{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:48:12Z","timestamp":1768571292232,"version":"3.49.0"},"posted":{"date-parts":[[2025,4,3]]},"group-title":"Public and Global Health","reference-count":30,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,4,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Latino individuals bear a disproportionate burden of Alzheimer\u2019s disease and related dementias (ADRD), with higher risk, underdiagnosis, and limited access to quality care. Primary care providers (PCPs) are crucial for early detection and management. However, organizational and policy factors significantly impact their ability to provide culturally competent and equitable ADRD care for this community. This study explores PCP perspectives on these organizational and policy factors to inform the development of accessible models that improve early diagnosis, preventive care, and quality of life for Latino individuals with ADRD.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used thematic analysis to analyze qualitative interviews with 23 diverse PCPs across the USA. We recruited our sample using snowball sampling. We strengthened the validity of our findings by using rigorous data reduction techniques.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Key themes emerged highlighting the interplay of organizational and policy factors: 1) Insurance eligibility and care options for those uninsured were foremost, with mandated language services facing access and quality challenges that affected the ability of clinicians to perform an accurate diagnosis. 2) Staffing and available resources dictated the type of care offered, leading to inconsistent protocols and options. Providers reported that workup was influenced by their level of training, time availability, and comfort. 3) While recognized as crucial, comprehensive assessments that include evaluation of their home and social environment were limited by appointment constraints and lack of follow-up resources.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Economic and organizational factors, including insurance, costs, staffing models, and resource navigation, shape PCPs\u2019 ability to deliver culturally competent and equitable ADRD care. Future interventions should address these barriers by training PCPs in diagnostic procedures in Latino communities and developing accessible service models and culturally appropriate diagnostic tools.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.03.27.25324793","type":"posted-content","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T18:46:48Z","timestamp":1743706008000},"source":"Crossref","is-referenced-by-count":0,"title":["Policy &amp; Organizational factors that Affect the Utilization of Health Services for Alzheimer\u2019s Disease Among the Latino Community \u2013 The Primary Care Provider Perspective"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8090-5509","authenticated-orcid":false,"given":"Maria","family":"Mora Pinzon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Martinez Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1013-7847","authenticated-orcid":false,"given":"Jaime","family":"Perales-Puchalt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025040504100954000_2025.03.27.25324793v1.1","unstructured":"American Geriatrics Society. Geriatrics Workforce By the Numbers. 2022. https:\/\/www.americangeriatrics.org\/geriatrics-profession\/about-geriatrics\/geriatrics-workforce-numbers"},{"key":"2025040504100954000_2025.03.27.25324793v1.2","doi-asserted-by":"publisher","DOI":"10.1177\/0898264319879325"},{"key":"2025040504100954000_2025.03.27.25324793v1.3","unstructured":"U.S. Department of Health and Human Services HRaSA, National Center for Health Workforce Analysis.. Health Workforce Projections: Neurology Physicians and Physician Assistants. (Accessed October 8, 2022 https:\/\/bhw.hrsa.gov\/sites\/default\/files\/bureau-health-workforce\/data-research\/bhw-factsheet-neurology.pdf). 2017;"},{"key":"2025040504100954000_2025.03.27.25324793v1.4","unstructured":"U.S. Department of Health and Human Services HRaSA, National Center for Health Workforce Analysis. National and Regional Projections of Supply and Demand for Geriatricians: 2013\u20132025. Rockville, Maryland. 2017;"},{"key":"2025040504100954000_2025.03.27.25324793v1.5","unstructured":"U.S. Department of Health and Human Services HRaSA, National Center for Health Workforce Analysis.. Behavioral Health Workforce Projections, 2017\u20132030. (Accessed October 8, 2022, https:\/\/bhw.hrsa.gov\/sites\/default\/files\/bureau-health-workforce\/data-research\/bh-workforce-projections-fact-sheet.pdf). 