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IMPACT-C team shares findings on study of vaccine hesitancy in frontline nursing home staff

Posted on by Sonya Sutton

The IMPACT-C supplement award recently shared the results of their “town hall” style discussions with frontline nursing home staff in a journal article and podcast.

The findings were shared in the Journal of the American Geriatrics Society on March 25th. The study included one hundred and ninety three staff from 50 facilities who participated in 26 meetings between December 30, 2020 and January 15, 2021. Most staff reported getting information about the vaccine from friends or social media. Concerns about how rapidly the vaccines were developed and side effects, including infertility or pregnancy related concerns, were frequently raised. There were no differences in concerns raised by discipline. Questions about returning to prior activities after being vaccinated were common and offered the opportunity to build on positive emotions to reduce vaccine hesitancy.

IMPACT-C study team members Sarah Berry, Kimberly Johnson, and David Gifford also discussed the research on the March 25th GeriPal Podcast.  The podcast discussion was around the devastating impact of COVID on nursing homes and the effects and update rates of vaccine among patients and staff in nursing home.

Click here to read the full journal article.

Click here to listen to the podcast.

Grand Rounds 14- March 2021

Update on Two IMPACT Funded Pilot Studies

Posted on by Erin Luers

March 2021 – In Grand Rounds 15, Drs. Forester and Hwang share experiences as Pilot Cycle 1 awardees and provide updates to their funded pilot studies.

Brent P. Forester, MD, MSc on his pilot: Implementation of the Care Ecosystem training model for individuals with dementia in a high risk, integrated care management program

Ula Hwang, MD, MPH on her pilot: Pathway to Detection & Differentiation of Delirium & Dementia in the Emergency Department

Speakers

Brent P. Forester, MD, MSc

Brent P. Forester, MD, MSc
Chief, Center of Excellence in Geriatric Psychiatry, McLean Hospital Medical
Director, Behavioral Health Integration, Quality, and Patient Experience, Mass General Brigham

Ula Hwang, MD, MPH

Ula Hwang, MD, MPH
Professor, Vice Chair for Research, Department of Emergency Medicine
Yale School of Medicine


Download Webinar Slides

Podcast

 

Podcast Transcript: Download the transcript here.

Learning Objectives

Dr. Forester:

  • To understand the rationale and design of our adaptation of the Care Ecosystem model to train nurse case managers to deliver telephone-based collaborative dementia care.
  • To appreciate the successes and challenges encountered in stakeholder engagement, adaptation of the Care Ecosystem training program and implementation of the model.
  • To describe updates on pilot progress to date and plans for a larger embedded pragmatic clinical trial.

Dr. Hwang:

  • To describe the Pathway to Detection & Differentiation of Delirium & Dementia in the Emergency Department (PD4ED) pilot.
  • To share challenges and solutions of implementation with an embedded pragmatic trial (during a pandemic and institution move).
  • To provide updates on the status of the PD4ED pilot study implementation.

 

Podcast 14: Ethical challenges with pragmatic RCTs: General issues and special considerations in dementia

Posted on by Sonya Sutton

link to brody profileStuart Nicholls, PhD, from the Clinical Epidemiology Program at the Ottawa Hospital Research Institute, continues the discussion from his February 18 Grand Rounds presentation. This discussion with IMPACT Principal Investigator Susan Mitchell, MD, MPH answers questions from Dr. Nicholls's presentation on giving an overview of ethical issues raised by pragmatic randomized controlled trials (RCTs) and which derive from ongoing work to develop guidance for those designing and conducting pragmatic RCTs.

 

 

Want to hear more? View the full Grand Rounds presentation.

For alerts about new episodes, subscribe free on iTunes or SoundCloud.

IMPACT Collaboratory Funds Four Pilot Study Awards

Posted on by Sonya Sutton

The NIA IMPACT Collaboratory is happy to announce the recipients of its second cycle (2A) of the IMPACT Pilot Grant award program. Recipients were selected from an impressive group of competitive applications.

