- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05760521
Optimizing Rural Community Health Through Dementia Detection and Care (ORCHID)
Optimizing Rural Community Health Through Interdisciplinary Dementia Detection and Care
Study Overview
Status
Conditions
Intervention / Treatment
Detailed 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.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Florida
-
Belle Glade, Florida, United States, 33430
- Palm Beach State College
-
Boca Raton, Florida, United States, 33431
- Florida Atlantic University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm A: Provider Educational Intervention
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.
|
Following the informed consent (10 min) and sociodemographic survey (5 minutes), the providers in Arm A will be offered education of two days, six hours each day, with support and follow-up.
They will also be asked to complete brief knowledge and confidence surveys pre-post-intervention (30 minutes total).
|
No Intervention: Arm B: Provider Control
Providers receiving AGNP assessments/recommendations only.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in rates of new dementia diagnosis and treatment
Time Frame: at baseline, 3 months, 6 months, and 12 months post-intervention
|
The intervention and control groups will be compared on rates of dementia diagnosis and treatment at four different time points; baseline and post-intervention.
|
at baseline, 3 months, 6 months, and 12 months post-intervention
|
Change in rates of referrals to Area Support Services
Time Frame: baseline, 3 months, 6 months, and 12 months post-intervention
|
The intervention and control groups will be compared on rates of referrals to support service at four different time points; baseline and post-intervention.
|
baseline, 3 months, 6 months, and 12 months post-intervention
|
Change in AD knowledge
Time Frame: : 6 weeks
|
Alzheimer's Disease Knowledge Scale (ADKS) will be collected from participants in the community educational intervention before (week 0) and immediately after the intervention (week 6).
Scores on the ADKS range from 0 to 13, with higher scores indicating greater knowledge
|
: 6 weeks
|
Change in AD literacy treatment plan.
Time Frame: 6 weeks
|
Dementia Literacy Assessment (DELA) will be administered as part of the community educational intervention before (week 0) and immediately after the intervention (week 6).
DELA consists of 25 items scored 0=incorrect/1=correct.
Total DELA score ranges from 0 to 25 with a higher score being indicative of greater dementia literacy.
|
6 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in rates of preventable admission related to ADRD to the local hospital
Time Frame: at baseline, 3 months, and 6 months post-intervention
|
The intervention and control groups will be compared on rates of hospitalization for ADRD-related complications, at baseline and at three different time points post-intervention.
|
at baseline, 3 months, and 6 months post-intervention
|
Change in provider knowledge related to ADRD
Time Frame: at baseline, 3 months, and 6 months post-intervention
|
Alzheimer's Disease Knowledge Scale (ADKS) will be administered at baseline, and at three different time points post-intervention.
|
at baseline, 3 months, and 6 months post-intervention
|
Change in provider confidence in establishing an ADRD diagnosis and treatment plan
Time Frame: at baseline, 3 months, and 6 months post-intervention
|
General Practitioners' Attitude and Confidence Scale for Dementia (GPACS-D) will be administered at baseline, and at three different time points post-intervention, in the intervention and control groups.
Total scores range from 15 to 75, with higher scores indicating greater confidence and attitudes towards dementia.
|
at baseline, 3 months, and 6 months post-intervention
|
Change in caregiver burden
Time Frame: at baseline, 3 months, and 6 months post-intervention
|
The 12-item Zarit Burden Inventory (ZBI) will be collected at baseline, and at three different time points post-intervention, in the intervention and control groups.
Scores range from 0 to 48, with higher scores indicating greater burden.
|
at baseline, 3 months, and 6 months post-intervention
|
Change in caregiver self-efficacy
Time Frame: at baseline, 3 months, and 6 months post-intervention
|
The Revised Scale for Caregiver Self-Efficacy (RSCSE) will be administered at baseline, and at three different time points post-intervention, in the intervention and control groups.
RSCSE consists of 3 subscales (Self-Efficacy for Obtaining Respite; Self-Efficacy for Responding to Disruptive Patient Behaviors; and Self-Efficacy for Controlling Upsetting Thoughts about Caregiving), each consisting of 5 statements scored on a 0-100 with higher scores indicating better self-efficacy.
|
at baseline, 3 months, and 6 months post-intervention
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Lisa A Wiese, Florida Atlantic University, C.E. Lynn College of Nursing
- Principal Investigator: Magdalena I Tolea, PhD, University of Miami
- Principal Investigator: Joanne Pulido, Palm Beach State College
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1851318
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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