Health Promotion and Disease Prevention Research Centers

健康促进和疾病预防研究中心

• 批准号: 10657526
• 负责人: Lisa Powell
• 金额: $ 100万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10657526
• 关键词: Health; Promotion; Disease; Prevention; Research

Providing patient- and family-centered care to address physical and mental health needs of the growing number of older adults in the United States is a national public health priority. Given the enormous personal and societal costs associated with Alzheimer’s disease and related dementias, there is an urgent need to implement and test patient- and family-centered approaches that would help detect cognitive changes at an early stage and provide resources and support for older adults to age in place in safe environments where they are understood, valued and respected. The purpose of this project is to pilot and test the feasibility and effectiveness of the KAER (Kickstart, Assess, Evaluate, Refer) Model to improve cognitive impairment detection and referral to resources for older adults in urban and rural primary care outpatient settings in Illinois that serve diverse older adult populations. We will leverage findings to guide refinement and expanded integration of the KAER Model into the health system. This project will examine the public health impact of implementation of the KAER Model by primary care providers (PCPs) in two settings (urban and rural) for timely and appropriate cognitive impairment detection and referral to resources for older adults. We will review and refine the KAER Model and study the impacts of the enhanced and expanded implementation. The project will have a very significant population health impact; it will improve the timely detection of cognitive impairment and connect those identified with cognitive impairment to appropriate resources and support to enhance the health and well-being of older adults. Patients and their family caregivers will be able to better manage their overall health and plan for the future. Longer term, the impact of integrating a refined KAER model has strong likelihood for improving the standard of care for persons with cognitive impairment, benefiting patients, families and caregivers, as well as the health care system. The urban primary care clinics in the proposed project are Family Medicine outpatient clinics that are part of the University of Illinois Health (UI Health) System. The rural primary care clinics are outpatient clinics in the Illinois Critical Access Hospital Network (ICAHN). The project is led by a strong leadership team with a proven track record of success in health services research, health professions education and primary care geriatrics, as well as a robust team of local and national experts who will serve on the project Advisory Board. Specific Aim 1: Conduct a mixed-methods baseline assessment of urban and rural PCPs’ cognitive screening practices using a survey and phone interviews. Specific Aim 2: Pilot the KAER model with a small sample of primary care outpatient urban and rural PCPs. Specific Aim 3: Use findings from the pilot and the baseline survey to review and refine the KAER model; train a large cohort of urban and rural PCPs to implement the refined model (KAER-2); and evaluate the feasibility, acceptability and effectiveness of the new patient-centered, culturally-competent KAER-2 intervention. 1

提供以患者和家庭为中心的护理，以满足不断增长的身心健康需求 鉴于巨大的个人人口数量，美国老年人的数量是国家公共卫生的优先事项。 以及与阿尔茨海默病和相关痴呆症相关的社会成本，迫切需要 实施和测试以患者和家庭为中心的方法，这将有助于及时发现认知变化 早期阶段，为老年人提供资源和支持，让他们在安全的环境中安享晚年 他们被理解、重视和尊重，该项目的目的是试点和测试可行性。 KAER（启动、评估、评价、推荐）模型改善认知的有效性 城市和农村初级保健中老年人的缺陷检测和资源转介 我们将利用研究结果来为伊利诺伊州的不同老年人群提供服务。 该项目将指导 KAER 模型的完善和扩大整合到卫生系统中。 检查初级保健提供者 (PCP) 实施 KAER 模型对公共卫生的影响 两种环境（城市和农村），以便及时、适当地检测认知障碍并转诊 我们将审查和完善 KAER 模型并研究增强后的影响。 该项目的扩大和实施将对人口健康产生非常重大的影响； 及时发现认知障碍并将那些识别出认知障碍的人与 适当的资源和支持，以增强老年人及其患者的健康和福祉。 家庭护理人员将能够更好地管理他们的整体健康并为未来做好计划。 整合完善的 KAER 模型的影响极有可能提高人员护理标准 认知障碍，使患者、家庭和护理人员以及医疗保健系统受益。 拟建项目中的城市初级保健诊所是家庭医学门诊诊所，属于家庭医学门诊诊所的一部分。 伊利诺伊大学健康 (UI Health) 系统的农村初级保健诊所是伊利诺伊州的门诊诊所。 关键接入医院网络 (ICAHN) 由一支实力雄厚、经验丰富的领导团队领导。 在卫生服务研究、卫生专业教育和初级保健老年病学方面也取得了成功 作为一支由当地和国家专家组成的强大团队，他们将在项目咨询委员会中任职。 具体目标 1：对城乡 PCP 认知筛查进行混合方法基线评估 使用调查和电话采访的做法。 具体目标 2：在城乡初级保健门诊 PCP 的小样本中试点 KAER 模式。 具体目标 3：利用试点和基线调查的结果来审查和完善 KAER 模型； 大量城市和农村 PCP 实施细化模型 (KAER-2) 并评估可行性； 新的以患者为中心、具有文化能力的 KAER-2 干预措施的可接受性和有效性。 1