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Item Opportunities to encourage adoption of a biomarker-enabled care pathway for Alzheimer's in primary care(Wiley, 2025-03-11) Borson, Soo; Au, Rhoda; Chodos, Anna H.; Gandy, Sam; Jain, Holly; Alagor, Amy; Cohn, Kristi; Kerwin, Diana R.; Mintzer, Jacobo; Monroe, Stephanie; Robinson, Delecia; Mielke, Michelle M.; Wilcock, Donna M.; Neurology, School of MedicineIdentification of early-stage Alzheimer's disease (AD) remains a challenge due to limited specialist availability, diagnostic access, disease awareness, and cultural factors. Blood-based biomarkers (BBBM) could play a critical role in the identification and referral of patients suspected of AD to specialty care. A multidisciplinary AD Biomarker Task Force was convened to evaluate current biomarker use cases, define an optimal biomarker-enabled AD diagnostic care pathway, and understand factors impacting adoption. The Task Force identified opportunities to support biomarker-enabled AD diagnostic care pathway adoption, including streamlining risk assessment and screening by leveraging digital tools, activating primary care providers through education, generating data to expand applicability to diverse populations, and advocating for aligned policies and quality measures. Adoption of BBBMs in the primary care setting will be critical to improve early AD detection. However, challenges to pathway adoption persist and will require action from clinicians, payers, policy makers, and patients to address. Highlights: Blood-based biomarkers can streamline the identification of AD in primary care. Future biomarker-enabled diagnostic care pathways will leverage digital assessments. Education, data generation, and policy advocacy are vital to encourage BBBM use. Implementation of AD care pathways requires the activation of diverse stakeholders.Item Testing 3 Modalities (Voice Assistant, Chatbot, and Mobile App) to Assist Older African American and Black Adults in Seeking Information on Alzheimer Disease and Related Dementias: Wizard of Oz Usability Study(JMIR, 2024-12-09) Bosco, Cristina; Shojaei, Fereshtehossadat; Theisz, Alec Andrew; Torres, John Osorio; Cureton, Bianca; Himes, Anna K.; Jessup, Nenette M.; Barnes, Priscilla A.; Lu, Yvonne; Hendrie, Hugh C.; Hill, Carl V.; Shih, Patrick C.; School of NursingBackground: Older African American and Black adults are twice as likely to develop Alzheimer disease and related dementias (ADRD) and have the lowest level of ADRD health literacy compared to any other ethnic group in the United States. Low health literacy concerning ADRD negatively impacts African American and Black people in accessing adequate health care. Objective: This study explored how 3 technological modalities-voice assistants, chatbots, and mobile apps-can assist older African American and Black adults in accessing ADRD information to improve ADRD health literacy. By testing each modality independently, the focus could be kept on understanding the unique needs and challenges of this population concerning the use of each modality when accessing ADRD-related information. Methods: Using the Wizard of Oz usability testing method, we assessed the 3 modalities with a sample of 15 older African American and Black adults aged >55 years. The 15 participants were asked to interact with the 3 modalities to search for information on local events happening in their geographical area and search for ADRD-related health information. Results: Our findings revealed that, across the 3 modalities, the content should avoid convoluted and complex language and give the possibility to save, store, and share it to be fully accessible by this population. In addition, content should come from credible sources, including information tailored to the participants' cultural values, as it has to be culturally relevant for African American and Black communities. Finally, the interaction with the tool must be time efficient, and it should be adapted to the user's needs to foster a sense of control and representation. Conclusions: We conclude that, when designing ADRD-related interventions for African American and Black older adults, it proves to be crucial to tailor the content provided by the technology to the community's values and construct an interaction with the technology that is built on African American and Black communities' needs and demands.