'We are the medicine ourselves' [Dutch: 'We zijn zelf het medicijn'] public health campaign

The growing prevalence of dementia is a major public health challenge. To change this prospect, research is running along two complementary lines: one focusing on developing curative pharmacological treatments, and the other on developing preventive measures targeting modifiable risk and protective factors.

While several of these risk factors have been identified in recent years, the general population is still largely unaware of the relationship between lifestyle and dementia risk. Therefore, the public health campaign “We zijn zelf het medicijn” (“We are the medicine ourselves”) was developed in 2016 and 2017 by the Alzheimer Centre Limburg at Maastricht University and Maastricht University Medical Centre+ in consultation with the two regional municipal health services in Limburg and the Department of Health Promotion of Maastricht University. It aimed to increase awareness of the relationship between modifiable risk and protective factors and dementia in Dutch people aged 40-75 years. The campaign was based on the well-validated LIBRA (LIfestyle for BRAin Health) score, which was developed after triangulation of results from a systematic literature review and a Delphi expert consensus study. The campaign was initially conducted in the Province of Limburg from April 2018 to February 2019 and consisted of a mass media approach, public outreach activities and a friendship program for regional stakeholders to support the campaign. The campaign focused on three main themes: ‘eat healthy’, ‘exercise regularly’ and ‘stay curious’ which were visualized by the campaign material. Interviews on local and national television, newspaper and social media outlets supported the campaign. Public events were scheduled on a regular basis or opportunistically joining other activities, such as public lectures, information markets and local events. Campaign material was developed by a design bureau in the form of posters, leaflets and banners, and distributed widely. Additionally, an extensive website with background information, news, campaign events and freely downloadable campaign material. In addition, the eHealth application "MijnBreincoach" ("MyBraincoach") was developed and offered free of charge. It included a personal risk profile, informed by the LIBRA index, and 12 modules (one for each risk factor) consisting of a series of micro-teaching snippets, quizzes and challenges for making brain-healthy lifestyle changes.

Results of the initial campaign did not show population-averaged changes in awareness in a pre-post comparison study, but more risk and protective factors were correctly identified after the campaign, and awareness and self-reports of healthy lifestyle changes were higher in those reporting exposure to the campaign. Several Dutch municipal health services adopted the campaign in other regions across the Netherlands. Following the initial rollout and informed by focus groups and interviews with stakeholders from other campaign regions, the campaign material and the MyBraincoach app have been updated as part of the Netherlands Dementia Prevention Initiative (NDPI). Current activities within NDPI focus on tailoring the campaign to the needs and wishes of at-risk groups that are less well reached by traditional preventive messages, i.e. people with financial constraints, low health literacy and migration background.