title: Improving dementia health literacy using the FLOW mnemonic: pilot findings from the Old SCHOOL hip-hop program.
abstract: BACKGROUND
  Dementia health literacy is low among the public and likely poses a significant barrier to Alzheimer's disease (AD) symptom recognition and treatment, particularly among minority populations already facing higher AD burden. We evaluated the pilot phase of a novel AD health education program, Old SCHOOL (Seniors Can Have Optimal Aging and Ongoing Longevity) Hip-Hop (OSHH), which is designed to enable children to be AD health educational conduits in the home ("child-mediated health communication").
  
  
  METHODS
  OSHH applied our stroke-validated model of engaging, dynamic, and age- and culturally appropriate curriculum delivered to elementary school-age children (fourth/fifth grades, ages 9-11 years). We assessed AD knowledge among the children at baseline, immediately following the intervention (1-hour program delivered daily over 3 consecutive days), and 3 months later. For key AD symptoms, we developed the FLOW mnemonic (forget, lose, overlook, write/wander); students were additionally taught action plans for recognized symptoms.
  
  
  RESULTS
  Seventy-five students completed baseline assessments, and 68 completed posttesting. AD symptoms in FLOW were not well known at baseline (individually ranging from 16% to 71% correct) but were highly learned after 3 days (89% to 98% correct) and retained well after 3 months (80% to 95% correct, p ≤ .01 for all comparisons vs. baseline). AD localization, including its effect on memory and the hippocampus, was also highly learned and retained (p < .001). Eighteen students (24%) reported having a close friend/family member with AD.
  
  
  CONCLUSIONS
  This study suggests our hip-hop health education model may be an effective method to improve AD health literacy.
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, NY, USA Hip Hop Public Health Research Center of Columbia University Medical Center and Harlem Hospital Center, New York, NY, USA Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA jn2054@columbia.edu.
authors.forename: James M
authors.initials: JM
authors.lastname: Noble
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, NY, USA Hip Hop Public Health Research Center of Columbia University Medical Center and Harlem Hospital Center, New York, NY, USA.
authors.forename: Monique G
authors.initials: MG
authors.lastname: Hedmann
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, NY, USA Hip Hop Public Health Research Center of Columbia University Medical Center and Harlem Hospital Center, New York, NY, USA.
authors.forename: Olajide
authors.initials: O
authors.lastname: Williams
mesh_terms: D001741:Black or African American; D000544:Alzheimer Disease / Q000523:psychology*; D000704:Analysis of Variance; D002648:Child; D055812:Community-Based Participatory Research; D003704:Dementia; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009519:New York City; D010865:Pilot Projects; D011203:Poverty; D012574:Schools; D014584:User-Computer Interface
keywords: aging and health; behavioral theories; community based participatory research; health behavior; health promotion; school-based; theory of reasoned action