Improving Alzheimer's Disease and Related Dementias Care in Rural Areas

改善农村地区阿尔茨海默病和相关痴呆症的护理

• 批准号: 10569554
• 负责人: Patricia Elizabeth Prusaczyk
• 金额: $ 11.16万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569554
• 关键词: Address; Affect; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Area; COVID-19 pandemic; Caregivers; Caring; Case Manager; Characteristics; Collaborations; Communication; Communities; Consultations; Data; Dementia; Diagnosis; Discipline of Nursing; Disease; Disparity; Doctor of Philosophy; Education; Elderly; Electronics; Failure; Future; Goals; Health; Health Disparities Research; Health Services; Health Services Research; Health Status; Health system; Hospitals; Informatics; Information Networks; Knowledge; Medication Management; Mentored Research Scientist Development Award; Mentorship; Methods; Modeling; Pathway Analysis; Patients; Pattern; Population; Population Heterogeneity; Primary Care; Process; Provider; Public Health; Randomized, Controlled Trials; Reporting; Research; Research Personnel; Resources; Risk; Rural; Rural Health Services; Services; Social Work; System; Technology; Testing; Training Activity; United States; Universities; Washington; Work; acceptability and feasibility; aging population; barrier to care; care coordination; care systems; clinical decision support; dementia care; design; evidence base; experience; follow-up; health disparity; health information technology; improved; innovation; medical schools; medical specialties; mobile application; network models; pilot test; primary care provider; provider communication; rural area; rural disparities; rural setting; service providers; skills; telehealth; tool; urban area; usability; web site

1 This is an application for a K01 award for Beth Prusaczyk, PhD, MSW, whose research focuses 2 on improving the health of vulnerable older adults, such as those with Alzheimer’s disease and 3 related dementias (ADRD) living in rural areas, by improving systems of care. The experiences 4 of those in rural areas with ADRD, including the older adults with ADRD, their caregivers, their 5 health and social service providers, and their community, are distinctly different from those in 6 urban areas. A lack of integration between services is a barrier to caregivers receiving information. 7 Providers desire more integrated services, such as having case managers at primary care offices 8 to help coordinate social services. Failure to improve the communication and care coordination 9 across rural ADRD networks as the aging population increases will compound these existing 10 disparities and result in poorer care for older adults with ADRD in rural settings. Health Information 11 Technology (HIT) tools, such as telehealth, clinical decision support, mobile applications, 12 electronic referrals or prescribing, and others, have been applied in rural areas to ADRD disease 13 risk, testing, and diagnosis, but have not yet been applied to communication and care 14 coordination. The purpose of this K01 is to build off preliminary data and use network analysis to 15 identifying communication and care coordination gaps in two rural ADRD care systems then, in 16 collaboration with local older adults with ADRD, their caregivers, their health and social service 17 providers, select and pilot test a HIT tool to fill those gaps. Specifically, this study will: 1) build 18 network models of communication and care coordination within two rural ADRD networks, and 19 identify factors related to communication and care coordination gaps; 2) assess the perceived 20 usability, feasibility, and acceptability of HIT tools designed to address communication and care 21 coordination in the networks and select a HIT tool to pilot test; and 3) pilot test the communication 22 and care coordination HIT tool in the network. Through this K01 award, Dr. Prusaczyk, who is a 23 health services researcher at Washington University School of Medicine in St. Louis (WUSM), will 24 improve upon and address gaps in her skill set through targeted training activities in: 1) advanced 25 network analysis; 2) HIT; and 3) rural ADRD research. These activities will be possible through 26 resources available at WUSM, including the Knight Alzheimer’s Disease Research Center and 27 the Institute for Informatics. Dr. Prusaczyk has the support of an outstanding mentorship team 28 with expertise in ADRD, network analysis, rural health services research, and HIT. This research 29 is significant because it will yield a comprehensive understanding of rural ADRD systems – a 30 critical context for which there is limited knowledge – and a possible solution for improvement.

这是对Beth Prusaczyk博士的K01奖的申请，她的研究重点是MSW 2关于改善脆弱老年人的健康，如阿尔茨海默氏症患者和 3生活在农村地区的相关痴呆症(ADRD)，改善护理系统。体验 在农村地区患有ADRD的人中，包括患有ADRD的老年人、他们的照顾者、他们的 5健康和社会服务提供者及其社区与 6个城区。服务之间缺乏整合是照顾者获得信息的障碍。 7服务提供者希望获得更全面的服务，例如在初级保健办公室配备病例管理人员 8帮助协调社会服务。未能改善沟通和护理协调 9随着老龄化人口的增加，农村地区的ADRD网络将使这些现有的 10个差距，并导致农村地区对患有ADRD的老年人的护理较差。健康信息 11种技术(HIT)工具，如远程医疗、临床决策支持、移动应用、 12个电子转介或处方等已在农村地区应用于ADRD疾病 13风险、测试和诊断，但尚未应用于沟通和护理 14协调。此K01的目的是在初步数据的基础上构建并使用网络分析 15查明两个农村ADRD保健系统的沟通和护理协调差距，然后，在 16与患有ADRD的当地老年人、他们的照顾者、他们的健康和社会服务合作 17个提供商，选择并试点测试Hit工具以填补这些空白。具体地说，本研究将：1)建立 两个农村ADRD网络内的18种通信和护理协调网络模式，以及 19确定与沟通和护理协调差距相关的因素；2)评估感知到的 20旨在解决沟通和护理问题的HIT工具的可用性、可行性和可接受性 21)网络中的协调，并选择HIT工具进行试点测试；3)试点测试通信 22和护理协调工具在网络中的命中。通过这个K01奖项，Prusaczyk博士，他是一名 23圣路易斯华盛顿大学医学院(WUSM)的卫生服务研究员，将 24通过以下方面的有针对性的培训活动改进和解决其技能方面的差距：1)高级 25网络分析；2)HIT；3)农村ADRD研究。这些活动将通过以下方式实现 WUSM上提供的26个资源，包括奈特阿尔茨海默病研究中心和 27信息学研究所。普鲁萨奇克博士得到了一支杰出的指导团队的支持 28具有ADRD、网络分析、农村卫生服务研究和HIT方面的专业知识。这项研究 29具有重要意义，因为它将产生对农村ADRD系统的全面了解--a 30知识有限的关键背景--以及可能的改进解决方案。