Revisioning the Role of Community in Creating Better Brain Health
摘要
Neurological conditions are the leading cause of illness and disability in the world today, yet their impacts are experienced differently by different individuals and communities across different geographic spaces. Often treated as an add-on or “footnote” in brain health solutions, this chapter explores the potential of community-based interventions not only to improve the lives of those affected by brain health challenges but also to address inequities in brain health. Without a full understanding of the role of community in brain health care, it is difficult to develop a theory of change for ‘integrated’ brain health solutions that can address the dynamic needs of diverse clients. Drawing on both the literature and our own experiences evaluating community interventions focused on brain health, this chapter explores some key elements of what community-level care can supply. We find that community approaches have the potential to be particularly good at providing care that is more holistic and person-centered and also meets the needs of individuals over time. Community tends to be uniquely positioned to help meet diverse and multiple needs due to its proximity and sensitivity to context, including values, knowledge, preferences, cultures, and lived experiences of individuals. Given the book’s focus on integration of care, we conclude the chapter by reflecting on the complexities of understanding the community’s causal role in a comprehensive framework of solutions for brain health care. We discuss the implications of these findings for brain health and the evaluation of brain health interventions, noting especially the value of supporting more integrated solutions that incorporate both neuroscience and community.