# Co-Designing a Green Activity Program With Chinese American People Living With Memory Loss

## TL;DR

This study co-designed a nature-based activity program with Chinese American people living with memory loss to improve brain health and physical activity.

## Contribution

The paper introduces a culturally tailored Green Activity Program co-designed with Chinese American individuals living with memory loss.

## Key findings

- Participants preferred 30-minute sessions, 4-8 times over 12 weeks, delivered in-person and virtually.
- Preferred activities included walking, Tai Chi, and Wuxing Cao (5-element exercises).
- Barriers included physical limitations and cost, while facilitators included personalized approaches.

## Abstract

Chinese American adults have the highest incidence of Alzheimer’s disease among Asian American groups. Few programs exist to address cognitive decline that are designed with their input. We sought to co-design a nature or ‘Green’ Activity Program (GAP) to promote physical activity tailored to the needs of Chinese American people living with memory loss (PLML) or dementia. Participants were recruited in Brooklyn, New York. Co-design (engaging end-users in design) occurred separately with Chinese American PLML, professional care partners, and outdoor professionals across three 60-90-minute focus groups. Sessions were recorded, transcribed, translated, and analyzed using directed content analysis. A priori Program Design codes were: ‘preferred nature activities,’ ‘session frequency, duration, delivery mode’; Research Design codes were: ‘outcomes,’ ‘recruitment strategies,’ and a ‘referral pathway.’ Participants included Chinese American PLML (n = 4), Chinese American professional care partners (n = 5), and outdoor professionals (n = 6). Program Design preferences were: 1) session duration: 30 minutes, 2) frequency: 4-8 across 12-weeks, and 3) delivery: in-person and virtual. ‘Existing nature activities’ included dance and walking, while ‘preferred nature activities’ included walking, Tai Chi, and Wuxing Cao (5-element exercises). Research Design preferences included ‘outcomes’ of delaying memory loss, improving physical function, and socializing. ‘Recruitment strategies’ included in-person events, with ‘preferred terms’ being “memory loss” and “brain health.” ‘Referral pathways’ involved champions at family health and older adult centers. ‘Barriers’ included physical limitations, inconveniences, and cost. ‘Facilitators’ were a personalized approach. Co-design led to a culturally tailored GAP with/for Chinese American PLML to guide piloting the program in preparation for efficacy testing.