Optimizing Rural Community Health Through Interdisciplinary Dementia Detection and Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 336
- 试验地点
- 4
- 主要终点
- Change in AD knowledge
研究概览
简要总结
The overall goal of this one-year study is to test a comprehensive protocol for Alzheimer's Disease and Related Dementias (ADRD) diagnosis and care management that can be used as a model for rural communities, which experience low rates of dementia diagnosis and treatment.
详细描述
The ORCHID study integrates 1) A one-group community educational intervention focused on increasing community awareness of brain-health promoting behaviors and dementia literacy and knowledge; and 2) A primary care provider dementia educational intervention designed to improve provider knowledge and confidence in detecting, diagnosing, and treating patients with cognitive impairment, with the goal of increasing ADRD diagnosis and treatment rates, reducing dementia-related hospitalization rates, increasing utilization of available local support services, and improving caregiver-related outcomes.
The community education intervention is a 6-week culturally-relevant educational program focused on brain health promotion. Effects of the community intervention on dementia knowledge and literacy will be assessed with a pre-post analytic approach using paired t-tests to compare changes in mean AD knowledge and literacy. The provider dementia educational intervention uses a cluster-randomized trial design with participating primary care provider offices randomly assigned to either receive the intervention (Arm A) or the control group (Arm B). Providers assigned to Arm A receive an educational intervention that includes training in ADRD detection, diagnosis, and care management. Providers assigned to Arm B do not receive educational intervention. Both groups receive the following: detailed reports from neuropsychological testing performed by a study clinician, hands-on training of provider office staff on dementia screening tools, and support with referrals to local support services. The two study groups (Arms A and B) will be compared on: 1) change in provider dementia knowledge and confidence, caregiver burden and self-efficacy; and 2) rates of dementia diagnosis and treatment, rates of dementia-related hospital admissions, and rates of referral to support service. A generalized linear mixed model analytic approach will be used to assess the effect of the provider intervention on study outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- Single (Participant)
盲法说明
Patients will not know to which Randomized group that they have been assigned (intervention or control).
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Aged 50 years and older
- •Lives in the Glades Area of Florida
- •Lives in the community/ be non-institutionalized
- •Has no known diagnosis of Alzheimer's Disease and Related Dementias
- •Speaks either English, Spanish, or Creole
- •Has no known plans to move out of the Glades Area in the next 12 months
排除标准
- •Previous diagnosis of a dementia-related illness
- •Aged under 50 years
结局指标
主要结局
Change in AD knowledge
时间窗: : 6 weeks
Alzheimer's Disease Knowledge Scale (ADKS) will be collected from participants in the community educational intervention before (week 0) and immediately after the intervention (week 6). Scores on the ADKS range from 0 to 13, with higher scores indicating greater knowledge
Change in rates of new dementia diagnosis and treatment
时间窗: at baseline, 3 months, 6 months, and 12 months post-intervention
The intervention and control groups will be compared on rates of dementia diagnosis and treatment at four different time points; baseline and post-intervention.
Change in rates of referrals to Area Support Services
时间窗: baseline, 3 months, 6 months, and 12 months post-intervention
The intervention and control groups will be compared on rates of referrals to support service at four different time points; baseline and post-intervention.
Change in AD literacy treatment plan.
时间窗: 6 weeks
Dementia Literacy Assessment (DELA) will be administered as part of the community educational intervention before (week 0) and immediately after the intervention (week 6). DELA consists of 25 items scored 0=incorrect/1=correct. Total DELA score ranges from 0 to 25 with a higher score being indicative of greater dementia literacy.
次要结局
- Change in caregiver self-efficacy(at baseline, 3 months, and 6 months post-intervention)
- Change in rates of preventable admission related to ADRD to the local hospital(at baseline, 3 months, and 6 months post-intervention)
- Change in provider knowledge related to ADRD(at baseline, 3 months, and 6 months post-intervention)
- Change in provider confidence in establishing an ADRD diagnosis and treatment plan(at baseline, 3 months, and 6 months post-intervention)
- Change in caregiver burden(at baseline, 3 months, and 6 months post-intervention)
研究者
Lisa A Wiese
Associate Professor, Nursing
Florida Atlantic University