Screening to Awareness: CHRs Lead the Way in Dementia Care
The Indian Health Service’s (IHS) Community Health Representative (CHR) Early Dementia Detection Initiative is helping more people in American Indian and Alaska Native communities take the first step toward better memory health—and the latest results show its impact is growing.
The initiative’s CHR Mini-Cog pilot launched in 2024 as a joint effort between the IHS Alzheimer’s Program and the CHR Program. It combines trusted community relationships with an easy-to-use screening tool to raise awareness, start meaningful conversations, and connect people to important follow-up care.
In this first pilot, CHRs learned how to administer the Mini-Cog, a screening tool to check for early signs of dementia. It also looked at ways to raise awareness about dementia and other dementia-related diseases. This year’s second pilot built on the findings from the first by increasing CHRs knowledge and understanding of dementia. It also included relational approaches to foster continued peer learning, making it easier to put the pilot into practice.
Data results from the 2025 pilot show that 967 people were screened for dementia. Of the 151 who screened positive, 33 of those were referred to their primary care provider for further care. Participating programs represented eight IHS Areas: Albuquerque, Bemidji, Nashville, Great Plains, Oklahoma, Phoenix, Portland, and Billings. The 20 CHR programs in the pilot included 15 Tribal clinics, three urban Indian Health Programs, and two IHS clinics across those areas.
“This pilot was extremely successful,” said Michelle Archuleta, IHS CHR consultant/program lead. “By building on the trust they already have in their communities, CHRs are helping people talk openly about memory health and take action sooner.”
When the pilot ended, program leaders met to share lessons learned. Their discussions highlighted the unique value CHRs bring to dementia prevention and care, including:
- Facilitating follow up care
- Conducting education and outreach
- Providing screening opportunities across multiple settings
- Partnering with medical staff
- Supporting navigation efforts
Insights from this work will guide a third pilot in 2026 which will focus on refining training, improving screening processes, and further strengthening clinical linkages to care in preparation for a broader rollout.
“Our result from each pilot shows the impact CHRs can have when they’re equipped with the right tools,” said Michelle. “They make a meaningful difference for our relatives, friends, and families in our native communities affected by dementia.”
In Part 4 - the final piece of our 
SAVE THE DATE: Empowering CHRs for Healthier Communities