IMPACT Collaboratory Pilot Grant Award Recipients (RFA 2020)

Joan Carpenter, PhD, CRNP, University of Maryland School of Nursing

Implementation of a Telehealth Palliative Care Model for Persons with Dementia

Richard Fortinsky, PhD, University of Connecticut Health Center

Pilot Pragmatic Clinical Trial to Embed Tele-Savvy into Health Care Systems

Jennifer Gabbard, MD, Wake Forest School of Medicine

Using Telemedicine to Improve Engagement in Advance Care Planning in Patients with Cognitive Impairment or Unrecognized Dementia

Ariel Green, MD, MPH, PhD, Johns Hopkins University School of Medicine

ALIGN: Aligning Medications with What Matters Most

Additional details on these recipients and their pilot studies can be found on Pilot Grants Awardees Page at this link.

About the IMPACT Pilot Grant Program

The IMPACT Collaboratory funds several one-year pilot studies annually, which are meant to generate the preliminary data necessary to design and conduct future full-scale, stage 4 effectiveness ePCTs funded through other grant mechanisms. Awards are for single Principal Investigator applications for one year and are non-renewable. In response to the coronavirus disease (COVID-2019) outbreak, in this award cycle, the IMPACT Collaboratory prioritized applications proposing pilot ePCTs of telemedicine, telehealth, and remote technologies interventions aimed at improving the health care, unmet needs, quality of life, and/or health outcomes for people living with AD/ADRD and their care partners. The IMPACT Collaboratory encourages applications that address dementia care for people of all backgrounds and promote health equity.

Currently Accepting Applications for 2021 IMPACT Pilot Grant Program

Award applications for the current awards cycle opened February 1, 2021. The application process is a 2-step competitive process. The first step, a mandatory LOI, is due no later than Friday, March 5, 2021.  Selected investigators will be invited to submit a full application.

Ethical challenges with pragmatic RCTs: General issues and special considerations in dementia

Posted on by Sonya Sutton

February 2021 – In Grand Rounds 14, Dr. Nicholls provides an overview of ethical issues raised by pragmatic randomized controlled trials (RCTs), outlines challenges in conducting empirical studies of the published literature, and provides preliminary data on the reporting of key ethical issues in published pragmatic RCTs in AD/ADRD.

Speaker

Stuart G. Nicholls, PhD

Stuart G. Nicholls, PhD
Ottawa Health Research Institute

Watch the Webinar

Webinar Slides

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

Podcast

IMPACT Collaboratory featured in New York Times opinion piece on effects of COVID-19 on people living with dementia with quotes from Harrison, Karlawish, and Berry

Posted on by Erin Luers

The NIA IMPACT Collaboratory has been featured in a New York Times opinion piece about the effects of COVID-19 restrictions on people living with dementia and their caregivers. Jill Harrison, PhD, Executive Director of the IMPACT Collaboratory, and Jason Karlawish, MD, the leader of the Ethics & Regulation Core are quoted, as is Sarah Berry, MD, MPH, the multiple PI of IMPACT-C, a COVID-19 supplement to the IMPACT Collaboratory. Dr. Harrison’s quote “We are Going to Keep you Safe, Even if It Kills Your Spirit” serves as the title.

“Dr. Karlawish thinks that blanket bans on dementia caregivers are akin to taking away a wheelchair from a person with physical disabilities. ‘And that’s a brutal metaphor,’ he said. ‘But all of a sudden, the people who would come there and help their minds function were taken away.’ Some geriatricians describe this separation as unfortunate and damaging, but necessary. Others believe that we should have allowed for a gentler nursing home quarantine, one that recognizes caregivers as ‘essential’ parts of dementia health care.

Jill Harrison, an executive director of the National Institute on Aging’s IMPACT Collaboratory, thinks the instinct to lock everything down reflects a broader tendency in dementia care to prioritize physical safety above all else… ‘I always call it surplus safety,’ Dr. Harrison told me. ‘It’s essentially like, we are going to keep you safe, even if it kills your spirit.’”

Read the full piece here.

