Community Health Worker Support for Dementia

(CEDART Trial)

Overseen By Jung Kwak, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas at Austin

Disqualifiers: Hospice eligibility, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if support from community health workers (CHWs) can assist caregivers and people living with dementia in managing the transition from hospital to home. The research will assess whether caregivers find this support beneficial and if it improves their situation over time. Suitable participants include those hospitalized with memory problems and their family caregivers who regularly assist with medical care. As an unphased trial, this study provides participants the opportunity to contribute to valuable research that could enhance support systems for dementia care.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications. It is best to consult with the trial coordinators or your healthcare provider for guidance.

What prior data suggests that this community health worker-led intervention is safe for dementia patients and their caregivers?

Research has shown that community health workers (CHWs) are helpful in caring for people with dementia. Studies indicate that CHWs can improve brain health and manage dementia effectively. They train to assist both caregivers and patients, easing the transition from hospital to home.

Support from CHWs presents no safety concerns. This method does not involve medication or medical procedures, which usually means fewer risks. Instead, it focuses on providing guidance and support. The aim is to enhance the quality of life for both the person with dementia and their caregiver.

Overall, the assistance provided by CHWs in dementia care is well-received and considered beneficial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Community Health Worker (CHW) Guided Support for dementia because it offers a unique, personalized approach to care. Unlike traditional treatments that often focus on medication and clinical settings, this intervention emphasizes direct support and education for both patients and caregivers in their everyday environments. By leveraging the skills and cultural competence of community health workers, this approach aims to improve the quality of life and care management for dementia patients and their families. This method could lead to more accessible, empathetic, and effective support tailored to individual needs, potentially transforming how dementia care is delivered.

What evidence suggests that the Community Health Worker Guided Support is effective for dementia?

Studies have shown that community health workers (CHWs) can greatly improve dementia care and support for caregivers. Research indicates that CHWs effectively manage long-term illnesses and reduce health disparities. In one study about dementia, CHWs helped families achieve better caregiving results. In this trial, participants will receive support from CHWs trained specifically in caring for older adults, making them well-prepared to assist dementia patients and their caregivers. These findings suggest that CHW support can be beneficial in managing dementia and alleviating caregiver stress. ^{1 2 6 7 8}

Who Is on the Research Team?

Jung Kwak, PhD

Principal Investigator

University of Texas at Austin

Are You a Good Fit for This Trial?

This trial is for individuals with memory loss or cognitive impairment, including those diagnosed with dementia. It's aimed at supporting both the patients and their caregivers. Participants must be willing to complete telephone sessions and assessments.

Inclusion Criteria

I am over 18, speak English or Spanish, and help with a relative or partner's medical care.

Key Informants meeting specific eligibility criteria based on role (hospital staff, family caregivers, content experts or community service providers)

I am 50 or older, have dementia or memory issues, and live at home.

Exclusion Criteria

Key Informants who do not meet the eligibility criteria

Caregivers who do not meet the eligibility criteria

I am a staff member not eligible or I don't speak English.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Community Health Worker (CHW)-led care transition support intervention for persons living with dementia and their caregivers

12 weeks

Weekly or bi-weekly telephone/Zoom check-ins

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Community Health Worker (CHW) Guided Support

Trial Overview

The study tests a support program led by community health workers (CHWs) for people living with dementia and their caregivers. The goal is to see if this approach is practical, helpful, and satisfactory over a period involving baseline assessment, follow-ups at 6 weeks, and post-discharge at 12 weeks.

How Is the Trial Designed?

Group I: CHW intervention group Experimental Treatment 1 Intervention

dementia patient and caregiver dyad

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

Published Research Related to This Trial

The study involved 98 semi-structured interviews and community forums with healthcare professionals and community members to co-create a new model of care for a multidisciplinary memory clinic, highlighting the need for better support and resources for dementia diagnosis and management.

Participants emphasized the importance of a 'one-stop-shop' approach for dementia services, including rapid referrals and case management, while identifying barriers such as transportation and funding that need to be addressed to improve access to care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"We need a one-stop-shop": co-creating the model of care for a multidisciplinary memory clinic with community members, GPs, aged care workers, service providers, and policy-makers. Steiner, GZ., Ee, C., Dubois, S., et al.[2023]

The review analyzed 67 studies across 25 dementia case management programs, highlighting that while all programs included essential case management steps, there were significant differences in their implementation and effectiveness.

