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- Page navigation anchor for Re-thinking the role of primary care in dementia preventionRe-thinking the role of primary care in dementia prevention
We read Jones and colleagues’ paper on the role of GPs in dementia prevention with great interest1. Whilst the research introduces a novel strategy for addressing this challenge and acknowledges barriers to communicating dementia risk such as time, there are some notable absences.
Firstly, while GPs might be better placed than secondary care colleagues to prevent dementia in the community, concerted effort towards a ‘public brain health agenda’ may be more effective for reducing the risk of dementia in the wider population than opportunistic dementia screening2. More focus could be placed on dementia prevention strategies initiated before people present to primary care and rather than relying on a form of dementia screening for which there is limited evidence3. The brain health agenda might include social participation, as well as cognitive and physical activity, access to which is predicated by societal structures and individual motivation, which are outside the remit of general practices.
Secondly, the article insufficiently addresses how its proposed suggestions would be implemented within primary care. While it suggested including dementia screening within the NHS health checks, there is limited data illustrating the impact of NHS health checks on health outcomes3. Pre-pandemic data revealed that only 48% of those invited to take part in NHS health checks had done so and among those, mo...
Competing Interests: None declared. - Page navigation anchor for Judgement of data saturation: replyJudgement of data saturation: reply
Dear Junki Mizumoto,
Thank you for the interest in the article and for the questions raised about the method.
As we detailed, our sample was relatively homogenous, all GPs were located in the UK, 82% were female, and over half have specialist postgraduate dementia education. As we did not aim to correlate findings with participant characteristics, collecting further participant information was unnecessary. We acknowledge that using convenience sampling can attract participants interested in the research topic. We do not suggest within the article that findings are transferrable to other populations or indeed outside the UK. As identified, further study in other populations would be required.
The scope of the study was discrete, defined to answer the identified research questions only, with interview questions limited to this focus. Unstructured questions about prevention may have yielded further insight, as you suggest, but this was not the approach for this study. We do not suggest we exhausted all views of GPs about dementia prevention, but those identified in the scope of the study.
We acknowledge there is no universal approach to thematic analysis (TA), or indeed identifying saturation. Braun and Clark suggest that when themes are conceptualised as analytic inputs, using this type of coding approach to TA, possible or actual themes will ‘saturate’ early. We had a rigorous process of coding data, reviewing codes and them...
Competing Interests: None declared. - Page navigation anchor for Judgment of data saturationJudgment of data saturation
I read the article by Jones et al.1 with great interest and strongly appreciate the importance of this study. The research question sheds light on the unique and indispensable role of GPs. The research topic, which focuses on dementia prevention and the GP's role, is expected to encompass a wide range of relevant themes.
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The authors mention that data saturation was achieved by interviewing 11 participants for an average of 26 minutes each. In the broader context, data saturation refers to the point in data collection where no additional insights are identified, and further data collection becomes redundant. Given the depth and breadth of the area covered by this research topic, it is challenging to imagine data saturation being reached in short-term interviews with a relatively small number of participants.
Two possible factors may have influenced the judgment of data saturation in this study. First, the participants might be from a homogeneous and small community. Hennink and Kaiser2 suggest that saturation may be reached within a few interviews (typically between 9 to 17) when participants belong to relatively homogenous populations with narrowly defined objectives. As a reader of the article, I am curious about the participants, but the authors did not provide detailed information about them, only stating that they recruited participants via convenience sampling from existing networks in the UK. It raises suspicion that the particip...Competing Interests: None declared.