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

Abstract Background 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. Methods 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. Results 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. Conclusions 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.