delivered dementia care and prevention interventions in ongoing Alzheimer’s Society Centre of Excellence and NIHR/ESRC-funded APPLE-Tree trials. This study will draw on psychiatry, engineering, implementation research and other interdisciplinary expertise within the APPLE-Tree collaboration to understand how this promising engagement within trials can be translated to deliver more effective engagement in care and prevention interventions in real-world, underserved populations.
We will consider how innovations in technology and adaptation of interventions can improve care in the contexts of inequalities and complex physical, mental and cognitive frailties. This work will examine how biological and physiological remote data collection (used in the APPLE-Tree trial) may be used to tailor, and measure impact of care. The research will be coproduced with The Academic Centre for Healthy Ageing (Barts Health NHS Trust) and PPI: the APPLE-Tree Community of Interest which we purposively recruited for minority ethnic representation.
The Fellow would work with clinical services in the UK’s most ethnically diverse areas – Newham, Tower Hamlets and Hackney. There is enthusiastic buy-in from East London Foundation NHS Trust and QMUL to increase engagement of these communities in research activities. Local big data resources (over 2.5m GP electronic records) would enable intervention reach to be evaluated within a mixed-methods implementation study. The target population have particularly high needs, relative to the rest of England, due to high deprivation. The Fellow would conduct comparisons to model how outcomes are likely to translate to dementia care and needs in the rest of England.
Research outputs can inform:
- implementation of the NHS Long Term Plan agendas of personalisation and digitalisation,
and
- Local Government Association 2020 recommendations to:
- co-produce digital innovation with people, carers and families;
- invest in digital to support longer-term adult social care reform
and
- level up the digital offer to people in every community.
