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

1这是Beth Prusaczyk博士的K 01奖申请，MSW，其研究重点是 2.改善易受伤害的老年人的健康，如阿尔茨海默病患者， 通过改善护理系统，改善生活在农村地区的3种相关痴呆症（ADRD）。的经验 4在农村地区的ADRD患者中，包括ADRD老年人，他们的照顾者， 5.卫生和社会服务提供者及其社区与 6城市各种服务之间缺乏整合是护理人员获得信息的一个障碍。 提供者希望获得更多的综合服务，例如在初级保健办公室配备病例管理员 8、帮助协调社会服务。未能改善沟通和护理协调 9随着人口老龄化的增加，农村ADRD网络将使现有的 10差距，导致农村地区ADRD老年人的护理较差。健康信息 11技术工具，如远程保健、临床决策支持、移动的应用， 12个电子转诊或处方，以及其他，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。本K 01的目的是建立初步数据并使用网络分析， 15确定两个农村ADRD护理系统中的沟通和护理协调差距， 16与当地患有ADRD的老年人、他们的照顾者、他们的健康和社会服务合作 17个供应商，选择和试点测试HIT工具，以填补这些空白。具体而言，本研究将：1）建立 在两个农村ADRD网络内建立了18个通信和护理协调网络模型， 19确定与沟通和护理协调差距有关的因素; 2）评估感知的 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协调在网络中，并选择一个HIT工具进行试点测试;和3）试点测试的沟通 22和护理协调网络中的HIT工具。通过这个K 01奖，Prusaczyk博士，谁是一个 圣路易斯华盛顿大学医学院（WUSM）的卫生服务研究人员将 24通过以下方面的有针对性的培训活动，改善和解决她的技能差距：1）高级 25网络分析; 2）HIT; 3）农村ADRD研究。这些活动将通过 WUSM提供26种资源，包括Knight阿尔茨海默病研究中心和 27信息学研究所。Prusaczyk博士拥有一支优秀的导师团队 28名具有ADRD，网络分析，农村卫生服务研究和HIT的专业知识。本研究 29是重要的，因为它将产生一个全面的了解农村ADRD系统- a 30个关键的背景下，有有限的知识-和一个可能的解决方案，以改善。

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.