title: Common Sense Model Factors Affecting African Americans' Willingness to Consult a Healthcare Provider Regarding Symptoms of Mild Cognitive Impairment.
abstract: Although at increased risk for developing dementia compared with white patients, older African Americans are diagnosed later in the course of dementia. Using the common sense model (CSM) of illness perception, we sought to clarify processes promoting timely diagnosis of mild cognitive impairment (MCI) for African American patients.
  
  
  
  In-person, cross-sectional survey data were obtained from 187 African American (mean age: 60.44 years). Data were collected at social and health-focused community events in three southern Wisconsin cities.
  
  
  
  The survey represented a compilation of published surveys querying CSM constructs focused on early detection of memory disorders, and willingness to discuss concerns about memory loss with healthcare providers. Derived CSM variables measuring perceived causes, consequences, and controllability of MCI were included in a structural equation model predicting the primary outcome: Willingness to discuss symptoms of MCI with a provider.
  
  
  
  Two CSM factors influenced willingness to discuss symptoms of MCI with providers: Anticipation of beneficial consequences and perception of low harm associated with an MCI diagnosis predicted participants' willingness to discuss concerns about cognitive changes. No association was found between perceived controllability and causes of MCI, and willingness to discuss symptoms with providers.
  
  
  
  These data suggest that allaying concerns about the deleterious effects of a diagnosis, and raising awareness of potential benefits, couldinfluence an African American patient's willingness to discuss symptoms of MCI with a provider. The findings offer guidance to designers of culturally congruent MCI education materials, and healthcare providers caring for older African Americans. .
authors.affiliation: Wisconsin Alzheimer's Disease Research Center, Madison, WI; Division of Geriatrics, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI; Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI. Electronic address: ceg@medicine.wisc.edu.
authors.forename: Carey E
authors.initials: CE
authors.lastname: Gleason
authors.affiliation: Wisconsin Alzheimer's Disease Research Center, Madison, WI; Geriatric Research, Education, and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI.
authors.forename: N Maritza
authors.initials: NM
authors.lastname: Dowling
authors.affiliation: Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin, Madison, WI.
authors.forename: Susan Flowers
authors.initials: SF
authors.lastname: Benton
authors.affiliation: Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin, Madison, WI.
authors.forename: Ashley
authors.initials: A
authors.lastname: Kaseroff
authors.affiliation: Kinesiology and Occupational Therapy, School of Education, University of Wisconsin, Madison, WI.
authors.forename: Wade
authors.initials: W
authors.lastname: Gunn
authors.affiliation: Wisconsin Alzheimer's Disease Research Center, Madison, WI; Kinesiology and Occupational Therapy, School of Education, University of Wisconsin, Madison, WI.
authors.forename: Dorothy Farrar
authors.initials: DF
authors.lastname: Edwards
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000523:psychology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014922:Wisconsin
keywords: common sense model; health disparities; mild cognitive impairment; structural equation modeling; timely diagnosis
references.citation: CNS Drugs. 2004;18(15):1143-8
references.pmid: 15581384
references.citation: J Am Geriatr Soc. 1999 Apr;47(4):482-6
references.pmid: 10203126
references.citation: Am J Alzheimers Dis Other Demen. 2013 Feb;28(1):84-92
references.pmid: 23196405
references.citation: Res Gerontol Nurs. 2012 Jul;5(3):195-206
references.pmid: 22716654
references.citation: Int J Geriatr Psychiatry. 2008 Aug;23(8):812-20
references.pmid: 18232061
references.citation: Psychiatr Serv. 2003 Jan;54(1):92-6
references.pmid: 12509673
references.citation: J Am Geriatr Soc. 2005 Nov;53(11):2012-7
references.pmid: 16274388
references.citation: Gerontologist. 2005 Apr;45(2):177-85
references.pmid: 15799982
references.citation: Int Psychogeriatr. 2011 Nov;23(9):1393-404
references.pmid: 21729410
references.citation: J Am Geriatr Soc. 2003 Jul;51(7):937-44
references.pmid: 12834513
references.citation: Arch Neurol. 1999 Mar;56(3):303-8
references.pmid: 10190820
references.citation: Arch Neurol. 2001 Dec;58(12):1985-92
references.pmid: 11735772
references.citation: Alzheimers Dement. 2013 Mar;9(2):208-45
references.pmid: 23507120
references.citation: Biometrics. 2010 Dec;66(4):1061-8
references.pmid: 20070298
references.citation: J Am Geriatr Soc. 2009 Sep;57(9):1562-8
references.pmid: 19682136
references.citation: Aging Ment Health. 2011 Sep;15(7):922-31
references.pmid: 21867385
references.citation: Prog Neurobiol. 2013 Nov;110:54-62
references.pmid: 23689068
references.citation: Psychol Bull. 1990 Mar;107(2):238-46
references.pmid: 2320703
references.citation: J Am Geriatr Soc. 2000 Mar;48(3):300-4
references.pmid: 10733057
references.citation: Alzheimers Dement. 2014 Mar;10(2):214-24
references.pmid: 23643457
references.citation: Alzheimer Dis Assoc Disord. 2006 Jul-Sep;20(3):182-91
references.pmid: 16917189
references.citation: West J Nurs Res. 2014 Feb;36(2):152-70
references.pmid: 23765710
references.citation: Alzheimers Dement. 2011 May;7(3):270-9
references.pmid: 21514249
references.citation: J Am Geriatr Soc. 2006 Sep;54(9):1388-94
references.pmid: 16970647
references.citation: J Law Med Ethics. 2012 Spring;40(1):26-32
references.pmid: 22458459
references.citation: Health Psychol. 1993 May;12(3):171-9
references.pmid: 8500446
references.citation: Alzheimers Dement. 2011 May;7(3):280-92
references.pmid: 21514248
references.citation: Lancet Neurol. 2013 Feb;12(2):207-16
references.pmid: 23332364