Barriers to early identification of dementia in a safety net healthcare system
安全网医疗保健系统中早期识别痴呆症的障碍
基本信息
- 批准号:10728164
- 负责人:
- 金额:$ 16.55万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-01 至 2025-05-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAdoptionAdultAffectAgingAlzheimer&aposs DiseaseAwarenessBehavioralBeliefBlack raceCaregiversCaringClinicalComplementCountryCountyDataData SetDementiaDemographic FactorsDiagnosisDiagnosticDiagnostic testsDisadvantagedDiseaseDisparity in diagnosisEarly identificationElderlyElectronic Health RecordEligibility DeterminationEquityEvaluationFamilyFamily memberFrightFutureGoalsHealth BenefitHealth ServicesHealth Services AccessibilityHealth Services ResearchHealth StatusHealth systemHealthcareHealthcare SystemsHispanicImpaired cognitionInterventionInterviewKnowledgeLogistic RegressionsLos AngelesMeasuresMedicalMedicareMemoryMemory DisordersMemory LossMemory impairmentMethodsMinorityMunicipalitiesNeeds AssessmentNeurobehavioral ManifestationsNot Hispanic or LatinoPathway interactionsPatient Self-ReportPatientsPersonsPhysiciansPopulationPreventive carePrimary CareProcessProviderPublic HealthReduce health disparitiesResourcesRisk FactorsSocioeconomic StatusStructureSurveysSymptomsTrustVisitbarrier to carebeneficiarycare deliverycare seekingcognitive testingcostdementia caredisadvantaged backgroundeconomic needethnic minorityevidence baseexperiencehealth care availabilityhealth disparityhealth literacyimprovedmodifiable riskpatient populationpatient subsetspsychologicpsychosocialracial minorityracial minority populationresponsesafety netscreeningshared decision makingsocial stigmasocioeconomic disadvantagewillingness
项目摘要
Project Summary
Early identification of cognitive impairment and dementia is associated with multiple public health benefits and
will become even more important if a disease-modifying treatments for Alzheimer’s disease becomes widely
available. However, delayed or missed identification of dementia is common, particularly among racial/ethnic
minorities and those from socioeconomically disadvantaged backgrounds. Possible explanations for this delay
may include patient beliefs about dementia such as it being part of the aging process or fear of associated
stigma; conversely, barriers at the level of provider or health-system may hinder timely diagnostic workup.
The overall goal of this mixed-methods study is to identify barriers to early identification of dementia
for older adults who receive healthcare in a safety net health system. We hypothesize that both patient
and health-system level factors are associated with delay in dementia diagnosis within this patient population.
We will first determine if the decision to seek evaluation for memory symptoms, assessed through hypothetical
clinical scenarios, is associated with a person’s dementia-specific health literacy after adjusting for
demographic factors and health status. We will then evaluate if patient self-report of memory symptoms on a
state-mandated preventive care visit is associated with a higher likelihood of undergoing diagnostic evaluation
for dementia, assessed using a unique electronic health record-derived dataset. We will complement the
analytic aims with semi-structured interviews with patients and caregivers to identify barriers to care for
memory disorders as well as unmet needs.This study will help identify specific barriers that can be targeted for
future interventions to improve early identification of dementia in the safety net population.
项目概要
早期识别认知障碍和痴呆症与多种公共健康益处相关,
如果阿尔茨海默病的疾病缓解疗法得到广泛应用,这一点将变得更加重要
可用的。然而,延迟或漏诊痴呆症的情况很常见,特别是在种族/族裔中
少数群体和来自社会经济弱势群体的群体。这种延迟的可能解释
可能包括患者对痴呆症的看法,例如它是衰老过程的一部分或对相关疾病的恐惧
柱头;相反,提供者或卫生系统层面的障碍可能会阻碍及时的诊断检查。
这项混合方法研究的总体目标是确定早期识别痴呆症的障碍
对于在安全网卫生系统中接受医疗保健的老年人。我们假设两个患者
卫生系统层面的因素与该患者群体中痴呆症诊断的延迟有关。
我们将首先确定是否决定寻求记忆症状评估,通过假设进行评估
临床情景,与一个人在调整后的痴呆症特定健康素养有关
人口因素和健康状况。然后,我们将评估患者是否自我报告记忆症状
国家规定的预防性护理就诊与接受诊断评估的可能性较高相关
对于痴呆症,使用独特的电子健康记录衍生数据集进行评估。我们将补充
分析目标是对患者和护理人员进行半结构化访谈,以确定护理障碍
记忆障碍以及未满足的需求。这项研究将有助于确定可针对的特定障碍
未来采取干预措施,以改善安全网人群中痴呆症的早期识别。
项目成果
期刊论文数量(0)
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Elizabeth Bartelt Joe其他文献
The role of a specialized memory clinic supporting primary care providers in a safety net health system
- DOI:
10.1186/s12875-025-02770-9 - 发表时间:
2025-03-20 - 期刊:
- 影响因子:2.600
- 作者:
Elizabeth Bartelt Joe;Freddi Segal-Gidan - 通讯作者:
Freddi Segal-Gidan
Elizabeth Bartelt Joe的其他文献
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