Project Summary

The University of Alaska Anchorage, University of Alaska Fairbanks, and University of Alaska Southeast Sitka have formed a consortium to create Alaska’s Geriatric Education Center (AKGEC). Through community-academic partnerships, service-learning models and interdisciplinary education, the AKGEC will improve the health status of medically underserved populations and eliminate health disparities through development of health professions curriculum and infrastructure that:

1. Improves the training of health professionals in underserved communities statewide through the development and dissemination of culturally sensitive interdisciplinary curricula related to the treatment of health problems of the elderly. Ethnogeriatric curricula and training will be developed in collaboration with community health care providers, consultants, Northwest GEC, Stanford Geriatric Education Center and delivered through on-site and/or distance delivery/telehealth methodologies.
2. Supports the training and retraining of faculty to provide instruction and clinical training for students in geriatrics through the development and dissemination of curriculum based on “best practices.” UA Faculty will participate in opportunities that ensure geriatric service learning and clinical approaches are incorporated into existing appropriate courses and will take part in training opportunities that promote interdisciplinary teamwork and collaboration across different health professions. In addition, courses and future curricula will be modified and/or designed for distance delivery.
3. Supports and promotes continuing education of health professionals though the development of on-site and distance delivered community education programs based on training needs survey and contributions from the GEC statewide advisory board and community partners.
4. Develops a web-based GEC Clearinghouse/library to facilitate access to historical and current geriatric resources (e.g. mental health, health promotion, ethnogeriatrics), training opportunities, databases, and links to other web sites, as well as geriatric curricula developed specifically for Alaska. A comprehensive geriatric database will be located within the Health Sciences Library’s Arctic Health information portal and available statewide.
5. Provides students with clinical training in geriatrics, including geriatric residences and traineeships.
6. Evaluates the effectiveness of GEC activities at primary and secondary levels to address the training needs of health care professionals, faculty, and students through formative, summative, and participatory methods.

Purpose, Need, and Rationale

The graying of America and the world is a recognized demographic phenomenon. The graying of Alaska, however, is more recent and is just beginning to be acknowledged by local media and policymakers. According to the most recent U.S. Census, the increase in elderly (65 years and older) in Alaska now places the state second only to Nevada in the increase in the senior population. While the population of individuals 65 and older increased by 13.2% in the U.S., from 1990 - 2000, the increase in Alaska was 60%.

This demographic imperative has major implications for life expectancy and health care and presents major challenges to the state where the number of Alaskans is expected to triple in number by 2018.  Alaska has some of the most dramatic scenic beauty in world; however, its geographic expansiveness and remoteness present significant barriers when people try to access health care, education, training, services, and other resources. Alaska covers 586, 412 square miles of land (about 365 million acres) and has an estimated 47,3000 miles of tidal shoreline. It is larger than the three next largest states (i.e. Texas, California, and Montana) combined, two and half times the size of Texas, and one-fifth the size of the entire continental United States. While a highway system connects the larger communities in Southeast and Southcentral Alaska and parts of the interior such as Fairbanks, the vast majority of the state is unreachable by road and frequent mode of travel is by water or air.

Due to Alaska's features, only Anchorage and Fairbanks are classified as urban. Approximately 32 % of Alaska's age 65+ population lives in rural areas, as compared to 27% on average in the United States. Nationwide, minorities are less common in rural areas, but this is not true in Alaska where much of the rural population is Alaska Native. Twenty-nine percent of Alaska communities have been designated by the federal government as economically distressed and disadvantaged. Alaska's unique geography and population characteristics, its transportation issues, designated economic status of its communities, an increase in its senior population have all contributed to the state being classified as a Health Professional Shortage Area (HPSA) and Medically Underserved Area (MUA/MUP). 

Based upon this designation and accompanying description, the mission of AKGEC will be to prepare present and future health professionals to serve Alaska's unique elderly population including those who live in remote and underserved urban areas through classroom, practical, and distance/telehealth education.

The goals of the current grant period reflect the pressing need within the state for improving geriatric health care training through collaboration, coordination, and leveraging resources. Establishing a web-based clearinghouse and point of dissemination for training materials to support training and retraining of faculty, to provide instruction, and to provide students with clinical training in geriatrics are also noteworthy and vitally important goals.

Objectives and Methodology

GOAL ONE: Improve and support the training of health professionals in geriatrics through continuing education opportunities.

1a. Collaborate and coordinate with community partners to hold institutes, conferences, workshops, and seminars.

1b. Develop training program that focus on identification, treatment, and prevention of geriatric health problems.

1c. Develop a 45-hour health promotion program.

GOAL TWO: Develop and disseminate curriculum relating to the treatment of health problems of elderly individuals.

2a. Develop and disseminate best practice modules on the treatment and care of health problems.

2b. Develop a GEC library/clearinghouse website.

2c. Market, develop, and disseminate process for collection and entry of ongoing geriatric documents.

2d. Maintain access to information about continuing geriatric education opportunities available statewide.

GOAL THREE: Support training and retraining of faculty to provide instruction in geriatrics through a faculty-training program.

3a. Enhance facultys’ professional knowledge and skills in geriatrics through Faculty Development Center (CAFÉ) and existing conferences.

3b. Develop modules for geriatric best practices content including ethnogeriatrics for infusion into minor courses, practicums, and internship sites.

3c. Develop geriatric community and academic partnerships and infuse Service Learning education into training modules.

3d. Support clinical faculty as they develop interdisciplinary geriatric material on the utilization of health care teams in community settings.

GOAL FOUR: Provide students with clinical training in geriatrics, including geriatric residencies and traineeships.

4a. Establish coordinated interdisciplinary clinical training opportunities in medical settings with special focus on underserved areas and populations.

4b. Develop a mechanism to place graduates and other qualified professionals in medically underserved communities in urban and remote areas.

4c. Develop Alaskan health promotion and clinical training model for students in practicums and internships.

4d. Develop student and faculty support services in remote and underserved areas in collaboration with Washington, Wyoming, Alaska, Montana, Idaho (WWAMI), Alaska Center for Rural Health (ACRH), and Alaska Family Practice Residency Program.

Evaluation

The foundation for the evaluation performed by the Alaska Geriatric Education Center (AKGEC) will be the Utilization Focused Evaluation Model; a model that ensures that a continuous "feedback loop" is in place through all aspects of the evaluation and the program accomplishes its objectives. The evaluation design entails a combination of quantitative and qualitative methods including course participant surveys, key informant interviews, and focus groups.  Formative and summative evaluation of the processes and outcomes of the AKGEC will occur in all five years and program fidelity will be assessed at the end of the funding cycle to understand why and how independent objectives or activities evolved.

The overall program goal is to support, enhance, and fill the training gaps of health professionals towards improving the health status of Alaska's elderly, and it is beyond the scope of the AKGEC to measure changes in health status of individual patients. For the purpose of this evaluation, changes in the health status of older adults will be measured indirectly. Essentially it will be measured by volume of health professionals receiving geriatric training; changes in health professionals and future health professionals in knowledge, perceptions of improved access to culturally sensitivity information in geriatric health care; improved health outcomes; and the number of new geriatric health care position vacancies statewide.

A program of: Consortium Partners:

The Alaska Geriatric Education Center is funded by the U.S. Department of Health and Human Services, Health Resources and Service Administration (HRSA) Grant #D31HP08826.

UA is an AA/EO employer and educational institution.