2017.;"},{"key":"2025040504100954000_2025.03.27.25324793v1.6","doi-asserted-by":"publisher","DOI":"10.1177\/2333721418777659"},{"key":"2025040504100954000_2025.03.27.25324793v1.7","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12068"},{"key":"2025040504100954000_2025.03.27.25324793v1.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2019.01.010"},{"key":"2025040504100954000_2025.03.27.25324793v1.9","first-page":"321","volume":"15","author":"Alzheimer\u2019s Association","year":"2019","journal-title":"Alzheimer\u2019s Disease Facts and Figures"},{"key":"2025040504100954000_2025.03.27.25324793v1.10","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4377-y"},{"key":"2025040504100954000_2025.03.27.25324793v1.11","unstructured":"U.S. Department of Health and Human Services OoDPaHP. Healthy People 2030. Development of the National Health Promotion and Disease Prevention Objectives for 2030. Accessed May 2020, 2020. https:\/\/www.healthypeople.gov\/2020\/About-Healthy-People\/Development-Healthy-People-2030"},{"key":"2025040504100954000_2025.03.27.25324793v1.12","doi-asserted-by":"publisher","DOI":"10.2196\/42211"},{"key":"2025040504100954000_2025.03.27.25324793v1.13","unstructured":"Andersen 2014 Improving Access to Care in Kominski Changing the US Health Care System. 2016."},{"key":"2025040504100954000_2025.03.27.25324793v1.14","unstructured":"Andersen RM , Davidson P. Improving access to care in America: individual and contextual indicators. In: Andersen RM , Rice TH , Kominski GF , eds. Changing the US Health Care System, CafeScribe: Key Issues in Health Services Policy and Management. Third Edition. ed. Jossey-Bass; 2011."},{"key":"2025040504100954000_2025.03.27.25324793v1.15","first-page":"Doc11","article-title":"Re-revisiting Andersen\u2019s Behavioral Model of Health Services Use: a systematic review of studies from 1998-2011","volume":"9","year":"2012","journal-title":"Psycho-social medicine"},{"key":"2025040504100954000_2025.03.27.25324793v1.16","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917712131"},{"key":"2025040504100954000_2025.03.27.25324793v1.17","doi-asserted-by":"publisher","DOI":"10.1080\/13557858.2012.730610"},{"key":"2025040504100954000_2025.03.27.25324793v1.18","doi-asserted-by":"publisher","DOI":"10.1177\/1090198114529130"},{"key":"2025040504100954000_2025.03.27.25324793v1.19","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3825-z"},{"key":"2025040504100954000_2025.03.27.25324793v1.20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.36030"},{"issue":"10","key":"2025040504100954000_2025.03.27.25324793v1.21","first-page":"S188","article-title":"The economic and societal burden of Alzheimer disease: managed care considerations","volume":"28","year":"2022","journal-title":"The American journal of managed care"},{"key":"2025040504100954000_2025.03.27.25324793v1.22","doi-asserted-by":"publisher","DOI":"10.1093\/haschl\/qxae167"},{"key":"2025040504100954000_2025.03.27.25324793v1.23","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181f380bc"},{"key":"2025040504100954000_2025.03.27.25324793v1.24","doi-asserted-by":"publisher","DOI":"10.1001\/amajethics.2021.109"},{"key":"2025040504100954000_2025.03.27.25324793v1.25","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1341-6"},{"key":"2025040504100954000_2025.03.27.25324793v1.26","doi-asserted-by":"publisher","DOI":"10.1177\/07334648241234982"},{"key":"2025040504100954000_2025.03.27.25324793v1.27","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-023-01314-6"},{"key":"2025040504100954000_2025.03.27.25324793v1.28","unstructured":"National Academies of Sciences E, Medicine. Reducing the Impact of Dementia in America: A Decadal Survey of the Behavioral and Social Sciences. The National Academies Press; 2021:360."},{"issue":"2","key":"2025040504100954000_2025.03.27.25324793v1.29","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/WAD.0000000000000077","article-title":"Effectiveness of a fotonovela for reducing depression and stress in Latino dementia family caregivers","volume":"29","year":"2015","journal-title":"Alzheimer disease and associated disorders"},{"key":"2025040504100954000_2025.03.27.25324793v1.30","unstructured":"National Institute on Aging. Caring for a person with Alzheimer\u2019s disease: Your easy-to-use guide from the National Institute on Aging. US Department of Health and Human Services, National Institutes of Health \u2026; 2019."}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.03.27.25324793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:32:42Z","timestamp":1768509162000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.03.27.25324793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":30,"URL":"https:\/\/doi.org\/10.1101\/2025.03.27.25324793","relation":{},"subject":[],"published":{"date-parts":[[2025,4,3]]},"subtype":"preprint"}}