Barriers and Facilitators for the Adaptation and Implementation of Cognitive Stimulation Therapy: A Systematic Review

Abstract

Cognitive Stimulation Therapy is a group-based psychosocial intervention for people living with dementia with a solid evidence base. Although Cognitive Stimulation Therapy provision is expanding, its access remains limited, particularly in low- and middle-income countries. To foster dissemination of this intervention, the purpose of the current article is to conduct a systematic review to identify barriers and facilitators that different countries experienced during the adaptation and/or implementation of Cognitive Stimulation Therapy. This was done to understand both shared and context-specific difficulties during these processes. We followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Studies describing cultural adaptation and implementation of Cognitive Stimulation Therapy in different countries were included. The databases used for this research were PubMed, Science Direct and PsycInfo. Social connection, emotional support, and spirituality were key facilitators. Stigma, caregiver burden, and lack of awareness about dementia were significant barriers, highlighting the need for culturally sensitive strategies. Cultural influences across different social contexts were crucial for the adaptation and exploration of the efficacy of the program. Lack of knowledge and stigma about dementia reinforce the importance of implementing and enhancing strategies to increase dementia awareness, subsequently encouraging greater uptake of psychosocial interventions.