Analysis of Barriers to Cognitive Screening in Rural Populations in the United States

Wiese, Lisa Kirk; Williams, Christine L.; Tappen, Ruth M.

doi:10.1097/ans.0000000000000049

Cited by 27 publications

(18 citation statements)

References 40 publications

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“…These percentages are generally comparable to those observed in Chapman et al (2020), who found that approximately 18%-20% of Australian neuropsychologists surveyed used TeleNP for feedback and intervention, while approximately 7% used TeleNP for clinical interview and testing. The general consistency between the Australian survey and the current international survey may reflect the importance of TeleNP service provision to rural or frontier settings (Grosch et al, 2011;Kirk Wiese et al, 2014), and the comparable demand for providing psychological services to rural or frontier communities. Specifically, in the primary countries in these surveys, 28% of Australians (ABS, 2017), 18% of Americans (United States Census Bureau, 2010), and 19% of Canadians (World Bank, 2019) live in areas classified as rural or frontier.…”

Section: Discussionmentioning

confidence: 89%

A survey of international clinical teleneuropsychology service provision prior to and in the context of COVID-19

Hammers

Stolwyk

Harder

et al. 2020

The Clinical Neuropsychologist

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Objective: Despite expansion of telecommunication strategies across health services and data supporting feasibility of videoconference-based neuropsychological assessment, relatively little is known about teleneuropsychology (TeleNP) use in practice. The current COVID-19 pandemic provides an opportunity for greater use of TeleNP and understanding of neuropsychologists' experience with this unique assessment medium. Methods: During the course of a no-cost global webinar related to practical/ethical considerations of TeleNP practice, attendees were invited to engage in a 26-question survey about their TeleNP use and related COVID-19 concerns. TeleNP practices before the COVID-19 pandemic and early on during the global outbreak were queried among survey participants, along with examination of TeleNP intentions following COVID-19. Results: Multiple countries were represented across five continents, with two-thirds of respondents being from the United States. Approximately one-fourth of respondents reported using TeleNP for clinical interview, feedback, and intervention prior to the onset of the COVID-19 pandemic, and approximately one-tenth of individuals used TeleNP for testadministration. Increased use of TeleNP for clinical interview, feedback, and intervention was reported within the first few weeks of the global COVID-19 outbreak, though the use of TeleNP for testing remained relatively unchanged. Most respondents indicated an intention for future use of TeleNP. Conclusions: Our findings suggest the use of TeleNP is increasing, although use of remote TeleNP testing is still developing. Findings also illustrate increasing use of TeleNP in the context of the COVID-19 pandemic and encourage follow-up investigation in future studies to understand the changing practices and rates of TeleNP provision over time.

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Section: Discussionmentioning

confidence: 89%

A survey of international clinical teleneuropsychology service provision prior to and in the context of COVID-19

Hammers

Stolwyk

Harder

et al. 2020

The Clinical Neuropsychologist

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show abstract

“…Bail et al., 2013), and local practitioners may be less well informed (e.g. Greenaway-Crombie, Snow, Disler, Davis, & Pond, 2012; Weise, Williams, & Tappen, 2014). In many remote areas, populations are ageing, with implications for the availability of family support (as families have moved away) as well as for the local workforce, which may be shrinking (e.g.…”

Section: Introductionmentioning

confidence: 99%

RemoDem: Delivering support for people with dementia in remote areas

2016

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RemoDem aimed to develop, test and evaluate services for people with dementia in remote areas of the Faroe Islands, Greenland, Sweden and Scotland. Formative and summative evaluation used a flexible research design including collection of baseline data, interviews and focus groups with key informants and data relating to service users i.e. people with dementia and their carers.Challenges for service providers included organisational difficulties, lack of clear information about their populations with dementia, lack of knowledge in local communities. Test sites which developed services building on their particular local starting points adopted both specialist and 'off the shelf' technologies, and found these were generally helpful for people with significant support needs.The flexible research design was found to be essential in the real world conditions of the service development and evaluation. Services were more successful where more mature and less experimental technologies were used. The new services promised to address effectively challenges of remoteness including distance, communication and workforce deployment issues.3

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“…Five per cent of the health care providers objected to cognitive screening because they believed that patients do not want to be told that they are at risk for a condition with no cure (eg, Alzheimer), and it is important to recognize that some providers do object to routine cognitive screening. However, although the USPSTF determined in 2003 and 2014 that more research was needed, the USPSTF also stated that routine cognitive screening could increase detection of cognitive impairment that would otherwise go unrecognized, with the potential to reduce health care costs and promote patient independence . It is unlikely that one single intervention would be sufficient to help health care providers adhere to guidelines, and a multipronged approach will certainly be necessary.…”

Section: Discussionmentioning

confidence: 99%

Application of cognitive screening guidelines by health care providers in diabetes care: A cross‐sectional descriptive study

Cuevas

Ward

2018

Evaluation Clinical Practice

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Rationale, aims, and objectives: The risk of cognitive dysfunction is higher in people with diabetes than in the general population, and approximately 50% of those with diabetes will develop cognitive impairments as they age. Screening for cognitive dysfunction in people with diabetes can help identify both pathology and those who are at risk for higher health care utilization, but we do not know how health care providers implement cognitive screening recommendations in this population. In this study, we examined health care providers' knowledge of those recommendations and their application of them, as well as factors associated with guideline use.Methods: This study used a cross-sectional, descriptive correlational design with a convenience sample. All data were collected with a 20-question online survey sent to advanced practice nurses (APNs), medical doctors/doctor of osteopathic medicines (MDs/DOs), and physician assistants (PAs) in Central Texas.Results: One-hundred eighty-one health care providers responded. Participants most frequently said they were "moderately familiar" with guidelines for cognitive impairment screening (60.9%). Twenty-three per cent of physicians, 37.4% of APNs, and 8.3% of PAs indicated that they incorporated routine screening into daily practice.However, 64% did not use standardized tools to assess cognitive function. The most common clinical tasks related to cognitive screening were referral for more in-depth cognitive screening (44%) and education of families regarding cognitive problems (29%). Lack of time was the most common barrier to screening (57.7%).Conclusions: Most respondents believed that there was a good rationale for assessing cognitive function in people with diabetes. However, despite some familiarity with guidelines for cognitive function screening, most respondents did not use standardized assessment tools. The results indicate variability in clinical practice regarding assessment and practices, such that there may be some variability in outcomes for patients.

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Analysis of Barriers to Cognitive Screening in Rural Populations in the United States

Cited by 27 publications

References 40 publications

A survey of international clinical teleneuropsychology service provision prior to and in the context of COVID-19

A survey of international clinical teleneuropsychology service provision prior to and in the context of COVID-19

RemoDem: Delivering support for people with dementia in remote areas

Application of cognitive screening guidelines by health care providers in diabetes care: A cross‐sectional descriptive study

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