Implementation of a best-practice model of care for cognitive impairment and dementia for first nations peoples attending primary care in Australia: a stepped-wedge cluster-randomised trial

Abstract

Background: Dementia and cognitive impairment not dementia (CIND) are under-detected amongst First Nations peoples attending primary care. This trial implemented a culturally adapted best-practice model of care to increase detection and optimise management of CIND/dementia. Methods: This closed cohort open-label, stepped-wedge, cluster-randomised trial recruited 12 Aboriginal community-controlled primary health care services (ACCHSs) across urban, regional and remote settings in Australia. ACCHSs were eligible to participate if they conducted annual health checks, engaged in continuous quality improvement processes and had ≥55 clients aged ≥50 years. After a baseline control period, four ACC..