Monitor & Evaluate: Barriers & Mitigation Strategies | DAC-SP Early Detection Blueprint

A lack of supportive government health policy at the regional or national level inhibiting program scalability.

Policy-level decisions and related funding can significantly help or hinder the future of the early detection program for cognitive impairment. A lack of governmental policy that prioritizes brain health and dementia planning is a significant barrier to the sustainability and scalability of early detection programs. Conveying the evidence of early detection and obtaining buy-in from key government policy-makers requires significant efforts from key program stakeholders.

HOW THIS BARRIER MIGHT TAKE PLACE:

No policies prioritizing brain health and dementia planning at the national level, or integrated across levels of government.
No dedicated budget or funding to facilitate scaling cognitive assessments and care for cognitive impairment.
Limited reimbursement (in the U.S.) for cognitive testing (e.g., government policy, insurance company policy) or support services that may limit program expansion to other settings.

Mitigation Strategy

Advocate for policy change by demonstrating the value of early detection through evidence

Advocating for policy change requires that key program stakeholders demonstrate the value and positive impact of early detection through credible evidence. Influencing government healthcare policy is a long-term effort that requires continued demonstrated success of the program. Foster support at the policy level by communicating the value and impact of early detection on target communities and society at large.

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Tactics Include

Sharing successful outcomes of the program with multiple levels of stakeholders (e.g., primary care providers, specialists, staff, the public, media, and government) to build awareness and advocate for policy change. Examples of successful outcomes may include: the number of cognitive assessments performed; number of diagnoses; caregiver satisfaction; and changes in healthcare system utilization including access to resources such as emergency department visits, hospitalizations, or specialist referrals.
Conducting regular environmental scans to stay up-to-date with the latest progress in early detection from other parts of the world and support your argument with evidence and compelling testimonials.

Challenge in scaling an early detection program in primary care settings.

In some instances, there may be barriers that hinder primary care providers (PCPs) from adopting an early detection program for cognitive impairment into their practice. This results in the healthcare system losing momentum in expanding the number of primary care clinics that offer cognitive assessments beyond the initial early adopters.

HOW THIS BARRIER MIGHT TAKE PLACE:

The program’s progress plateaus in the number of cognitive assessments performed.
Some PCPs may be waiting to see the program’s impact before committing to participation; some may be overburdened with current patient capacity; or not consider brain health (i.e. cognitive impairment, Alzheimer’s disease and related dementias) as something they can treat in their current practice.

Mitigation Strategy

Tailor your approach for awareness and education by addressing the barriers experienced by primary care providers

Understanding PCPs’ barriers and needs can help you figure out the right approach to adoption and scaling the early detection programs. This, in combination with building awareness and education about the value of the program at the organizational level, may help tackle the adopting and scaling challenge.

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Tactics include

Connecting with the PCPs to learn about the barriers, concerns, or questions they may have about the program or cognitive impairment. Share credible evidence-based and actionable resources to address their needs.
Sharing the successes of the clinics who were early adopters of the program. This could be done by communicating the impact of the program through data, peer testimonials, or patient stories.
Developing a learning community in your healthcare system to encourage mentorship and knowledge-sharing for integrating the early detection program into practice.
Over time, working with your healthcare system to establish the early detection program as a core practice with the goal of mandating it as a healthcare system (e.g., incorporating the program as a strategic priority).
Continuing to leverage the support of relevant professional societies, advocacy groups, and other organizations to build and share evidence for early detection.

Barriers & Mitigation Strategies

Challenge in scaling an early detection program in primary care settings.

A lack of supportive government health policy at the regional or national level inhibiting program scalability.

A lack of supportive government health policy at the regional or national level inhibiting program scalability.

HOW THIS BARRIER MIGHT TAKE PLACE:

Mitigation Strategy

Advocate for policy change by demonstrating the value of early detection through evidence

Tactics Include

Challenge in scaling an early detection program in primary care settings.

HOW THIS BARRIER MIGHT TAKE PLACE:

Mitigation Strategy

Tailor your approach for awareness and education by addressing the barriers experienced by primary care providers

Tactics include

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