The NIA IMPACT Collaboratory published its first newsletter on October 26. The newsletter includes updates from the first year of the IMPACT Collaboratory, news, and upcoming events. Read the newsletter at this link, and sign up to receive future newsletters here.
Administration
IMPACT Collaboratory receives 4 NIA COVID-19 Supplement Awards
The National Institute on Aging (NIA) Imbedded Pragmatic Alzheimer’s Disease (AD) and AD-Related Dementias (AD/ADRD) Clinical Trials (IMPACT) Collaboratory is pleased to announce that the IMPACT community has been awarded 4 NIA COVID-19 Supplements for research efforts in response to the urgent public health needs arising from COVID-19 and it’s devastating impact on people living with dementia, their families and care partners.
Effect of a COVID-Specific Advance Care Planning Intervention on Documentation of Advance Directives and Goals of Care
Principal Investigator: Ellen McCreedy, PhD, MPH, Brown University School of Public Health
Dr. McCreedy and her team will conduct a cluster randomized embedded pragmatic clinical trial (ePCT) by leveraging electronic health records of Bluestone Physician Services to test the effectiveness of a COVID-specific, advance care planning (ACP) intervention on documentation of care preferences among assisted living community (ALC) residents with AD/ADRD from 150 ALCs in 3 states.
Evaluation of a State-wide Effort to Improve COVID-19 Infection Control in Massachusetts Nursing Homes
Principal Investigator: Lewis Lipsitz, MD, Marcus Institute for Aging Research, Hebrew SeniorLife
Dr. Lipsitz and his team will evaluate the efficacy of a Massachusetts state-funded strategy to minimize the spread of COVID-19 among older adults and their care providers within Massachusetts NHs using multiple data sources. Efficacy will be measured over the 2-month intervention period among all residents in nursing homes (NHs) across Massachusetts compared to those in Connecticut, Rhode Island, New Hampshire, and Vermont.
COVID-19 Serologic Strategies for Skilled Nursing Facilities (CERO)
Principal Investigator: Joshua Chodosh, MD, MSHS, NYU Langone Health
Dr. Chodosh and his team will design and pilot test an intervention that leverages the COVID-19 antibody and PCR status of residents and staff to inform staff-residents care assignments to minimize COVID-19 transmission rates. The team will conduct the study in two New York City facilities with high minority and AD/ADRD representation and compare intervention units using this strategy with those that do not.
Improved Testing for COVID-19 in Skilled Nursing Facilities: IMPACT-C
Principal Investigators: Sarah Berry, MD, MPH, Marcus Institute for Aging Research, Hebrew Senior Life; Vince Mor, PhD, Brown University School of Public Health
Drs. Berry and Mor were awarded a supplement to improve COVID-19 testing for underserved and vulnerable populations as part of the Rapid Acceleration of Diagnostics (RADx) initiative, the RADx Underserved Populations (RADx-UP) program. This initiative will leverage the foundation of the IMPACT Collaboratory to establish IMPACT-COVID-19 (IMPACT-C), a collaborative dedicated to developing and evaluating SARS-CoV-2 testing strategies in highly vulnerable residents and health care workers of skilled nursing facilities. IMPACT-C will assemble the organizational, administrative, and expertise components necessary to swiftly conduct a rigorous vaccine trial, when available.
IMPACT-C to develop and evaluate equitable and compassionate COVID-19 testing strategies in skilled nursing facilities
The National Institutes of Health has awarded nearly $234 million to improve COVID-19 testing for underserved and vulnerable populations. A part of the Rapid Acceleration of Diagnostics (RADx) initiative, the RADx Underserved Populations (RADx-UP) program will support 32 institutions across the United States and will focus on populations disproportionately affected by the pandemic.
IMPACT Principal Investigator Vince Mor, PhD and Sarah Berry, MD from Hebrew Senior Life received a RADx-UP award for Improved Testing for COVID-19 in Skilled Nursing Facilities. IMPACT-C is a collaborative initiative to develop and evaluate equitable and compassionate SARS-CoV-2 testing strategies in vulnerable patients and workers within skilled nursing facilities.
McKnight’s names Mor one of 40 notable newsmakers
As part of the 40th anniversary of McKnight’s, McKnight’s Senior Living and McKnight’s Long-Term Care News are recognizing 40 notable newsmakers. Each week, the brands will highlight a new, high-profile leader from the past four decades. On Monday, September 28, they included IMPACT Collaboratory Principal Investigator Vince Mor on the list.
“Numerous top-flight academic researchers delve into nursing home care and policy, but few, if any, approach the track record of Vince Mor,” said the authors of the article.
