Public Health

Area of Science:

• Geriatrics
• Public Health
• Health Services Research

Background:

• California's Medicaid program, Medi-Cal, introduced annual dementia screenings for older adults in July 2022.
• A mandatory training component led to the creation of the Dementia Care Aware program to support primary care clinicians.

Purpose of the Study:

• To evaluate the implementation and impact of a statewide dementia screening initiative.
• To identify key facilitators and barriers to training and screening uptake in primary care settings.
• To establish a research consortium for studying the effects of cognitive screening on patient care quality.

Main Methods:

• Programmatic data analysis of training reach and learner engagement.
• Qualitative assessment of environmental factors influencing program adoption.
• Development of a novel "cognitive health assessment" screening tool.
• Formation of a research consortium in Los Angeles and San Francisco county public health systems.

Main Results:

• Nearly 6000 learners were trained across California.
• The "cognitive health assessment" screening approach was developed and implemented.
• Strategies for learner recruitment and environmental support were identified.
• A research consortium was established to investigate screening program impacts on care quality for positive screens.

Conclusions:

• Statewide implementation of cognitive screening benefits presents significant logistical and engagement challenges.
• Successful uptake requires tailored strategies for diverse primary care practices and supportive environmental factors.
• The Dementia Care Aware program provides a model for disseminating dementia screening and care initiatives within Medicaid programs.