ArticleBMC geriatrics2022
Perceived extrinsic barriers hinder community detection and management of mild cognitive impairment: a cross-sectional study of general practitioners in Shanghai, China.
Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Dilemmas of early dementia screening among community-dwelling older adults: a qualitative study from the perspective of social determinants of health.Frontiers in public health · 2026Article
- Community detection and management of mild cognitive impairment in Shanghai: a mixed-methods study.Health policy and planning · 2025Article
- A mixed-methods study on collaborative health governance for older adults with mild cognitive impairment in Hangzhou, China.Frontiers in public health · 2025Article
- A spatial feature analysis of primary health care utilization in a large city in China and its implications for family doctor contract service policy.BMC health services research · 2024Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeneral 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.
methodsA 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, respectively. 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 square (PLS) approach.
resultsThe 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 (β = - 0.012, p = 0.025) the association between knowledge and practice. Training moderated the effect of knowledge on practice (β = - 0.066, p = 0.014).
conclusionsPerceived 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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