Refined conceptual model for implementing dementia risk reduction: incorporating perspectives from Australian general practice

Aust J Prim Health. 2020 Jun;26(3):247-255. doi: 10.1071/PY19249.

Abstract

Dementia is now a global health priority. With no known cure, the best way to reduce the number of people who will be living with dementia is by promoting dementia risk reduction (DRR). However, despite evidence-based guidelines, DRR is not yet routinely promoted in Australian general practice. Previously, we proposed a preliminary conceptual model for implementing DRR in primary care based on our scoping review of practitioners' views. The present study aimed to refine this model for the Australian context by incorporating the current perspectives of Australian general practitioners (GPs) and general practice nurses (GPNs) about DRR. Interviews with 17 GPs and GPNs were analysed using the framework method, underpinned by the Consolidated Framework for Implementation Research (CFIR). We identified 12 barriers to promoting DRR in Australian general practice, along with five facilitators. Using the CFIR-Expert Recommendations for Implementing Change (ERIC) Matching Tool to select prioritised implementation strategies from the ERIC project, the findings were incorporated into a refined conceptual model. The refined model points to an implementation intervention that uses educational materials and meetings to reach consensus with GPs and GPNs on the importance of promoting DRR and an appropriate approach. Champion GPs and GPNs should be prepared to drive the agreed implementation forward, and general practices should share successes and lessons learned. This model is a crucial step in bridging the gap between DRR guidelines and routine practice.

MeSH terms

  • Attitude of Health Personnel*
  • Australia
  • Dementia / psychology*
  • Female
  • General Practice / methods*
  • General Practitioners / psychology*
  • Humans
  • Interviews as Topic
  • Male
  • Primary Care Nursing / psychology*
  • Risk Reduction Behavior*
  • Self Efficacy