DP19-001, Health Promotion and Disease Prevention Research Centers

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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