The research team will train primary care practitioners from Kansas City clinics to enhance
skills in cultural competence, dementia detection, treatment and referral to a Health
Navigator among Latinos 65 and older with dementia. The Health Navigator will provide
patient/caregiver dyads referred by Alianza Latina providers with care management,
psychosocial support and links to relevant community resources. Outcomes include feasibility
and acceptability of 1) PCP training and 2) patient and caregiver dementia care.
Alzheimer's disease and related dementias (ADRD) are a major cause of mortality and
disability in later life and cost the US healthcare system more than cancer or heart disease.
The National Alzheimer's Plan Act and the National Institutes of Health have identified ADRD
disparities among ethnic minorities as a public health priority. Latinos with ADRD experience
substantial disparities with reduced rates of early diagnosis and lower quality care compared
to their non-Latino white peers, which put them at an increased risk for steeper cognitive
decline, morbidity, mortality and higher caregiver burden. A number of barriers conspire to
create these disparities including a lack of an evidence-based strategy to address ADRD in
clinics, patient and primary care provider (PCP) reduced ADRD knowledge, negative attitudes
regarding ADRD, PCP's lack of time, cultural and language barriers and health insurance
status. To improve healthcare delivery to Latinos with ADRD, researchers need to redesign
current ADRD detection and care systems to follow evidence-based recommendations for early
detection and culturally appropriate chronic care.
The overall aim of this proposal is to enhance the delivery of ADRD services to Latinos in
primary care through a scalable systems approach that includes evidence-based
recommendations. Primary care clinics are the ideal setting to provide ADRD services, as 93%
of older Latinos have a usual source of healthcare. The novel systems approach (Alianza
Latina/Latino Alliance) will enhance timely ADRD diagnosis and optimal care to minimize
behavioral symptoms and cognitive decline among Latinos in a linguistically and
culturally-appropriate way. Alianza Latina will use the Collaborative Care Framework that
capitalizes on PCPs and Health Navigators. 1) PCPs will undergo evidence-based training to
enhance timely and culturally appropriate diagnosis and implement it in their work routine.
2) PCPs will detect, treat and refer Latino ADRD patients to a bilingual Health Navigator to
provide chronic care management, which will reduce PCP time burden.
Aim 2: Test the feasibility and acceptability of Alianza Latina. Aim 2.a: The research team
will train PCPs from Kansas City clinics to enhance skills in cultural competence, ADRD
detection, treatment and referral to a Health Navigator among Latinos 65 and older with ADRD.
Aim 2.b. The Health Navigator will provide patients/caregiver dyads referred by Alianza
Latina PCPs with care management, psychosocial support and links to relevant community
resources. The research team will assess the feasibility and acceptability of 1) PCP training
and 2) patient and caregiver ADRD care. Caregivers will be enrolled in a text messaging
program, called CuidaTEXT, that will educate about memory and thinking problems, solve
problems that are common among families with memory and thinking problems, send reminders for
appointments and medications, and improve communication with the PCP, family, friends, and