Overview
The goal of this pilot randomized controlled trial is to assess the impact of D2D rideshare services with a trained companion driver on the rate of medical appointments for older adults and individuals with AD/ADRD. Participants will be assigned either door-through-door (D2D) rideshare or curb-to-curb (C2C) rideshare services. he main question it aims to answer is:
Do D2D rideshare services reduce missed medical appointment rates compared to C2C rideshare services?
Description
A pilot randomized controlled trial (Stage 1). By stratifying on levels of cognitive impairment, i.e., no cognitive impairment vs. have mild to moderate cognitive impairment/MCI or subjective cognitive decline/SCD, the research team will randomly assign 120 riders, who have scheduled medical appointments at partner practices of Onward, to one of two groups: Onward D2D service (intervention) vs. C2C rideshare (control).
Intervention Group (D2D): Door-to-Door rideshare services with a trained companion driver.
Control Group (C2C): Standard Curb-to-Curb rideshare services.
Eligibility
Inclusion Criteria:
- All participants (or their surrogate) have the capacity to agree to allow Onward service for transportation;
- have scheduled medical appointments at partner practices of Onward;
- ages 60+
- community-dwelling;
- 60 participants who self-reported cognitive problems, such as memory issue, or have mild cognitive impairment, subjective cognitive decline, or AD/ADRD diagnosis
- Resides and attends appointments in the following San Francisco Bay Area Counties (San Francisco, Alameda, Contra Costa, Marin, San Mateo, Sonoma)
Exclusion Criteria:
- current enrollment in another transportation study;
- already using any type of free or heavily subsized transportation service;
- enrollees with comfort care only;
- Not wheelchair bound, e.g. if using a wheelchair must be foldable and must be able to transfer
- Transient, lacking consistent long term housing
- Resides outside of the San Francisco Bay Area