Improving Access to Alzheimer's disease and Related Dementias care services for Latinx individuals at Community Health Clinics. A multiphase mixed methods study.

改善社区健康诊所的拉丁裔个人获得阿尔茨海默病和相关痴呆症护理服务的机会。

• 批准号: 10624936
• 负责人: Maria Carolina Mora Pinzon
• 金额: $ 13.64万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10624936
• 关键词: Acceleration; Acculturation; Address; Adult; Affect; Alzheimer' s disease diagnosis; Alzheimer' s disease patient; Alzheimer' s disease related dementia; Area; Award; Behavior; Behavioral Model; Belief; Caregivers; Characteristics; Chicago; Cities; Clinic; Clinical; Clinical Research; Communities; Community Health; Consolidated Framework for Implementation Research; Data; Diagnosis; Disease; Effectiveness of Interventions; Elderly; Factor Analysis; Focus Groups; Funding; Future; Goals; Health; Health Care Seeking Behavior; Health Personnel; Health Services Accessibility; Healthcare; Human; Improve Access; Individual; Intervention; Interview; Knowledge; Language; Latinx; Latinx population; Lead; Linguistics; Link; Location; Los Angeles; Malignant Neoplasms; Maps; Measures; Methods; Mexican Americans; Modeling; National Institute on Aging; Neurobehavioral Manifestations; New York; Outcome; Patient-Focused Outcomes; Patients; Phase; Planning Theory; Process; Research; Research Methodology; Research Personnel; Resource-limited setting; Resources; Sampling; Series; Services; Subgroup; Surveys; Symptoms; System; Testing; Theory of Change; Thinking; Training; Use Effectiveness; Validation; acceptability and feasibility; behavior change; care seeking; care systems; career; contextual factors; dementia care; design; effectiveness testing; experience; health care availability; health care service; health care service utilization; health disparity; health service use; improved; informant; innovation; instrument; meetings; nonalzheimer dementia; normal aging; poor health outcome; pragmatic trial; programs; prototype; recruit; response; sociocultural determinant; socioeconomics; theories; therapy development; tool; underserved area

PROJECT SUMMARY/ABSTRACT Latinx individuals are 1.5 times more likely to develop Alzheimer's disease and related dementia (ADRD) than non-Latinx White adults. However, compared with non-Latinx Whites, they are less likely to receive a diagnosis, and when they do, they are more likely to be at late stages in the disease process. This is a result of individual and contextual factors that limit access to health care services in older Latinx adults, resulting in worse health outcomes for patients and caregiv- ers. To improve access to care for Latinx individuals, it is necessary to account for Latinx individ- uals' diverse backgrounds and socioeconomic characteristics, and develop innovative interven- tions that are feasible to implement in underserved areas. The proposed K99 phase includes training to fill my gaps in knowledge—the organizational factors affecting access to ADRD healthcare services, the use of behavior change theories and design thinking in health interven- tions, and the conduct of pragmatic trials in ADRD research. The overarching objective of this proposal is to increase access to culturally appropriate ADRD services by performing a compre- hensive assessment of the barriers existing at five locations in the US and engaging a team of stakeholders in a human-centered process to develop a systems-level intervention for increasing access to ADRD services. To achieve these goals, we propose a multiphase mixed methods research process. Aim 1 (K99 Phase) includes the validation of a survey instrument that measures beliefs that affect intentions to seek care for cognitive symptoms. This instrument will be an im- portant tool to describe the individual beliefs that sustain health disparities in subsequent stages. Aim 2 (K99-R00 phase) includes partnering with five (5) community health clinics in different cities around the US to characterize the individual and contextual factors that affect Latinx access to ADRD healthcare services. For this, we will use the BESIC instrument to describe beliefs among Latinx patients, hold five focus groups with Latinx patients with ADRD and their caregivers, and conduct up to 50 interviews with key informant stakeholders. Aim 3 (R00 Phase) will involve part- nering with one community health clinic to co-design a human-centered intervention for promoting Latinx access to healthcare services for ADRD. At the conclusion of this project, we will have a validated survey instrument to assess ADRD beliefs linked to health care seeking behaviors in heterogeneous Latinx populations and a prototype of an intervention to increase access to ADRD services. Future studies will pilot the intervention and subsequently evaluate its effectiveness us- ing an embedded pragmatic trial.

项目概要/摘要 拉丁美洲人患阿尔茨海默病和相关痴呆症的可能性是其他人的 1.5 倍 (ADRD) 高于非拉丁裔白人成年人 但是，与非拉丁裔白人相比，他们较少。 可能会得到诊断，而且当他们这样做时，他们更有可能处于疾病的晚期 这是限制获得健康的个人和背景因素的结果。 拉丁裔老年人的护理服务，导致患者和护理人员的健康结果更差 为了改善拉丁裔人士获得护理的机会，有必要考虑拉丁裔人士。 不同背景和社会经济特征，并制定创新干预措施 拟议的 K99 阶段包括在服务欠缺地区实施的可行措施。 填补我知识空白的培训——影响 ADRD 获取的组织因素 医疗保健服务、行为改变理论和设计思维在健康干预中的运用 ADRD 研究的总体目标。 提案的目的是通过开展全面的评估来增加获得文化上适当的 ADRD 服务的机会 对美国五个地点存在的障碍进行了深入评估，并聘请了一个团队 利益相关者在以人为本的过程中制定系统级干预措施，以提高 为了实现这些目标，我们提出了多阶段混合方法。 研究过程的目标 1（K99 阶段）包括验证测量工具。 影响寻求认知症状护理意图的信念该工具将是一个重要的工具。 描述维持后续阶段健康差异的个人信念的重要工具。 目标 2（K99-R00 阶段）包括与不同城市的五 (5) 个社区卫生诊所合作 美国各地的个人和背景因素影响拉丁裔获得 为此，我们将使用 BESIC 工具来描述人们的信念。 拉丁裔患者，与患有 ADRD 的拉丁裔患者及其护理人员举行五个焦点小组，以及 与关键知情人利益相关者进行最多 50 次访谈，目标 3（R00 阶段）将涉及部分内容： 与一家社区卫生诊所共同设计一项以人为本的干预措施，以促进 拉丁裔获得 ADRD 医疗服务的机会 在该项目结束时，我们将拥有一个 经验证的调查工具，用于评估与医疗保健寻求行为相关的 ADRD 信念 异质拉丁裔人群和增加获得 ADRD 的干预措施原型 未来的研究将试点该干预措施，并随后评估其有效性 嵌入实用主义试验。