Collective efficacy and community readiness for dementia prevention: a spatial spillover analysis

Dementia represents a growing public health challenge in Taiwan, particularly within its rapidly aging population. This study employed the Community Readiness Model (CRM) to systematically assess community readiness for dementia prevention across multiple domains. It further examined whether collective efficacy, defined as shared social cohesion and a community's capacity for collective action, is associated with greater readiness for dementia-related prevention efforts. A cross-sectional survey was conducted from March to June 2021 among 3,129 community leaders in 456 communities in Taipei City. A total of 447 valid responses were analyzed, representing 288 communities (63.2% of all communities). A spatial lag regression model was conducted, and spatial spillover effects were further assessed. Spatial lag regressions revealed that willingness to intervene (B=0.256, p<0.0001), social cohesion (B=0.375, p<0.0001), and prior dementia prevention programs (B=1.036, p=0.01) were significantly associated with higher community readiness for dementia prevention. Spill-over patterns - particularly for social cohesion and prior programs - appeared to play a potential, though not fully conclusive, role in shaping readiness across neighbouring communities. Those with higher proportions of residents aged 85+ showed lower readiness, while average income was not a significant predictor. Collective efficacy and prior dementia efforts were associated with higher community readiness. Tailored, community-based strategies that foster social cohesion and proactive engagement while accounting for spatial disparities are considered essential for effective dementia prevention.