ID-5184 Wonca Abstracts supplement L-Z 13-10-23 - Flipbook - Page 48
WONCA 2023 Supplement 2: WONCA 2023 abstracts (L–Z)
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Perceived extrinsic barriers hinder community detection
and management of mild cognitive impairment in China
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Prof Yuan Lu1
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La Trobe University, 2Yangpu Hospital, Tongji University
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. 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 squares (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 (ß = −0.012, P = 0.025) the association
between knowledge and practice. Training moderated the effect of knowledge on practice (ß =
−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.
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