TY - JOUR
T1 - Preparing for pragmatic trials in dementia care
T2 - Health equity considerations for nonpharmacological interventions
AU - Aranda, María P.
AU - Baier, Rosa
AU - Hinton, Ladson
AU - Peak, Katherine D.
AU - Jackson, Jonathan D.
AU - Dilworth-Anderson, Peggye
AU - Gitlin, Laura N.
AU - Jutkowitz, Eric
AU - Quiñones, Ana R.
N1 - Publisher Copyright:
© 2023 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.
PY - 2023/12
Y1 - 2023/12
N2 - Inequities with regard to brain health, economic costs, and the evidence base for dementia care continue. Achieving health equity in dementia care requires rigorous efforts that ensure disproportionately affected populations participate fully in—and benefit from—clinical research. Embedding-proven interventions under real-world conditions and within existing healthcare systems have the potential to examine the effectiveness of an intervention, improve dementia care, and leverage the use of existing resources. Developing embedded pragmatic controlled trials (ePCT) research designs for nonpharmacological dementia care interventions involves a plethora of a priori assumptions and decisions. Although frameworks exist to determine whether interventions are “ready” for ePCT, there is no heuristic to assess health equity-readiness. We discuss health equity considerations, case examples, and research strategies across ePCT study domains of evidence, risk, and alignment. Future discussions regarding health equity considerations across other domains are needed.
AB - Inequities with regard to brain health, economic costs, and the evidence base for dementia care continue. Achieving health equity in dementia care requires rigorous efforts that ensure disproportionately affected populations participate fully in—and benefit from—clinical research. Embedding-proven interventions under real-world conditions and within existing healthcare systems have the potential to examine the effectiveness of an intervention, improve dementia care, and leverage the use of existing resources. Developing embedded pragmatic controlled trials (ePCT) research designs for nonpharmacological dementia care interventions involves a plethora of a priori assumptions and decisions. Although frameworks exist to determine whether interventions are “ready” for ePCT, there is no heuristic to assess health equity-readiness. We discuss health equity considerations, case examples, and research strategies across ePCT study domains of evidence, risk, and alignment. Future discussions regarding health equity considerations across other domains are needed.
KW - dementia care
KW - embedded pragmatic controlled trials
KW - health equity
KW - nonpharmacological interventions
KW - underrepresented groups
UR - http://www.scopus.com/inward/record.url?scp=85169553369&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85169553369&partnerID=8YFLogxK
U2 - 10.1111/jgs.18568
DO - 10.1111/jgs.18568
M3 - Article
C2 - 37656062
AN - SCOPUS:85169553369
SN - 0002-8614
VL - 71
SP - 3874
EP - 3885
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -