Graduation Semester and Year
Spring 2025
Language
English
Document Type
Dissertation
Degree Name
Doctor of Philosophy in Social Work
Department
Social Work
First Advisor
Kathy Lee Siepker
Second Advisor
Genevieve Graaf
Third Advisor
Regina Praetorius
Fourth Advisor
Elizabeth Merwin
Abstract
Older adults living in rural communities are at heightened risk of dementia; however, preventative strategies can reduce these risks. To facilitate dementia prevention efforts in rural communities, this methodological study developed the Rural Older Adults Dementia prevention–Health Behaviors questionnaire (ROAD-HB) by applying a lifespan approach to the Health Belief Model (HBM). The questionnaire contained three embedded instruments and was constructed following a stage development design involving item pool processes with community and expert review panels. Convergent mixed methods were used to assess the ROAD-HB’s validity, including a pretest in 36 older adults from two rural Northeast Texas counties and cognitive interviews with 20 participants. Quantitative analyses were conducted to identify problematic items, followed by a qualitative content analysis to explore participant perceptions regarding the questionnaire’s utility and to gather suggestions for improvement. Although the combined results showed moderate evidence of face validity and weak evidence of content and construct validity, the merged findings guided revisions to address areas of concern. Revisions included: (1) a revised title for greater inclusivity, (2) clearer instructions, (3) revisions to Instrument One to address interrelated problematic items, (4) revisions to Instrument Two to increase the cultural relevance of health belief items, and (5) revisions to Instrument Three to improve content validity in the items and response options. The findings of this dissertation provide empirical evidence supporting a lifespan approach to the HBM and present a novel, culturally relevant questionnaire ready for further testing. Together, these findings may inform future dementia prevention efforts, which are urgently needed in rural communities.
Keywords
dementia prevention, rural health disparities, older adults, dementia risk reduction, rural cognitive health promotion, mixed methods, instrument development
Disciplines
Social Work
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Cassidy, Jessica, "Developing the Rural Older Adult Dementia prevention-Health Behaviors (ROAD-HB) Questionnaire: A Mixed Methods Approach to Instrument Development" (2025). Social Work Dissertations. 192.
https://mavmatrix.uta.edu/socialwork_dissertations/192