Mobile Clinics for Brain Health Equity: A Feasibility Study of Dementia Risk Reduction in Underserved Communities

Introduction: Mobile health clinics (MHCs) may improve access to dementia risk-reduction (DRR) services among underserved populations, yet evidence supporting their use for Alzheimer’s disease and related dementias (AD/ADRD) prevention remains limited. This pilot study evaluated the feasibility of implementing an MHC-based DRR (MHC-DRR) program and explored preliminary changes in knowledge, risk awareness, motivation, and brain-health behavior engagement. Methods: A single-arm pilot feasibility study was conducted at two MHC sites. Feasibility was assessed through recruitment, retention, protocol fidelity, outcome data availability, and perspectives from program participants and implementation staff. The program included individualized dementia risk assessment, tailored brain-health education, and community resource linkage. Exploratory outcomes included DRR knowledge, individualized risk awareness, motivation for brain-health behavior change, and reported brain-health behavior engagement. Results: Recruitment (88.0%) and protocol fidelity (100%) met or exceeded prespecified progression criteria, whereas retention and follow-up data availability were 59.1% (13/22), slightly below the predefined 60% criterion. Participants and implementation staff reported favorable perceptions of acceptability, implementation, and maintenance. Among participants with complete assessments, self-knowledge and demonstrated knowledge improved from baseline to follow-up, with large effect sizes (Cohen's d = 1.44 and 0.90, respectively). Participants also demonstrated favorable changes in motivation, identified multiple personally relevant dementia risk factors, and reported changes in physical activity, diet, sleep, cognitive engagement, and social participation. CONCLUSION: The MHC-DRR program was feasible to implement within an MHC serving underserved American adults. Findings provide preliminary support for using MHC infrastructure to expand access to dementia risk-reduction services and inform future evaluation, sustainability, and scale-up efforts.