Improving Postsurgical Cognitive Outcomes in Limited English Proficient Older Adults with a Perioperative Care Partner Program: A Pilot Pragmatic Randomized Controlled Trial
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Postoperative Delirium (POD) is the most common complication after surgery in older adults, and is associated with increased mortality, cognitive decline, and loss of independence. As the United States (US) population ages and more older adults undergo surgery, POD and cognitive decline after surgery are becoming a public health emergency. Dr. Canales has developed the Perioperative Care Partner Program (PCPP), that combines established strategies for risk reduction and early diagnosis with improved communication and community engagement to diminish the risk of POD within this vulnerable population. This initiative pairs older adults at high risk for POD with a care partner throughout the perioperative period. The primary objective of this proposed K76 Beeson Career Development Award is to equip Dr. Canales with the necessary training and hands-on mentored research experience to emerge as a leader in perioperative aging research. The career development and mentorship plans were crafted to fill gaps in current knowledge and experience. With the support of her mentors and collaborators, career development goals are to:(A) become proficient in pragmatic clinical trials in older adults in the perioperative setting;(B) gain skills in implementation science and (C) study communication and community engagement in the aging surgical population. The overarching goal of this proposal is to conduct a pilot pragmatic Hybrid Type 1 Effectiveness-Implementation randomized controlled trial of the PCPP program in older adults undergoing major surgery. The aims of the proposal are: Aim 1. Using state of the art implementation science methods, iteratively refine PCPP for older adults at high-risk of POD; Aim 2. Conduct a pilot pragmatic randomized controlled Hybrid Type 1 Effectiveness-Implementation trial of PCPP vs standard care (n= 80) in older adults undergoing surgery; Aim 3. Define and standardize the core protocols, guidelines and materials needed to create a PCPP implementation bundle that can be tailored for different languages and health settings.
