SUMMARY Alzheimer's disease (AD) has high economic impact and places significant burden on patients, caregivers, providers and healthcare delivery systems, fostering the need for an evaluation of alternative approaches to healthcare delivery for dementia. Collaborative care models are team-based, multicomponent interventions that provide a pragmatic strategy to deliver integrated healthcare to patients and families across a wide range of populations and clinical settings. Healthcare reform and national plans for AD goals to integrate quality care, health promotion and preventive services, and reduce the impact of disease on patients and families reinforcing the need for a system-level evaluation of how to best meet the needs of patients and families. We review collaborative care models for AD and offer evidence for improved patient- and family-centered outcomes, quality indicators of care and potential cost savings.

Objectives:To develop an educational video to reach elderly Latinos in order to improve understanding and encourage evaluation of cognitive changes by 1) using focus groups to identify dementia knowledge gaps, health communication preferences and trusted advisors for health concerns; 2) collaborating with elderly Latino community members to create a video; and 3) collecting survey data regarding community response to the video.Design:Grounded theory qualitative approach using focus groups; collaborative community based model to create the video and anonymous survey at community screenings.Setting:Community senior centers in East Harlem, New York.Participants:A team of low-income mono and bilingual elderly Latino community residents, researchers, clinicians, and a film professional.Measurements:Thematic analysis of focus group transcripts; three item survey.Results:A collaboratively produced video and initial assessment in 49 Latino elders that indicated the video had a positive effect on interest in obtaining a brief memory screening at outreach events (71%).Conclusions:The project demonstrates the feasibility of this interdisciplinary partnership to create a culturally and linguistically sensitive video to promote service use concerning memory loss and cognitive evaluations among elderly Latinos. Initial survey results suggested a positive response and an increase in interest in memory screening.

A mail questionnaire was used to survey the social and demographic characteristics, educational background, attitudinal profiles and expected career choice of 243 first-year students enrolled in three US medical schools. The aim was to determine whether different types of schools selected different types of students. Two schools were considered as conventional whereas one school was considered as innovative both in its admission policies and in its curriculum which emphasizes a biopsychosocial approach to health care. The survey achieved an 84% response rate. The results showed no difference in students' career expectations. Students recruited in the innovative school, however, differed from students recruited in the conventional schools with regard to their social and demographic characteristics, educational background and attitudinal profiles. This study suggests that as some medical schools are innovating in their curriculum and admission policies, new types of medical students are entering medicine. Implications of these results are discussed.

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