# Building Primary Care Workforce Capacity in the Dementia Diagnostic Process

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $821,286

## Abstract

PROJECT SUMMARY/ABSTRACT
Primary care is the first point of contact for most people experiencing cognitive concerns, and its providers are
a critical workforce for dementia care. Timely and equitable diagnosis of Alzheimer’s disease and related
dementias (ADRD) in primary care is a key national priority and enables primary care providers (PCPs) to
identify treatment opportunities and to support patients and their caregivers in planning ahead and making
decisions about safety, medications, management of comorbid conditions, and caregiving. Yet, missed and
delayed diagnosis of ADRD in primary care is a persistent problem, occurring in over 60% of affected persons,
impeding these key care functions, and is especially common among racial/ethnic minorities and
socioeconomically disadvantaged populations. Early, equitable detection and diagnosis in primary care will be
crucial as new disease-modifying therapies become available, but workforce studies indicate that there are
insufficient specialists to make these diagnoses, especially in low-resource settings. Therefore, the overall goal
of this project is to build on strengths and overcome barriers in the primary care workforce that contribute to
missed and delayed diagnosis of ADRD, particularly among patients impacted by health disparities.
To do so, this study will take place in 7 primary care practices (safety net, community, academic) that serve
diverse populations in both urban and rural locations. We will use comparative ethnography to ascertain how
the most efficacious PCPs do successfully and proactively identify and diagnose dementia in diverse primary
care settings, and we will also identify drivers of disparities and barriers to timely diagnosis. Comparative
ethnography, an innovative lens we will bring to this persistent health system challenge, is a qualitative
approach used to holistically determine how social and cultural processes and individual and structural
contexts impact healthcare. Our Specific Aims are: (1) Assess the diagnostic journeys of people with ADRD
across diverse clinical settings and analyze their interactions with the primary care workforce to identify ways
social, cultural, and structural contexts impact the ADRD diagnostic process; (2) Analyze how PCPs, their
practice cultures, and available resources across these contexts strengthen or impede the ADRD diagnostic
process; and (3) a) Identify systems and policy-level factors that impact the ADRD diagnostic process, b)
Triangulate and compare findings across sites and domains, and c) Develop intervention targets, towards
future translation. We will identify how patient/caregiver factors, clinician and practice culture, and policies and
health systems strengthen or impede PCP engagement in the ADRD diagnostic process. A Stakeholder
Advisory Board will partner with the research team to help identify intervention targets for future studies.
The results will inform development of practice and policy intervention targets t...

## Key facts

- **NIH application ID:** 10881423
- **Project number:** 1R01AG087166-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Alissa Bernstein Sideman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $821,286
- **Award type:** 1
- **Project period:** 2024-06-01 → 2029-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10881423

## Citation

> US National Institutes of Health, RePORTER application 10881423, Building Primary Care Workforce Capacity in the Dementia Diagnostic Process (1R01AG087166-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10881423. Licensed CC0.

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