Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China
Abstract Background General practitioners (GPs) play a critical role in community detection and management of mild cognitive impairment (MCI). Although adequate knowledge is essential, healthcare practice is shaped by intrinsic and extrinsic factors. This study aimed to test the mediating effect of...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-022-03175-4 |
| _version_ | 1828333928058978304 |
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| author | Yuan Lu Chaojie Liu Sally Fawkes Zhaoxin Wang Dehua Yu |
| author_facet | Yuan Lu Chaojie Liu Sally Fawkes Zhaoxin Wang Dehua Yu |
| author_sort | Yuan Lu |
| collection | DOAJ |
| description | Abstract Background General practitioners (GPs) play a critical role in community detection and management of mild cognitive impairment (MCI). Although adequate knowledge is essential, healthcare practice is shaped by intrinsic and extrinsic factors. This study aimed to test the mediating effect of perceived extrinsic barriers on the associations between knowledge, attitudes, and intended practice of GPs in community detection and management of MCI. Methods A cross-sectional study was conducted through an online survey of 1253 GPs sampled from 56 community health centres (CHCs) in Shanghai in 2021. Perceived extrinsic barriers were rated on a five-point Likert scale for patient engagement, working environment, and system context, respectively. A summed score was generated subsequently for each domain ranging from 0 to 100, with a higher score indicating higher barriers. The mediating effect of perceived extrinsic barriers (second-order) and the moderation effect of training on the association between MCI knowledge and practice scores, as well as the moderation effect of past experience on the association between MCI knowledge and extrinsic barriers, were tested through structural equation modelling (SEM) with a partial least square (PLS) approach. Results The study participants reported an average barrier score of 65.23 (SD = 13.98), 58.34 (SD = 16.95), and 60.37 (SD = 16.99) for patient engagement, working environment, and system context, respectively. Although knowledge had both direct and indirect (through attitudes) effects on intended practice, perceived extrinsic barriers negatively mediated (β = − 0.012, p = 0.025) the association between knowledge and practice. Training moderated the effect of knowledge on practice (β = − 0.066, p = 0.014). Conclusions Perceived extrinsic barriers have a detrimental effect on the translation of knowledge into practice for community detection and management of MCI. The effect of training on practice declines when knowledge scores become higher. |
| first_indexed | 2024-04-13T21:26:20Z |
| format | Article |
| id | doaj.art-cc6a462de72440f7980b2a1a1ebf3c89 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-13T21:26:20Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-cc6a462de72440f7980b2a1a1ebf3c892022-12-22T02:29:18ZengBMCBMC Geriatrics1471-23182022-06-0122111210.1186/s12877-022-03175-4Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, ChinaYuan Lu0Chaojie Liu1Sally Fawkes2Zhaoxin Wang3Dehua Yu4Department of General Practice, Yangpu Hospital, Tongji University School of MedicineSchool of Psychology and Public Health, La Trobe UniversitySchool of Psychology and Public Health, La Trobe UniversitySchool of Public Health, Shanghai Jiaotong University School of MedicineDepartment of General Practice, Yangpu Hospital, Tongji University School of MedicineAbstract Background General practitioners (GPs) play a critical role in community detection and management of mild cognitive impairment (MCI). Although adequate knowledge is essential, healthcare practice is shaped by intrinsic and extrinsic factors. This study aimed to test the mediating effect of perceived extrinsic barriers on the associations between knowledge, attitudes, and intended practice of GPs in community detection and management of MCI. Methods A cross-sectional study was conducted through an online survey of 1253 GPs sampled from 56 community health centres (CHCs) in Shanghai in 2021. Perceived extrinsic barriers were rated on a five-point Likert scale for patient engagement, working environment, and system context, respectively. A summed score was generated subsequently for each domain ranging from 0 to 100, with a higher score indicating higher barriers. The mediating effect of perceived extrinsic barriers (second-order) and the moderation effect of training on the association between MCI knowledge and practice scores, as well as the moderation effect of past experience on the association between MCI knowledge and extrinsic barriers, were tested through structural equation modelling (SEM) with a partial least square (PLS) approach. Results The study participants reported an average barrier score of 65.23 (SD = 13.98), 58.34 (SD = 16.95), and 60.37 (SD = 16.99) for patient engagement, working environment, and system context, respectively. Although knowledge had both direct and indirect (through attitudes) effects on intended practice, perceived extrinsic barriers negatively mediated (β = − 0.012, p = 0.025) the association between knowledge and practice. Training moderated the effect of knowledge on practice (β = − 0.066, p = 0.014). Conclusions Perceived extrinsic barriers have a detrimental effect on the translation of knowledge into practice for community detection and management of MCI. The effect of training on practice declines when knowledge scores become higher.https://doi.org/10.1186/s12877-022-03175-4Mild cognitive impairmentStructural equation modelGeneral practitionerPrimary careExtrinsic barriers |
| spellingShingle | Yuan Lu Chaojie Liu Sally Fawkes Zhaoxin Wang Dehua Yu Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China BMC Geriatrics Mild cognitive impairment Structural equation model General practitioner Primary care Extrinsic barriers |
| title | Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China |
| title_full | Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China |
| title_fullStr | Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China |
| title_full_unstemmed | Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China |
| title_short | Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China |
| title_sort | perceived extrinsic barriers hinder community detection and management of mild cognitive impairment a cross sectional study of general practitioners in shanghai china |
| topic | Mild cognitive impairment Structural equation model General practitioner Primary care Extrinsic barriers |
| url | https://doi.org/10.1186/s12877-022-03175-4 |
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