Evaluation of a public awareness campaign for dementia risk reduction in the Netherlands: a mixed methods study

About 45% of dementia cases are attributable to known modifiable risk factors, yet public awareness remains low. The public awareness campaign "We are the medicine ourselves" (2018-2023) aimed to increase public awareness of dementia risk reduction in nine regions. This mixed methods study evaluated the campaign's effectiveness in reaching individuals aged 40-75 years and explored facilitators and barriers to successful implementation.

Cross-sectional online surveys were conducted in independent samples of community-dwelling individuals aged 40-75 years before (n = 4,981) and after (n = 3,379) the campaign to assess awareness of dementia risk reduction, knowledge of dementia risk and protective factors, and campaign exposure. Differences between pre- and post-campaign samples were assessed using χ²-tests for categorical variables and independent t-tests for continuous variables. Adjusted effects were estimated using probit regression for binary outcomes and linear regression for continuous outcomes, controlling for region, age, gender, educational level, and self-reported knowledge of dementia. Semi-structured interviews with 21 campaign coordinators and stakeholders explored facilitators and barriers for implementation.

No significant difference in awareness was found between the pre-campaign (54.6% aware) and post-campaign (55.7% aware) samples (adjusted probit regression: z = 0.97, p = 0.334). Knowledge of risk and protective factors modestly increased (from 5.3 to 5.5; B = 0.18, 95% confidence interval: 0.04 - 0.33, p = 0.013). Self-reported campaign exposure was associated with higher awareness, better knowledge of risk and protective factors, and greater motivation to adopt brain-healthy lifestyle changes. Implementation barriers included limited financial resources, difficulty reaching younger individuals (40-60 years), and limited engagement with regional stakeholders. Facilitators included the campaign framework and strong local networks.

While the multi-regional campaign did not lead to a general increase in population-level awareness of dementia risk reduction, it modestly improved knowledge of specific dementia risk and protective factors.