Addressing shared decision making related to cancer prevention and control for individuals with Alzheimer's disease and related dementia and caregivers in rural primary care

解决阿尔茨海默病和相关痴呆症患者以及农村初级保健护理人员与癌症预防和控制相关的共同决策

• 批准号: 10120418
• 负责人: RUSSELL E GLASGOW
• 金额: $ 36.76万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10120418
• 关键词: Address; Affect; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Applications Grants; Cancer Center; Cancer Control; Caring; Clinic; Clinical; Colorado; Communities; Costs and Benefits; Dementia; Dementia caregivers; Development; Diagnosis; Doctor of Philosophy; Elderly; Etiology; Face; Family; Family Caregiver; Funding; Future; Healthcare Systems; Individual; Infrastructure; Interview; Knowledge; Laboratories; Malignant Neoplasms; Measurement; Methods; Modeling; Participant; Patient Care; Patients; Perception; Persons; Phase; Population; Prevention; Primary Health Care; Research; Research Proposals; Resources; Risk; Rural; Science; Screening for cancer; Severities; Surveys; Testing; Translating; cancer prevention; collaboratory; comorbidity; contextual factors; cost; decision-making capacity; dementia care; evidence base; implementation science; implementation strategy; innovation; lung cancer screening; outreach; practice setting; primary care setting; programs; recruit; rural residence; screening; shared decision making; smoking cessation

PROJECT SUMMARY/ABSTRACT This supplement aims to address shared decision making related to cancer prevention and control for rural- dwelling individuals with Alzheimer's disease and related dementias (ADRD), their family caregivers/care partners, and primary care stakeholders, using the expertise and existing infrastructure of the Colorado Implementation Science Center for Cancer Control (ISC3), funded by NCI P50CA24468, PI: Russell Glasgow, PhD. The Colorado ISC3 Center is developing, validating, and disseminating innovative pragmatic models and methods related to the costs, benefits, and value of translating evidence-based cancer programs into rural primary care settings. Thus, within the scope of our Center theme of `Pragmatic implementation science approaches to assess and enhance the value of cancer prevention and control in rural primary care', this Alzheimer's disease supplement will conduct a mixed methods study with multiple ADRD stakeholders in rural primary care settings to understand value considerations and pragmatic shared decision making approaches related to cancer screening and prevention. As examples of specific shared decision making issues affected by dementia, we will investigate patient and care partner perceptions of over- or under-screening and approaches to pragmatic care partner involvement in shared decision making like agenda setting. This will be guided by our enhanced RE-AIM/PRISM framework that includes costs, benefits and value considerations as well as contextual factors. In four rural primary care clinics engaged in our `Implementation Laboratory', we will interview and survey: a) patients with ADRD and their care partners (12-16 dyads), b) care partners of persons with ADRD who lack decision making capacity (8-10 care partners), and c) primary care stakeholders (n=24, including practitioners and staff). The study will address: Aim 1 - Identify the most salient risks, benefits, costs, and relative value of CPC activities in rural primary care settings from the perspectives of patients with ADRD, care partners, and primary care stakeholders, and Aim 2 - Identify potential pragmatic adaptations to implementing shared decision making approaches to cancer screening and smoking cessation for the specific needs of patients with ADRD, care partners, and primary care stakeholders to facilitate shared decision making and implementation strategies in rural primary care settings. Upon completion of the Alzheimer's supplement activities, we will integrate findings into the Colorado ISC3 Center to inform adaptation of pragmatic approaches to shared decision making that meet the needs of patients and care partners affected by ADRD. We will disseminate findings across the NCI-funded Implementation Science Center network and the NIA- funded IMPACT Collaboratory. Findings will inform future pragmatic research and grant proposals related to shared decision making for CPC in rural primary care focused on ADRD.

项目概要/摘要 本增刊旨在解决农村地区与癌症预防和控制相关的共同决策问题。 患有阿尔茨海默病和相关痴呆症 (ADRD) 的居民及其家庭护理人员/护理人员 合作伙伴和初级保健利益相关者，利用科罗拉多州的专业知识和现有基础设施 癌症控制实施科学中心 (ISC3)，由 NCI P50CA24468 资助，PI：Russell Glasgow， 博士。科罗拉多州 ISC3 中心正在开发、验证和传播创新的实用模型和 与将循证癌症项目转化为农村的成本、效益和价值相关的方法 初级保健机构。因此，在我们中心“务实实施科学”主题的范围内 评估和提高农村初级保健中癌症预防和控制价值的方法”， 阿尔茨海默病补充剂将与农村地区的多个 ADRD 利益相关者进行混合方法研究 初级保健机构了解价值考虑因素和务实的共同决策方法 与癌症筛查和预防相关。作为受以下因素影响的具体共同决策问题的示例： 痴呆症，我们将调查患者和护理伙伴对过度或不足筛查和方法的看法 让护理合作伙伴参与议程制定等共同决策。这将由我们的指导 增强的 RE-AIM/PRISM 框架，包括成本、收益和价值考虑因素以及 背景因素。在参与我们“实施实验室”的四个农村初级保健诊所，我们将 访谈和调查：a) ADRD 患者及其护理伙伴（12-16 人），b) 人员的护理伙伴 患有 ADRD 且缺乏决策能力的人（8-10 名护理合作伙伴），以及 c) 初级护理利益相关者（n=24， 包括从业人员和工作人员）。该研究将解决： 目标 1 - 确定最显着的风险、收益、成本、 从 ADRD 患者的角度来看，CPC 活动在农村初级保健机构中的相对价值， 护理合作伙伴和初级护理利益相关者，以及目标 2 - 确定潜在的务实适应措施 针对特定人群实施癌症筛查和戒烟的共同决策方法 ADRD 患者、护理合作伙伴和初级保健利益相关者的需求，以促进共同决策 以及农村初级保健机构的实施战略。完成阿尔茨海默氏症补充剂后 活动，我们将把调查结果整合到科罗拉多州 ISC3 中心，为务实的适应提供信息 满足受 ADRD 影响的患者和护理合作伙伴需求的共同决策方法。 我们将在 NCI 资助的实施科学中心网络和 NIA 中传播研究结果 资助 IMPACT 合作实验室。研究结果将为未来相关的务实研究和拨款提案提供信息 CPC 在农村初级保健领域的共同决策重点是 ADRD。