Health Promotion and Disease Prevention Research Centers

摘要：AZ-KAER：KAER模型在亚利桑那州图森市班纳健康中心的应用 班纳大学“将KAER模式应用于初级保健”项目的长期成果 医学”是建议未来实施KAER（Kickstart，Assess，Evaluate，Refer）模型， 初级保健站点，以改善认知障碍的检测、诊断和管理 在老年人中，并将有需要的人与社区支持和服务联系起来。广大 该项目的具体目标是：1）增加接受标准评估的老年人人数， 初级保健提供者（PCP）对认知障碍的评估和转诊; 2）增加 供应商在可接受性、易用性和有效性方面使用KAER模型的可靠性;以及 3)增加其他卫生系统未来采用模型可能性。 阿尔茨海默病（或相关痴呆症）（ADRD）是一个日益重要的公共卫生问题，因为 负担是巨大的，影响是重大的，有一些方法可以使公共卫生工具和技术 减轻影响。虽然ADRD在PCP中相对常见，但许多研究表明， 超过一半的认知障碍老年患者从他们的初级保健提供者那里得到了诊断。 该项目的目的是提高项目协调员的能力，以便系统和有效地纳入 将循证诊断策略纳入现有治疗方案。 通过与亚利桑那州预防研究中心的合作，亚利桑那大学中心 老化，班纳阿尔茨海默氏症研究所，班纳大学医学的初级保健服务线，这个项目 将在Banner Health的初级保健环境中实施、评估和完善KAER工具包。 普通内科和家庭及社区医学诊所的医生和执业护士将 提供工具来评估潜在的认知障碍，并将有障碍的人转介到相关的 社区服务和支持。经过一个短暂的发展阶段， 行动研究法，将项目采用准实验、事前事后设计的方式考察可接受性、可行性 评估和完善模型，找出差距和需要改进的领域， 并传播成果。该项目团队带来了老年病学、认知障碍、公共卫生、 评估、临床管理和操作。班纳诊所为目标人群提供服务（与 美国人口）年龄较大，约30%为西班牙裔，3%为美洲原住民，因此测试了KAER模型 在不同的患者中。Banner Health是美国最大的非营利性医疗系统之一， 有机会在班纳系统内外传播改进的KAER模型。

ABSTRACT: AZ-KAER: Applying the KAER Model in Banner Health, Tucson Arizona The long-term outcome of the project, “Applying the KAER Model to Primary Care within Banner University Medicine” is to advise future implementation of the KAER (Kickstart, Assess, Evaluate, Refer) model across primary care sites in order to improve the detection, diagnosis and management of cognitive impairment among older adults, and connect people in need with community-based support and services. The broad project specific aims are to: 1) increase the number of older adults who receive standard assessment, evaluation and referral for cognitive impairment by their primary care providers (PCPs); 2) increase the dependability of provider use of the KAER model in areas of acceptability, ease of use and effectiveness; and 3) increase likelihood of future model adoption in other health systems. Alzheimer's disease (or a related dementia) (ADRD) is an increasingly important public health issue because the burden is large, the impact is major, and there are ways common public health tools and techniques can mitigate the impact. Although ADRD is relatively commonly seen by PCPs, numerous studies show that less than half of older patients with cognitive impairment received the diagnosis from their primary care providers. The purpose of this project is to increase the capacity of PCPs to systematically and efficiently incorporate evidence-based diagnostic strategies into their existing treatment protocols. Through a collaboration with the Arizona Prevention Research Center, the University of Arizona Center on Aging, Banner Alzheimer's Institute, and Banner University Medicine's Primary Care Service Line, this project will implement, evaluate and refine the KAER toolkit within a primary care setting within Banner Health. Physicians and nurse practitioners in general internal medicine and family & community medicine clinics will be given tools to evaluate for potential cognitive impairment and refer those with impairment to relevant community services and supports. After a short developmental phase guided by the principles of Participatory Action Research, the project will use a quasi-experimental, pre-post design to examine acceptability, feasibility and effectiveness of model implementation, assess and refine the model for gaps and areas for improvement, and disseminate results. The project team brings expertise in geriatrics, cognitive impairment, public health, evaluation, clinical administration and operations. The Banner clinics serve a target population (comparable to the US population) that is older, ~30% Hispanic, and 3% Native American, thus testing the KAER model among diverse patients. Banner Health is one of the largest non-profit health systems in the US and provides the opportunity to disseminate the refined KAER model across the Banner system and beyond.