Date of Conferral

8-22-2025

Degree

Ph.D.

School

Health Education and Promotion

Advisor

Theresa Gibble

Abstract

The 2011 Patient Protection and Affordable Care Act (PPACA) mandated that Primary Care Providers (PCPs) offer brief cognitive assessments during the Medicare Annual Wellness Visit (AWV), but this practice was inconsistent at best. This study investigated factors that influenced PCPs intentions to routinely assess cognition during the AWV. The theory of planned behavior (TPB) was used to assess the relationship between PCPs' behavior beliefs, subjective norm beliefs, perceived behavioral control (PBC) beliefs, and external control factors and their intentions to conduct brief cognitive assessments during the AWV. Using a quantitative correlational design, a cross-sectional online survey was administered to 86 PCPs. The results indicated that behavior beliefs were the strongest predictor of PCPs' intentions to conduct brief cognitive assessments during the AWV, while PBC beliefs and subjective norm beliefs were also statistically significant. External control factors were not statistically significant in this model. The findings support interventions targeting PCPs that promote awareness regarding the benefits of early detection and diagnosis of Alzheimer’s disease and related dementia (ADRD), knowledge and self-efficacy, and positive social norms. This study contributed to positive social change by shedding light on the relationship between PCP beliefs and their intentions to conduct brief cognitive assessments during the AWV. Future interventions that support PCPs in routinely offering brief cognitive assessments during the AWV would increase opportunities for them to address modifiable risk behaviors, identify treatable health issues, diagnose ADRD at the earliest stage, and help their patients and families access treatment, care and support earlier in their journey.

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