Primary care providers' sources and preferences for cognitive health information in the United States

Abstract

SUMMARYIn most countries, physicians and other health-care providers play key roles in promoting health. Accumulating scientific evidence suggests that providers may soon want to include cognitive health among the areas they promote. Cognitive health is the maintenance of cognitive abilities that enable social connectedness, foster a sense of purpose, promote independent living, allow recovery from illness or injury and promote effective coping with functional deficits. The US Centers for Disease Control and Prevention has established health promotion about cognitive health as a policy priority, with health providers included as one key group to participate in this effort. This study presents results from focus groups and interviews with primary care physicians (n ¼ 28) and midlevel health-care providers ( physician assistants and nurse practitioners, n ¼ 21) in three states of the US. Providers were asked about their sources of information on cognitive health and for their ideas on how best to communicate with primary care providers about research on cognitive health. In results, providers cited online sources, popular media and continuing medical education as their most common sources of information about cognitive health. Popular media sources were used both proactively and reactively to respond to patient inquiries. Differences in sources of information were noted for physicians as compared with midlevel providers, and for rural and urban providers. Several potential ways to disseminate information about cognitive health were identified. Effective messaging is likely to require multiple strategies to reach diverse groups of primary care providers, and to include continuing medical education.

Implementing dementia risk reduction in primary care: a preliminary conceptual model based on a scoping review of practitioners’ views

“…Two studies examined PCPs’ perceptions of the quality and validity of evidence supporting the belief that promoting brain health will have desired outcomes. In the qualitative study, some PCPs expressed concern that current cognitive health research is inconclusive (Warren-Findlow et al ., 2010), whereas others felt there was no harm in making recommendations based on weak evidence (Hochhalter et al ., 2012). Some participants felt that vascular dementia was preventable, whereas Alzheimer’s disease was not (Hochhalter et al ., 2012).…”

Promoting Cognitive Health

“…The results may not represent developments in smaller health care systems, where evidence suggests that general practitioners and internists may have limited knowledge about promoting cognitive health and may find it difficult to keep current in this area. 12…”

“…11 Research suggests that the latter advice most often emphasizes the usefulness of mental activity. 12 An increasing body of research following large groups of people over many years, as well as research with animals, suggests that certain behaviors may help to maintain cognitive health. The behaviors include being physically active, having a heart healthy diet, and being socially involved.…”

“…Until recently, the CDC’s project was largely limited to conducting formative research to better understand public views about cognitive health, 4,7 –9,26,28,29 completing a formal review of the scientific literature that may support public health initiatives to promote cognitive health, 30 planning for communications to inform public health departments about promoting cognitive health, 27 and conducting research on health care providers’ beliefs and practices regarding cognitive health. 11,12 In a recent development, the CDC now offers specific messages to the public about maintaining cognitive health by being physically active and socially involved, having stimulating mental activity, avoiding head injury, avoiding smoking, lowering cholesterol, reducing sodium intake, and limiting alcohol consumption. 31…”

Positive Neuropsychology

“…While scant data exist that would clarify the effectiveness of various public education strategies in neuropsychology, there is evidence that primary care providersa common referral source for some practitioners-receive little if any information about cognitive health from neuropsychologists. Indeed, the top fi ve sources of such information in one recent study were continuing medical education, popular media, the internet, experience, and pharmaceutical representatives (Warren-Findlow, Price, Hochhalter, & Laditka, 2010 ). Neuropsychologists engaging in public education efforts can provide more accurate and updated information about cognition and cognitive health than many other sources and help promote the fi eld in the process.…”