Optimizing Rural Community Health Through Dementia Detection and Care (ORCHID)

Florida Atlantic University

Status: Completed

Conditions: Alzheimer' Disease

Treatments: Other: Provider Educational Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT05760521

1851318

Details and patient eligibility

About

The overall goal of this one-year study is to test a comprehensive protocol for Alzheimer's Disease and Related Dementias (ADRD) diagnosis and care management that can be used as a model for rural communities, which experience low rates of dementia diagnosis and treatment.

Full description

The ORCHID study integrates 1) A one-group community educational intervention focused on increasing community awareness of brain-health promoting behaviors and dementia literacy and knowledge; and 2) A primary care provider dementia educational intervention designed to improve provider knowledge and confidence in detecting, diagnosing, and treating patients with cognitive impairment, with the goal of increasing ADRD diagnosis and treatment rates, reducing dementia-related hospitalization rates, increasing utilization of available local support services, and improving caregiver-related outcomes.

The community education intervention is a 6-week culturally-relevant educational program focused on brain health promotion. Effects of the community intervention on dementia knowledge and literacy will be assessed with a pre-post analytic approach using paired t-tests to compare changes in mean AD knowledge and literacy. The provider dementia educational intervention uses a cluster-randomized trial design with participating primary care provider offices randomly assigned to either receive the intervention (Arm A) or the control group (Arm B). Providers assigned to Arm A receive an educational intervention that includes training in ADRD detection, diagnosis, and care management. Providers assigned to Arm B do not receive educational intervention. Both groups receive the following: detailed reports from neuropsychological testing performed by a study clinician, hands-on training of provider office staff on dementia screening tools, and support with referrals to local support services. The two study groups (Arms A and B) will be compared on: 1) change in provider dementia knowledge and confidence, caregiver burden and self-efficacy; and 2) rates of dementia diagnosis and treatment, rates of dementia-related hospital admissions, and rates of referral to support service. A generalized linear mixed model analytic approach will be used to assess the effect of the provider intervention on study outcomes.

Enrollment: 336 patients

Sex: All

Ages: 50+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Aged 50 years and older
• Lives in the Glades Area of Florida
• Lives in the community/ be non-institutionalized
• Has no known diagnosis of Alzheimer's Disease and Related Dementias
• Speaks either English, Spanish, or Creole
• Has no known plans to move out of the Glades Area in the next 12 months

Exclusion criteria

• Previous diagnosis of a dementia-related illness
• Aged under 50 years

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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336 participants in 2 patient groups

Arm A: Provider Educational Intervention

Experimental group

Description:

Providers receiving education/support from neurology teams, Adult Gerontological Nurse Practitioner (AGNP) assessments/recommendations, and training of office staff regarding ADRD and community resources support for patients/caregivers.

Treatment:

Other: Provider Educational Intervention

Arm B: Provider Control

No Intervention group

Description:

Providers receiving AGNP assessments/recommendations only.