Moe is professor of health services, policy and practice and the Florence Pirce Grant University Professor in the Brown University School of Public Health, Mor has been the principal investigator of more than 40 National Institutes of Health-funded grants during his 40 years at the university. Read the full article here.
Previously published installments of the series are posted here.
NIA IMPACT Collaboratory Featured in JAGS Special Issue
The Journal of the American Geriatrics Society (JAGS) has published a special issue (Volume 68, S2) focused solely on the National Institute on Aging (NIA) Imbedded Pragmatic Alzheimer’s Disease (AD) and AD-Related Dementias (AD/ADRD) Clinical Trials (IMPACT) Collaboratory and the activities and progress it has made since the September 2019 announcement.
The special issue, published online June 26, includes an introductory article describing the mission and vision of the IMPACT Collaboratory and articles from each of the 10 IMPACT cores and teams describing how they are working to achieve that mission. The introductory article authors are the two IMPACT principal investigators, Susan Mitchell, MD, MPH, senior scientist at Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research and professor of medicine at Harvard Medical School and Vincent Mor, PhD, Professor of Health Services, Policy & Practice and the Florence Pirce Grant University Professor, Brown University School of Public Health, as well as the two executive directors, Ellen McCarthy, PhD, MPH, Associate Scientist, Marcus Institute, and Associate Professor of Medicine and Epidemiology, Harvard Medical School, and Jill Harrison, PhD, Assistant Professor of Health Services, Policy and Practice, Brown University School of Public Health.
Mitchell is guest editor for the special issue of JAGS, which includes articles from the IMPACT cores and teams to provide insight into how each is working to improve the quality and effectiveness of ePCTs in PLWD and their care partners. The article titles are:
- Achieving Health Equity in Embedded Pragmatic Trials for People Living with Dementia and Their Family Caregivers
- Building a National Program for Pilot Studies of Embedded Pragmatic Clinical Trials in Dementia Care
- Training the Workforce to Conduct Embedded Pragmatic Clinical Trials to Improve Care for People Living with Dementia and Their Caregivers
- Dissemination and Implementation of Evidence-Based Dementia Care Using Embedded Pragmatic Trials
- Ethical and Regulatory Issues for Embedded Pragmatic Trials Involving People Living with Dementia
- Transforming Dementia Care Through Pragmatic Clinical Trials Embedded in Learning Healthcare Systems
- Using Healthcare Data in Embedded Pragmatic Clinical Trials among People Living with Dementia and Their Caregivers: State of the Art
- Selecting Outcomes to Ensure Pragmatic Trials Are Relevant to People Living with Dementia
- Engaging Stakeholders in the Design and Conduct of Embedded Pragmatic Clinical Trials for Alzheimer’s Disease and Alzheimer’s Disease–Related Dementias
- Statistical Considerations for Embedded Pragmatic Clinical Trials in People Living with Dementia
Covid-19 Among Older Persons in Health Care Systems: Pragmatic Responses to the Crisis
June 2020 – In this Special Grand Rounds, Drs. Lipsitz, Rudolph, and White discuss their ongoing projects to meet the unique challenges COVID-19 presents managing care of older persons.
Lewis Lipsitz, MD
Marcus Institute for Aging Research
Hebrew SeniorLife
James Rudolph, MD
Brown University
Elizabeth White, PhD, ARPN
Brown University
Learning Objectives
- Describe key ethical issues raised by pragmatic RCTs and which may be particularly salient to the ADRD context
- Describe the challenges of identifying a sample of pragmatic RCTs from the literature
- Describe the landscape of key ethical issues in published pragmatic RCTs in ADRD
COVID-19 in Nursing Homes: Pragmatic Research Responses to the Crisis
May 2020 – In this Special Grand Rounds, Drs. Grabowski, Mitchell, and Mor, experts in dementia care and pragmatic clinical trials, provide an update on how COVID-19 is impacting nursing homes and to share preliminary data for research related to COVID-19.
Professor of Health Care Policy
Department of Health Care Policy, Harvard Medical School
Principal Investigator, Administration & Management Core (AC)
Member, Steering Committee
Senior Scientist, Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research
Professor of Medicine, Harvard Medical School
Faculty, Division of Geriatrics, Beth Israel Deaconess Medical Center
Learning Objectives
- Learn about impact of COVID-19 in U.S nursing homes
- Gain knowledge about rapid pragmatic research approaches in response to the crisis in health care systems
• Hebrew SeniorLife
• Genesis Health Care
• Bluestone