From Dementia Prevention Literacy to Realist-Informed Digital Dementia Education: An Integrated Theoretical Perspective

Abstract

Peter Carey

The growing use of digital health education to support dementia prevention has intensified interest in understanding how educational interventions influence knowledge, engagement, and behaviour change. This paper presents a comparative conceptual analysis of two frameworks: the Dementia Prevention Literacy Translation Framework (DPLTF) and the Realist-Informed Digital Dementia Education Framework.

The DPLTF explains how dementia prevention evidence is translated into preventive action through processes of health literacy, interpretation, appraisal, and behavioural engagement. In contrast, the Realist-Informed Digital Dementia Education Framework adopts a realist evaluation perspective, explaining how digital educational interventions generate outcomes through Context–Mechanism–Outcome (CMO) configurations, with particular emphasis on engagement, interpretative processes, and behavioural readiness.

The analysis shows that although both frameworks seek to explain pathways from exposure to information through to behaviour change, they differ in theoretical foundations, treatment of context, and conceptualisation of mechanisms. The DPLTF emphasises knowledge translation and health literacy processes, whereas the realist-informed framework explicitly theorises contextual conditions and mechanisms that shape intervention effectiveness across settings. Despite these differences, the frameworks are complementary. The realist-informed framework extends the DPLTF by making mechanisms explicit and embedding them within a CMO structure, while retaining core principles of health literacy and behavioural appraisal.

This paper argues that integrating both frameworks provides a more comprehensive explanation of how digital dementia education influences behaviour change. Such integration bridges health literacy, implementation science, behaviour change theory, and realist evaluation, enabling a more complete understanding of how evidence is translated into action, for whom, and under what circumstances. The comparative analysis contributes to theoretical development in dementia prevention education and supports the design, implementation, and evaluation of more effective digital interventions.

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