Going to the People: Community Health Workers Advancing Hmong and Hispanic Health Equity through Case Management in Community-Based Settings

This project aimed to improve the care of Wisconsin residents living with dementia by increasing primary care provider and trainees’ knowledge and skills related to dementia diagnosis and management of the behavioral and psychological symptoms of dementia (BPSD). Alzheimer’s disease currently affects 110,000 Wisconsinites and the number is expected to increase to 130,000 by 2025. About 90 percent of individuals with dementia experience BPSD, which includes depression, physical aggression, wandering and sleep disturbance, among others. As a result, there is a need to train future and practicing primary care clinicians in the identification and management of BPSD to help caregivers manage these behaviors in the home setting, potentially preventing crisis escalation and unnecessary institutionalization. The project successfully increased medical trainees’ and primary care providers’ knowledge and skills in dementia diagnosis and BPSD management. A web-based curriculum for third- and fourth-year medical students at the University of Wisconsin School of Medicine and Public Health improved students’ self-reported attitudes towards dementia care and informed the design of a new Dementia and Public Health elective that began in 2023. Additionally, academic detailing sessions for primary care providers at Richland Center Hospital and Milwaukee Health Services resulted in significant knowledge gains and improved confidence in managing BPSD. Lastly, the DICE Approach was used to train social workers, nurses, medical assistants and assisted living and nursing home frontline staff and led to increased knowledge, self-efficacy and comfort in managing BPSD.