Addressing disparities in Alzheimer's disease through culturally tailored health information

LEXINGTON, Ky. (May 21, 2024) — Yolanda Jackson worked for years as a clinical dietitian and University of Kentucky lecturer in dietetics and human nutrition before she decided to pursue a Ph.D. in health communication —a field she describes as a “missing link” for making a positive impact in public health.

Now in the fourth year of her Ph.D. program, she works as a graduate research assistant with the UK Center for Health Equity Transformation (CHET) and just completed her first year as a TL1 Scholar with the UK Center for Clinical and Translational Science (CCTS).

The TL1 Training Program in Clinical and Translational Science equips exceptional pre- and postdoctoral trainees with the necessary skills for a career in multidisciplinary health research. TL1 Scholars complete a certificate program in clinical and translational science (CTS), receive mentorship from a range of faculty, network with other trainees, attend national conferences and conduct a research project of their own.

Jackson’s TL1 project focuses on developing culturally tailored health messaging about Alzheimer’s disease for rural Black adults, highlighting modifiable risk factors like obesity, diabetes, hypertension, physical inactivity, obesity, smoking and depression — many of which are impacted by poor diet. Through her experiences as a clinical dietitian, instructor and student, she’s learned that many patients who are labeled “non-compliant” are in fact experiencing environmental barriers that prevent them from engaging in healthy behaviors.

“Once I learned about the modifiable risk factors (for Alzheimer’s disease), I realized I could use my dietetics background in this field,” Jackson said.  “As a health communication scholar, I’m trying to put out messages that are evidence-based and theoretically supported to hopefully curtail all the misinformation out there.”

Community Connections

Through one of her mentors, Elizabeth K. Rhodus, Ph.D., an assistant professor with the UK Sanders-Brown Center on Aging, Jackson connected with the First Baptist Church Frankfort in Frankfort, Ky., a city with the nation’s second-highest prevalence of Alzheimer’s in Black adults. She conducted focus groups with church members to refine messaging from the Alzheimer’s Association so that it was better tailored for their community.

“To start, I evaluated what they knew, believed and thought about Alzheimer’s disease. Then I showed them an Alzheimer’s Association handout that was very wordy and asked what they liked and disliked about it.”

She found that limited knowledge about Alzheimer’s disease led to feelings of powerlessness, whereas awareness and education led to hope. She also found that past healthcare experiences significantly influenced beliefs and behaviors among the focus group participants and that cultural norms played a crucial role in how health messaging was received.

Based on the feedback from the focus groups, Jackson converted the information from the text-heavy Alzheimer’s Association handout into a regionally specific infographic that uses visual cues and simplified lists to explain warning signs and modifiable risk factors for the disease. It also includes prominent information about how to find local care and support.

Jackson describes her community-engaged research as an “amazing bi-directional transfer of knowledge” between the community and the research world.

“The participants’ first comment on the new handout was ‘Oh my gosh, look what you’ve created!’ and I said ‘No, look what we created!’ I think the process changed their perspective about what participating in research can look like. I am so thankful to the First Baptist Church Frankfort for helping with this research and being so kind with their time. They treat me like I’m their granddaughter. They’re just the nicest people.”

Making an Impact

For the second and final year of her TL1 appointment, Jackson is working with her mentors, Rhodus and Nancy G. Harrington, Ph.D., professor of communication, to develop additional infographics focused on modifiable risk factors for Alzheimer’s disease. She’s also working with the UK Office of Technology Commercialization to copyright the infographics and get them published.

“I feel like I found my home with the UK CCTS TL1 program. It was the first time that people understood me and how my clinical background connects to my Ph.D. research,” Jackson said. “Being a TL1 Scholar links that clinical background with health communication, which allows me to do research that can impact public health and chronic disease management. Communication is a science and not as easy as you might think.”

Drawing on her health communication training, Jackson recently won third place in the annual Von Allmen Center for Entrepreneurship (VACE) 60-Second Poster Pitch Competition at the 2024 CCTS Spring Conference. Although intimidated by the prospect of publicly pitching her research with a tight time constraint and no visual aids, she knew the coaching she could get through the process would benefit her.

“The coaching was phenomenal. Mariam Gorjian, assistant director of VACE, is amazing," she said. "She made me feel like I could conquer the world!”

Jackson additionally presented an oral presentation at the CCTS conference’s health equity session, which had a standing-room-only audience. Just days before that, she also presented her research at the Association of Clinical and Translational Science national conference in Las Vegas.

The professional growth and networking she’s gained through the TL1 program makes Jackson encourage health researchers from all fields to participate in the program.

“Regardless of your background, consider applying to the program. I’m glad that I was different from other participants. Even if you’re not a bench scientist or medical doctor, or if you don’t have an extensive research background, think about all the tools you have in your toolbox, how the program can sharpen or expand those tools, and what you can bring to the program.”

A Lexington native, Jackson will have completed her bachelor’s degree, master’s degree, CTS certificate and Ph.D. at UK, in addition to working as a clinician and a faculty member here.

“UK has so many resources and my philosophy is ‘We’re not leaving opportunities on the table.’ I truly believe in training, and I know opportunities don’t always come twice. I’m doing things and sitting in rooms I never would have thought imaginable.”

If you are interested in learning more about participating in health research, visit UKClinicalResearch.com.

The project described was supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.