Lv Xiaozhen, Zhao Mei, Li Tao, Yuan Changzheng, Zhang Haifeng, Pu Chengcheng, Li Zhiying, Zhang Na, Yu Xin, Wang Huali
Beijing Dementia Key Lab, Dementia Care & Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.
NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, China.
Front Neurol. 2021 Jul 23;12:651826. doi: 10.3389/fneur.2021.651826. eCollection 2021.
Effective training programs for primary care providers (PCPs) to support dementia detection are needed, especially in developing countries. This study aimed to investigate the effect of an enhanced training on the competency and service of PCPs for dementia detection. We conducted a cluster randomized trial in Beijing, China. Community healthcare centers (CHCs) located in Fengtai or Fangshan District were eligible. The enrolled CHCs in each district were randomly assigned to the standard or the enhanced training group at a 1:1 ratio. PCPs serving older adults in enrolled CHCs were eligible to participate. The standard training group received three-hour didactic lectures, three monthly supervisions, 3 months of online support and dementia screening packages. The enhanced training group additionally received three monthly face-to-face supervisions and 3 months of online support. The participants became aware of their group membership at the end of the standard training. The knowledge, attitudes, service, and skills regarding dementia detection were assessed using questionnaires and submitted dementia detection records, respectively. A total of 23 and 21 CHCs were randomly assigned to the standard and the enhanced training group, respectively, and 58 participants from 20 CHCs assigned to the standard training group and 48 from 16 CHCs assigned to the enhanced training group were included in the final analysis (mean age 37.5 years, and 67.0% women). A significant increase in the knowledge score was found in both groups, but the increase was similar in the two groups ( = 0.262). The attitude score remained stable in both groups, and no between-group difference was found. Compared with the baseline, both groups reported an increase in dementia detection service, especially the enhanced training group (24.1% to 31.0% in the standard training group and 14.6% to 45.8% in the enhanced training group). The completion rate and accuracy of submitted dementia detection records in the enhanced training group were both significantly higher than those in the standard training group (both < 0.001). The enhanced training had similar effect on the knowledge of PCPs comparing with the standard training, but was better on continuous service and skills of PCPs related to dementia detection. www.ClinicalTrials.gov, identifier: NCT02782000. Registration date: May 2016. The trial was completed in July 2017.
需要为初级保健提供者（PCP）制定有效的培训计划以支持痴呆症检测，尤其是在发展中国家。本研究旨在调查强化培训对PCP进行痴呆症检测的能力和服务的影响。我们在中国北京进行了一项整群随机试验。位于丰台区或房山区的社区卫生服务中心（CHC）符合条件。每个区中入选的CHC以1:1的比例随机分配到标准培训组或强化培训组。在入选CHC中为老年人服务的PCP有资格参与。标准培训组接受三小时的理论讲座、三个月的月度督导、三个月的在线支持以及痴呆症筛查包。强化培训组额外接受三个月的面对面督导和三个月的在线支持。参与者在标准培训结束时知晓自己所属的组。分别使用问卷和提交的痴呆症检测记录评估关于痴呆症检测的知识、态度、服务和技能。共有23个和21个CHC分别被随机分配到标准培训组和强化培训组，最终分析纳入了来自20个被分配到标准培训组的CHC的58名参与者以及来自16个被分配到强化培训组的CHC的48名参与者（平均年龄37.5岁，女性占67.0%）。两组的知识得分均显著提高，但两组的提高幅度相似（=0.262）。两组的态度得分均保持稳定，未发现组间差异。与基线相比，两组报告的痴呆症检测服务均有所增加，尤其是强化培训组（标准培训组从24.1%增至31.0%，强化培训组从14.6%增至45.8%）。强化培训组提交的痴呆症检测记录的完成率和准确率均显著高于标准培训组（均P<0.001）。与标准培训相比，强化培训对PCP的知识影响相似，但在与痴呆症检测相关的PCP持续服务和技能方面效果更好。ClinicalTrials.gov网站，标识符：NCT02782000。注册日期：2016年5月。该试验于2017年7月完成。
