DP19-001, Health Promotion and Disease Prevention Research Centers

提供以病人和家庭为中心的护理，以满足日益增长的老年人的身心健康需求 美国老年人的数量是国家公共卫生的优先事项。考虑到巨大的个人利益 以及与阿尔茨海默病和相关痴呆症相关的社会成本，迫切需要 实施和测试以患者和家庭为中心的方法，帮助检测患者的认知变化 早期为老年人提供资源和支持，让他们在安全的环境中安享晚年 他们被理解、重视和尊重。该项目的目的是试行和测试可行性。 和KICER(KickStart，评估、评估、参考)模式对改善认知的有效性 城乡初级保健中老年人的损害检测和资源转介 伊利诺伊州为不同的老年人口提供服务的门诊设施。我们将利用调查结果来 指导改进和扩大将Kaer模式纳入卫生系统的工作。这个项目将 审查初级保健提供者(PCP)实施Kaer模式对公共卫生的影响 两个环境(城市和农村)，用于及时和适当地检测和转介认知障碍 为老年人提供的资源。我们将审查和改进Kaer模型，并研究增强的 和扩大实施。该项目将对人口健康产生非常重大的影响；它将改善 及时检测认知障碍，并将那些被识别为认知障碍的人连接到 提供适当的资源和支持，以增进老年人的健康和福祉。患者和他们的 家庭照顾者将能够更好地管理他们的整体健康状况并规划未来。从长远来看， 整合改进的Kaer模型的影响很有可能提高对个人的护理标准 与认知障碍，使患者、家庭和照顾者以及卫生保健系统受益。这个 拟议项目中的城市初级保健诊所是家庭医学门诊诊所，是 伊利诺伊大学健康(UI Health)系统。农村初级保健诊所是伊利诺伊州的门诊诊所 关键访问医院网络(Icahn)。该项目由一个强大的领导团队领导，具有经过验证的轨道 在卫生服务研究、卫生职业教育和初级保健老年病学方面的成功记录 作为一个由当地和国家专家组成的强大团队，他们将在项目咨询委员会任职。 具体目标1：对城市和农村初级保健医生的认知筛查进行混合方法基线评估 通过调查和电话采访进行练习。 具体目标2：在初级保健、门诊、城市和农村初级保健初级卫生服务的小样本中试行Kaer模式。 具体目标3：利用试点和基线调查的结果审查和改进Kaer模型；培训 一大批城市和农村初级保健医生，以实施改进的模式(Kaer-2)；并评估其可行性， 新的以患者为中心、具有文化能力的Kaer-2干预的可接受性和有效性。 1

Providing patient- and family-centered care to address physical and mental health needs of the growing number of older adults in the United States is a national public health priority. Given the enormous personal and societal costs associated with Alzheimer’s disease and related dementias, there is an urgent need to implement and test patient- and family-centered approaches that would help detect cognitive changes at an early stage and provide resources and support for older adults to age in place in safe environments where they are understood, valued and respected. The purpose of this project is to pilot and test the feasibility and effectiveness of the KAER (Kickstart, Assess, Evaluate, Refer) Model to improve cognitive impairment detection and referral to resources for older adults in urban and rural primary care outpatient settings in Illinois that serve diverse older adult populations. We will leverage findings to guide refinement and expanded integration of the KAER Model into the health system. This project will examine the public health impact of implementation of the KAER Model by primary care providers (PCPs) in two settings (urban and rural) for timely and appropriate cognitive impairment detection and referral to resources for older adults. We will review and refine the KAER Model and study the impacts of the enhanced and expanded implementation. The project will have a very significant population health impact; it will improve the timely detection of cognitive impairment and connect those identified with cognitive impairment to appropriate resources and support to enhance the health and well-being of older adults. Patients and their family caregivers will be able to better manage their overall health and plan for the future. Longer term, the impact of integrating a refined KAER model has strong likelihood for improving the standard of care for persons with cognitive impairment, benefiting patients, families and caregivers, as well as the health care system. The urban primary care clinics in the proposed project are Family Medicine outpatient clinics that are part of the University of Illinois Health (UI Health) System. The rural primary care clinics are outpatient clinics in the Illinois Critical Access Hospital Network (ICAHN). The project is led by a strong leadership team with a proven track record of success in health services research, health professions education and primary care geriatrics, as well as a robust team of local and national experts who will serve on the project Advisory Board. Specific Aim 1: Conduct a mixed-methods baseline assessment of urban and rural PCPs’ cognitive screening practices using a survey and phone interviews. Specific Aim 2: Pilot the KAER model with a small sample of primary care outpatient urban and rural PCPs. Specific Aim 3: Use findings from the pilot and the baseline survey to review and refine the KAER model; train a large cohort of urban and rural PCPs to implement the refined model (KAER-2); and evaluate the feasibility, acceptability and effectiveness of the new patient-centered, culturally-competent KAER-2 intervention. 1