IMPACT Collaboratory announces three new funding opportunities

Posted on by Sonya Sutton

The NIA IMPACT Collaboratory is pleased to announce three new funding opportunities; Pilot Grants Cycle 3A, and funding opportunities for two new programs, Demonstration Projects and Health Care Systems (HCS) Scholars . These three funding opportunities will support research and training aimed at increasing the nation’s capacity to conduct pragmatic clinical trials (ePCTs) of non-pharmacological interventions within health care systems to improve the care of people living with Alzheimer's disease and related dementias (AD/ADRD) and their care partners.

Demonstration Projects Program

The IMPACT Collaboratory will fund up to two Demonstration Projects (maximum duration 24 months) designed as full-scale, Stage IV effectiveness ePCT (based on the NIH Stage Model) that test non-pharmacological interventions for people living with AD/ADRD and their care partners embedded within and linked to the needs of a health care system. The goal of the Demonstration Projects is to generate evidence on effective care delivery practices that can be expanded and/or implemented in other systems. Interventions must be linked to the needs of a health care system. The intervention will typically encompass relatively simple system changes or direct patient outreach, or successfully piloted programs ready for testing at scale. Preference will be given to applications for Demonstration Projects that address dementia care for populations traditionally marginalized or underrepresented in clinical trials and those that promote health equity.

HCS Scholars Program

The new Health Care Systems (HCS) Embedded Research Scholars Program offers junior and senior investigators an opportunity to work directly with health care systems interested in improving the care provided to people living with dementia (PLWD) and their care partners. The goals of the HCS Scholars Program are to embed investigators in health care systems to:

  • Establish mutually beneficial partnerships to improve the care of PLWD and care partners
  • Train investigators about health care settings needs and how new programs are successfully introduced at all levels of the organization
  • Engage HCS in learning more about what it means to conduct ePCTs and provide resources for understanding opportunities for improvement in dementia care or evaluation of related quality improvement projects
  • Strengthen collaborations between investigators and HCS that may lead to pilot studies or demonstration projects.

Pilot Grant Program –Cycle 3A

The IMPACT Collaboratory funds several one-year pilot studies annually; these are meant to generate the preliminary data necessary to design and conduct a future full-scale Stage IV effectiveness ePCT (based on the NIH Stage Model) funded through other grant mechanisms (National Institutes of Health or other sources). The IMPACT Collaboratory will consider applications for pilot ePCTs that test non-pharmacological interventions embedded in health care system(s) for people living with AD/ADRD and their care partners. All applications should make a convincing case that the pilot ePCT proposed can be scaled up to a full-scale, Stage IV effectiveness ePCT as the next step.

Please check upcoming events for webinars for each opportunity, as well as the IMPACT Twitter feed and mailing list for additional updates.

Implementation in ongoing ADRD ePCTS in different health care settings using real examples

Posted on by Sonya Sutton

January 2021 – Ground Rounds 13, features Drs. Brody, McCreedy, and Colburn providing examples of ongoing implementation of ePCTs within health care systems for people with AD/ADRD followed by a response from Dr. Mittman, a prominent scientist with expertise in implementation of complex interventions in health care systems.

Webinar Slides

Webinar Recording

Ab Brody, PhD, RN, FAAN

Ab Brody, PhD, RN, FAAN

Core Leader, Pilot Studies Core
Member, Steering Committee

Associate Professor of Nursing and Medicine, New York University Rory Meyers College of Nursing
Associate Director, Hartford Institute for Geriatric Nursing
Founder, Aliviado Health

Ellen McCreedy, PhD, MPH

Ellen McCreedy, PhD, MPH

Executive Committee, Technical Data Core

Assistant Professor, Brown University School of Public Health

Jessica Colburn, MD

Jessica Colburn, MD

Johns Hopkins University School of Medicine

Implementation Workgroup Lead

 

Learning Objectives

  • Understand the implementation strategies used in 3 pragmatic clinical trials among persons living with dementia
  • Gain knowledge about implementation barriers and facilitators of complex interventions in pragmatic trials
  • Apply a novel framework to promote complex health intervention implementation in health care systems

 

Podcast