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.

项目总结/摘要 该补充旨在解决与农村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）的居住个体，他们的家庭照顾者/护理 合作伙伴和初级保健利益相关者，利用科罗拉多的专业知识和现有基础设施， 癌症控制实施科学中心（ISC 3），由NCI P50 CA 24468资助，PI：Russell格拉斯哥， PhD.科罗拉多ISC 3中心正在开发、验证和传播创新的实用模式， 与将循证癌症项目转化为农村癌症项目的成本、收益和价值相关的方法 初级保健机构。因此，在我们的中心主题“务实的实施科学”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“， 阿尔茨海默病补充将与农村的多个ADRD利益相关者进行混合方法研究 初级保健环境，以了解价值考虑和务实的共同决策方法 与癌症筛查和预防有关。作为具体的共同决策问题的例子， 痴呆症，我们将调查病人和护理伙伴的看法过度或不足的筛选和方法 到务实的护理伙伴参与共同决策，如议程设置。这将由我们的 增强的RE-AIM/PRISM框架，包括成本、收益和价值考虑因素，以及 背景因素在四个参与我们的“执行计划”的农村初级保健诊所，我们将 访谈和调查：a）ADRD患者及其护理伴侣（12-16对），B）患者的护理伴侣 缺乏决策能力的ADRD患者（8-10个护理伙伴），和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 -确定最突出的风险，效益，成本， 从ADRD患者的角度， 护理合作伙伴和初级保健利益相关者，以及目标2 -确定潜在的务实适应， 实施癌症筛查和戒烟的共同决策方法， ADRD患者、护理伙伴和初级保健利益相关者的需求，以促进共同决策 和农村初级保健环境的实施战略。在完成老年痴呆症的补充后 活动，我们将把研究结果整合到科罗拉多ISC 3中心，以告知务实的适应 共同决策的方法，以满足受ADRD影响的患者和护理伙伴的需求。 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， IMPACT合作实验室。调查结果将为未来的务实研究和相关的赠款提案提供信息， 农村初级保健中的CPC共同决策侧重于ADRD。