About half of the programs provided education and training for informal caregivers, and the review suggests that using a standardized framework could improve the effectiveness and generalizability of these interventions in future research and practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Case management for people with dementia living at home and their informal caregivers: A scoping review. Schiller, C., Grünzig, M., Heinrich, S., et al.[2022]

A comprehensive review of 52 studies led to the development of a theoretical model that outlines effective strategies for supporting people with dementia to live independently and with a good quality of life at home.

The systematic review of 11 randomized controlled trials identified two specific interventions that successfully increased the time individuals with dementia could live in their own homes, emphasizing the importance of relational and recovery models, as well as family carer support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing the New Interventions for independence in Dementia Study (NIDUS) theoretical model for supporting people to live well with dementia at home for longer: a systematic review of theoretical models and Randomised Controlled Trial evidence. Lord, K., Beresford-Dent, J., Rapaport, P., et al.[2020]

A community-based, telephone-delivered dementia care management program significantly reduced caregiver burden over time compared to standard clinical evaluation, based on a study involving 440 caregivers of older adults with dementia.

Caregivers in the intervention group also reported fewer challenging behaviors from care recipients and less distress in response to these behaviors at the 3-month follow-up, indicating improved outcomes for both caregivers and care recipients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a Telephone-Delivered, Community-Based Collaborative Care Management Program for Caregivers of Older Adults with Dementia. Mavandadi, S., Wray, LO., DiFilippo, S., et al.[2018]

A 15-hour training course significantly improved the asthma medication instruction abilities of 11 immigrant Mexican community health workers (CHWs), with median correct technique scores rising from 25% to 69% for metered dose inhalers and from 0% to 64% for spacers after training.

Post-training evaluations showed that all CHWs demonstrated adequate understanding of medication delivery techniques, indicating that with proper training, CHWs can effectively help families manage asthma medications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of an asthma medication training program for immigrant Mexican community health workers. Martin, MA., Mosnaim, GS., Rojas, D., et al.[2011]

A survey of 775 Community Health Workers (CHWs) in Brazil revealed that the COVID-19 pandemic has intensified challenges in their roles, particularly due to a rise in misinformation and denial about the virus, which hampers public health efforts.

The study highlights that the unique difficulties faced by CHWs in low-income communities during the pandemic have been largely overlooked in Brazilian health policies, suggesting a need for more tailored support and strategies for these essential workers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community health workers' attitudes, practices and perceptions towards the COVID-19 pandemic in brazilian low-income communities. do Rosário Costa, N., Bellas, H., da Silva, PRF., et al.[2021]

Community Health Workers (CHWs) have proven effective in improving asthma management and education for children and their families, as shown in a review of 15 studies conducted in the U.S.

The Rhode Island Integrated Response Asthma Care Implementation Program (RI-AIR) highlights the importance of CHWs in providing services like home assessments and resource linkage, emphasizing the need for further research on integrating CHWs into healthcare teams and ensuring their services are reimbursed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community Health Workers' Role in Supporting Pediatric Asthma Management: A Review. Coutinho, MT., Subzwari, SS., McQuaid, EL., et al.[2022]

Community health workers (CHWs) have proven effective in various health care settings, but their perceived value is diminished due to inconsistent credentialing and lack of billing structures for their services.

The article proposes a framework to better define CHW roles and competencies, which could help integrate them into health care systems and improve recognition and payment for their contributions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of a Framework to Describe Functions and Practice of Community Health Workers. Corder-Mabe, J., Johnson, S., Mazmanian, PE., et al.[2021]

Psychoeducational programs and multicomponent interventions have shown promising results in improving the quality of care for people with dementia living at home, based on a review of 23 randomized controlled trials.

Cognitive rehabilitation is particularly effective when implemented early in the disease, and case managers can help reduce the need for institutionalization and other community services for dementia patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Best practices interventions to improve quality of care of people with dementia living at home. Zabalegui, A., Hamers, JP., Karlsson, S., et al.[2022]

Community health worker (CHW) interventions significantly increase screening mammography rates among women aged 40 and older, with a risk ratio of 1.06, indicating a positive impact on women's health.

