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Indiase zorgtraining voor transformatie van Alzheimer (INTACT) (INTACT)

23 september 2026 bijgewerkt door: Patrik Johansson, Washington State University

INTACT will utilize a group-randomized trial, to test the effectiveness of a culturally informed provider training and "dementia friendly clinic" intervention for detection and appropriate management of AI/AN patients with ADRD and MCI in 28 urban and rural clinics serving AI/ANs.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

The INTACT team will conduct a group-randomized trial (GRT) to test the effectiveness of the INTACT program, a culturally informed primary care provider training and clinic level workflow intervention for detection and appropriate management of AI/AN patients with Mild Cognitive Impairment (MCI) and ADRD in 28 urban and rural clinics serving AI/ANs. The clinics are the primary unit of randomization. Within each participating clinic, PCPs who are routinely seeing AI/AN patients ages 55 years and older will be recruited for data collection at baseline and 1-year follow-up. Each clinic will be randomized either to the immediate intervention or to a wait-list control arm. Data will be collected from PCP questionnaires, Electronic Health Records (EHR) data extraction and manual medical chart reviews. At the clinic level, we will rely on EHRs to document INTACT's effect on new ADRD diagnoses. At the PCP level, we will test whether INTACT increases knowledge and confidence in dementia assessment, ADRD care, and caregiver support. Patient-level data will be collected from the EHR and by manual chart review.

Once enrolled, clinics will complete a clinic profile interview and clinic and patient population information form, PCPs will be consented and complete a baseline survey. Next the clinics will be randomized into the immediate intervention or the wait-list control arms. Data collection will be conducted at baseline and 1-year follow-up. After completing the 1-year study period, clinics in the wait-list arm will have the opportunity to receive the INTACT intervention.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

7

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • Washington
      • Seattle, Washington, Verenigde Staten, 98101
        • Washington State University

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

CLINIC Eligibility criteria

To be eligible to participate in INTACT a clinic must be:

  1. A primary care clinic
  2. Have at least 20 AI/AN active patients 55 years or older
  3. Have an EHR system
  4. Not intending to change EHR systems in the next year
  5. Willing to conduct a total of 40 limited patient chart reviews to assess quality of care metrics for AI/AN patients with MCI and ADRD, staff permitting

PCP

Eligibility criteria:

To be eligible to participate in the baseline and follow-up surveys a primary care provider must be:

  1. have a title of MD, DO, Nurse Practitioner, or PA, and
  2. regularly provides care to AI/ANs aged 65 and older.

PATIENTS

We will only collect patient EHR data from eligible patients who:

  1. Recorded as AI/AN in the EHR system
  2. Active clinic patient with prevalent ADRD as of the first day of the time period each data extraction will cover
  3. Age 55 or older at the start of the surveillance interval
  4. At least one primary care clinic visit during the time period each data extraction will cover.

There are no exclusion criteria for the clinic, PCPs and patients.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Onderzoek naar gezondheidsdiensten
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Intervention

The INTACT Program has three components:

  1. provide a training for Primary Care Providers (PCPs) training in screening, diagnosis, and care for ADRD,
  2. at the PCP level, provide quarterly webinars. Topics will address driving and dementia; communication tips for someone with dementia; eating and drinking in advanced dementia; and advanced care planning for dementia.
  3. At the clinic level, provide a workflow model for cognitive evaluation and setting a plan for the newly diagnosed patient. The INTACT intervention lasts 12 months and Continuing Medical Education credits will be available to PCPs who complete the INTACT training program

The INTACT Program has three components:

  1. provide a training for Primary Care Providers (PCPs) training in screening, diagnosis, and care for ADRD,
  2. at the PCP level, provide three optional webinars scheduled within the intervention time period. Webinars will address topics such as driving and dementia; communication tips for someone with dementia; and eating and drinking in advanced dementia.
  3. At the clinic level, provide a workflow model for cognitive evaluation and setting a plan for the newly diagnosed patient. The INTACT intervention lasts 12 months and Continuing Medical Education credits will be available to PCPs who complete the INTACT training program
Ander: Waitlist

