Evaluating a dementia risk reduction training program for primary health care educators in Nigeria

Dementia imposes significant health and economic burdens on low- and middle-income countries, yet nearly 40% of cases are potentially preventable through lifestyle modifications. This study developed and evaluated a dementia risk-reduction training program for 57 primary health care (PHC) health educators in Lagos State, Nigeria, to assess its effectiveness in improving community-level competencies. Using a mixed-methods design, one educator from each local district received training on the WHO mhGAP manual, the ANU-ADRI risk index, and the IDEA cognitive screening tool. Quantitative assessments measured knowledge, skills, and confidence, while focus group discussions explored the intervention's feasibility and acceptability. Participants were predominantly female (84%), with only 9% having received prior formal dementia training. Post-intervention results showed significant improvements in knowledge regarding symptoms (p = 0.023) and caregiver support (p = 0.029). Attitudes toward specialist diagnosis (p < 0.001) and referral pathways (p = 0.018) shifted positively. Furthermore, competency in using risk assessment tools increased significantly (p < 0.001). The qualitative findings showed improved confidence, skill application, and perceived community benefits, despite resources and referral challenges. Overall, the training program significantly improved participants' knowledge, attitudes, confidence, and competency, supporting integration into primary health care systems.