The effectiveness of CHW programs is particularly strong in medical settings, urban areas, and when CHWs are matched with participants by race or ethnicity, suggesting that tailored approaches enhance the success of these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Wells, KJ., Luque, JS., Miladinovic, B., et al.[2022]

Trained community health workers (CHWs) were able to identify mild cognitive impairment (MCI) and dementia in 61.1% of participants, showing a strong agreement with physician diagnoses, which identified 56.7%.

The CDR ratings by CHWs demonstrated high predictive ability for detecting MCI and dementia, with a sensitivity of 85.5% and specificity of 88.6%, indicating that CHWs can play a crucial role in early identification and care for elderly individuals in communities with limited access to bilingual healthcare providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and validity of dementia assessment by trained community health workers based on Clinical Dementia Rating. Han, HR., Park, SY., Song, H., et al.[2021]

Community health workers (CHWs) can play a vital role in improving dementia care by providing cost-effective services, as highlighted in a scoping review of 10 studies.

The review identified five key areas where CHWs can contribute: raising community awareness, screening for dementia, assisting with HIV-associated dementia, helping patients navigate healthcare systems, and supporting caregivers of individuals with dementia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Role of Community Health Workers in Addressing Dementia: A Scoping Review and Global Perspective. Alam, RB., Ashrafi, SA., Pionke, JJ., et al.[2022]

A survey of 77 Community Health Workers (CHWs) revealed that while 79.2% provide medication management services, over half (57.1%) rated their confidence in this area as 'poor' or 'fair', indicating a significant gap in self-assessed competency.

The findings suggest a strong need for enhanced medication management training in CHW certificate and continuing education programs to improve their confidence and effectiveness in delivering these services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying Medication Management Confidence and Gaps in Training Among Community Health Workers in the United States. Jam, VA., McKay, KL., Holmes, JT.[2020]

Community health worker (CHW) programs in Egypt, Pakistan, and Afghanistan show significant strengths, such as community acceptance and support from health ministries, which enhance sustainability and empower women, but they also face challenges like inadequate training and unpredictable pay.

The review highlights the need for policy-makers to improve CHW working conditions, update training curricula, and standardize practices to maximize the effectiveness of these programs in reducing healthcare disparities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Task sharing in health workforce: An overview of community health worker programmes in Afghanistan, Egypt and Pakistan. Folz, R., Ali, M.[2022]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12263905/

Community health workers: developing roles in public ...

We outline key roles CHWs can play throughout the continuum of dementia care, improving brain health and reducing dementia risk at all life stages.

2.

frontiersin.org

frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1601388/full

Geriatric-focused education for community health workers

Dementia training outcomes were measured by a validated 27-item assessment (10, 33). To test for effectiveness, an aggregate analysis was ...

3.

sciencedirect.com

sciencedirect.com/science/article/pii/S0883941724000633

Effectiveness of a health education program for people with ...

This study assesses the effectiveness of a health education program on caregiving outcomes for people with dementia and their families.

4.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12434011/

Geriatric-focused education for community health workers

CHWs are known to be effective in improving chronic disease management and chronic disease disparities (22–26). Recent evidence also shows that ...

5.

alz.org

alz.org/getmedia/01534d07-e0fb-470d-b2d3-747f6afcfda2/community-health-workers-a-resource-for-healthy-aging-and-addressing-dementia.pdf

A Resource for Healthy Aging and Addressing Dementia

This resource guide provides an easy way for health departments to learn about available. CHW-related training, education, frameworks, and tools that can help ...

6.

cms.gov

cms.gov/priorities/innovation/innovation-models/guide

Guiding an Improved Dementia Experience (GUIDE) Model

The GUIDE Model focuses on comprehensive, coordinated dementia care and aims to improve quality of life for people with dementia, reduce strain on their unpaid ...

7.

alz.org

alz.org/professionals/public-health/public-health-topics/health-professionals-education

Health Professionals Education

Community Health Workers: A Resource for Healthy Aging and Addressing Dementia (PDF) explores how community health workers (CHWs) can promote healthy aging ...

8.

bolddementiacaregiving.org

bolddementiacaregiving.org/wp-content/uploads/2024/04/Presentation-Slides-for-9.12-Webinar.pdf

Partnering with Community Health Workers to Support ...

Designed to support state, tribal and local public health agencies nationwide in developing their dementia caregiving-focused programs and ...