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F2‐02‐04: Dissemination Science: Addressing Challenges to the Widespread use of Evidence‐Based Home Dementia Care
Author(s) -
Callahan Christopher
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.387
Subject(s) - workforce , dementia , health care , psychology , public relations , knowledge management , business , nursing , medicine , political science , computer science , disease , pathology , law
feasibility and preliminary efficacy, found that participants receiving MIND had a significant delay in transition from home, fewer unmet care needs, improved quality of life, and caregiver’s had reduced time burden, compared to those receiving augmented usual care. Phase 3 (on-going) consists of two projects, an RCT to evaluate impact of a streamlined version of MIND on nursing home placement and societal cost, and a CMMI demonstration of an intensive version ofMIND to test impact on outcomes and health care costs, to develop a web-based training platform to enhance adoption, and to develop a sustainable payment model for the Medicare/Medicaid dual eligible population. Results: From inception, pragmatic and translational considerations and design features have been iteratively incorporated into all phases of development, testing, and implementation of the MIND at Home program, with future adoption by service organizations as the ultimate goal. Critical considerations include: selection of patient-oriented outcomes/ targets; stakeholder/community partnerships and input; pragmatic design (e.g. broad inclusion criteria, diversity); use of conceptual models; multi-pronged outreach approaches; intervention protocolization, materials, and packaging; and delivery and savings cost considerations. Conclusions:MIND at Home is one example of a dementia model of care that promotes evidence-based dementia care activities; family focus; individualization; and linkage and leveraging multiple services and resources to make clinically meaningful improvements in outcomes important to patients and caregivers. Born from a grassroots coalition, lessons learned include community partners and shared vision, use of hybrid trial design for implementation and dissemination, incorporation of theory, and considerations of social and policy contexts for sustainability.