cda-awardee

Jennifer Gabbard, MD

Posted on by Erin Luers

Wake Forest School of Medicine

Use of a Dementia-Specific Portal-Based Tool for Advance Care Planning Engagement

Investigator Spotlight

Dr. Gabbard is an assistant professor in the Department of Internal Medicine. She is triple boarded in Internal Medicine, Geriatrics, and Hospice and Palliative Medicine. She trained at the University of Arizona and then completed a clinician-educator fellowship at Johns Hopkins University. Her clinical interests include integration of early palliative care in patients with serious illnesses, clinical care of comorbid chronically ill and frail older adults, and promotion of healthy aging. These interests translate into both educational and research settings. Dr. Gabbard serves as the Palliative Care Research Director and Associate Program Director of the Hospice and Palliative Medicine Fellowship Program at Wake Forest School of Medicine. She is a physician-scholar and educator seeking to develop her strong interests in implementation science, clinical informatics, and pragmatic clinical trial design.

People living with dementia and those with cognitive frailty (i.e., mild cognitive impairment plus frailty) often experience high symptom burden affecting their quality of life and that of their care partners, with many receiving burdensome interventions that may be of limited benefit and that do not promote comfort. Because decision making capacity is often compromised as dementia progresses, it is important to have advance care planning (ACP) discussions early in the disease course to ensure goal concordant care. The Career Development Award will provide Dr. Gabbard with the necessary experience and training in implementation science, clinical informatics, and pragmatic clinical trial design to become an independent clinician-investigator conducting embedded pragmatic clinical trials to improve ACP and other care innovations among people living with dementia or cognitive frailty cared for within health care systems. This training will support the following Specific Aims: (1) To develop a dementia-specific, health care system patient portal-based ACP Tool for patients living with dementia or cognitive frailty and engage end-users in its design, and (2) To pilot test feasibility and preliminary effectiveness of linking the dementia-specific ACP tool to the patient portal to improve ACP engagement and documentation within the electronic health record.

Tina Sadarangani, PhD, RN, ANP-BC, GNP-BC

Posted on by Erin Luers

NYU Rory Meyers College of Nursing

Leveraging mHealth to reduce avoidable utilization by people with dementia in day centers

Investigator Spotlight

Dr. Sadarangani is an assistant professor at NYU Rory Meyers College of Nursing and a board-certified nurse practitioner. She is committed to improving the health of older adults in diverse communities by leveraging the strengths of community-based organizations. Her current research focuses on using mobile health mechanisms to integrate health and social services provided to persons with dementia within adult day centers with primary care settings in order to reduce avoidable healthcare utilization. Dr. Sadarangani is a Fellow of the Hartford Institute for Geriatric Nursing and a Senior Fellow of the NYU Aging Incubator. She is a leading member of the National Adult Day Services Association Research Committee and is committed to using community-based participatory action research methods to enhance stakeholder engagement in the research process.

People living with dementia (PLWD) in the community are highly susceptible to experiencing emergency department visits and hospitalizations that are potentially avoidable. Adult day service centers (ADCs) provide community-based care to a growing number of racial/ethnically diverse people with dementia. Daily assessment by ADC staff (e.g., registered nurses, social workers) supports early detection of clinical problems such that timely notification of acute changes in health care to primary care providers could potentially prevent minor health issues from escalating into medical emergencies. Mobile health (mHealth) interventions improve communication across a variety of health care settings but have not been designed for ADCs. The Career Development Award will provide Dr. Sadarangani with necessary training in stakeholder engaged approaches to developing mHeath technology and embedded pragmatic trial design to lead independent research that integrates care from ADCs and primary care physicians using mHealth. This training will support the following Specific Aims: (1) To identify key domains of an mHealth application intended to support communication between ADCs, primary care physicians, and informal care partners regarding people with dementia and (2) To design an mHealth application intervention intended to support communication between ADCs, primary care physicians, and informal care partners. This study innovatively leverages ADCs’ strengths and stakeholders’ perspectives to inform the development of a pragmatic user-centered mHealth application. Findings from this study will provide a basis for reducing costly and traumatic outcomes affecting vulnerable PLWD cared for in ADC networks.