The INTACT Program has three components:

  1. provide a training for Primary Care Providers (PCPs) training in screening, diagnosis, and care for ADRD,
  2. at the PCP level, provide quarterly webinars. Topics will address driving and dementia; communication tips for someone with dementia; eating and drinking in advanced dementia; and advanced care planning for dementia.
  3. At the clinic level, provide a workflow model for cognitive evaluation and setting a plan for the newly diagnosed patient. The INTACT intervention lasts 12 months and Continuing Medical Education credits will be available to PCPs who complete the INTACT training program

The INTACT Program has three components:

  1. provide a training for Primary Care Providers (PCPs) training in screening, diagnosis, and care for ADRD,
  2. at the PCP level, provide three optional webinars scheduled within the intervention time period. Webinars will address topics such as driving and dementia; communication tips for someone with dementia; and eating and drinking in advanced dementia.
  3. At the clinic level, provide a workflow model for cognitive evaluation and setting a plan for the newly diagnosed patient. The INTACT intervention lasts 12 months and Continuing Medical Education credits will be available to PCPs who complete the INTACT training program

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Clinic Level - new diagnoses of ADRD and MCI (Aim 2)
Tijdsspanne: Baseline and 12-month follow-up

Primary outcome (as obtained directly from EHRs) will reflect the aggregate counts of new diagnoses (MCI, ADRD, other dementia) during the study period, based on the ICD-10 codes for these diagnoses.

Baseline and 12-month follow-up
PCP level - care confidence (Aim 1)
Tijdsspanne: Baseline and a 12-month follow-up

Within each clinic, each participating PCP will complete a baseline and a 12-month follow-up survey. The PCP level primary outcome is care confidence in providing dementia care to patients and their families. Care confience wil be measured using the General Practitioners Confidence and Attitude scale for Dementia (GPACS-D) whic uses a 5 point Likert scale from 1 (strongly agree) to 5 (strongly disagree). The GPACS-D scale has 3 subscales:

  1. Confidence in Clinical Abilities for which a lower score means a better outcome
  2. Attitude to Care for which a lower score means a better outcome
  3. Engagement for which a higher score means a better outcome
Baseline and a 12-month follow-up
Patient level - quality of care 1 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up

Primary outcome (as obtained directly from EHRs) will reflect the number and type of ADRD diagnostic tests.

Baseline and a 12-month follow-up
Patient level - quality of care 2 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up

Primary outcome (as obtained directly from EHRs) will reflect the number of prescriptions of appropriate medications for cognitive and mood symptoms.

Baseline and a 12-month follow-up
Patient level - quality of care 3 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up

Primary outcome (as obtained directly from EHRs) will reflect the number of annual cognitive assessments.

Baseline and a 12-month follow-up
Patient level - quality of care 4 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up

Primary outcome (as obtained directly from EHRs) will reflect the number advance care directive.

Baseline and a 12-month follow-up
Patient level - quality of care 5 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up

Primary outcome (as obtained directly from EHRs) will reflect the number of annual evauations of functional status.

Baseline and a 12-month follow-up
Patient level - quality of care 5 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up

Primary outcome (as obtained directly from EHRs) will reflect the number of pharmacoligical treatment changes.

Baseline and a 12-month follow-up

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Medewerkers

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

5 oktober 2022

Primaire voltooiing (Werkelijk)

30 april 2026

Studie voltooiing (Werkelijk)

30 april 2026

Studieregistratiedata

Eerst ingediend

15 maart 2024

Eerst ingediend dat voldeed aan de QC-criteria

29 april 2024

Eerst geplaatst (Werkelijk)

2 mei 2024

Updates van studierecords

Laatste update geplaatst (Werkelijk)

29 september 2026

Laatste update ingediend die voldeed aan QC-criteria

23 september 2026

Laatst geverifieerd

1 juni 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Andere studie-ID-nummers

  • 19630

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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