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.

项目总结/摘要 拉丁裔人患阿尔茨海默病和相关痴呆症的可能性高1.5倍 （ADRD）比非拉丁裔白色成人。然而，与非拉丁裔白人相比， 他们可能会接受诊断，当他们这样做时，他们更有可能处于晚期阶段， 疾病过程。这是限制获得保健的个人和背景因素造成的结果 老年拉丁美洲成年人的护理服务，导致患者和老年人的健康状况更差， 呃。为了改善拉丁裔个人获得护理的机会，有必要对拉丁裔个人进行核算， UALS的不同背景和社会经济特点，并开发创新的干预， 在服务不足的地区实施可行的措施。K99项目包括 培训，以填补我的知识空白-影响获得ADRD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应用， 以及ADRD研究中的务实试验。本报告的总体目标 建议是通过执行一项比较， 对美国五个地点存在的障碍进行全面评估，并邀请一个 在以人为本的过程中，利益攸关方制定系统级干预措施， 获得ADRD服务。为了实现这些目标，我们提出了一种多相混合方法 研究过程。目标1（K99阶段）包括验证一种测量 信念影响寻求认知症状护理的意图。该仪器将是一个IM- 这是一个重要的工具，用来描述在随后阶段维持健康差异的个人信念。 目标2（K99-R 00阶段）包括与不同城市的五（5）个社区卫生诊所合作 在美国各地，以表征影响拉丁裔访问的个人和背景因素 ADRD医疗服务。为此，我们将使用BESIC工具来描述 Latinx患者，与患有ADRD的Latinx患者及其护理人员组成五个焦点小组， 与主要知情人利益攸关方进行多达50次访谈。目标3（R 00阶段）将涉及部分- 与一个社区卫生诊所合作，共同设计以人为本的干预措施， Latinx获得ADRD的医疗保健服务。在这个项目结束时，我们将有一个 经验证的调查工具，以评估与寻求医疗保健行为相关的ADRD信念， 异质性Latinx人群和增加ADRD可及性的干预原型 服务未来的研究将试点干预，并随后评估其有效性，我们- 进行一场嵌入式的务实审判