Johns Hopkins Bloomberg School of Public Health
Engaging and Integrating Direct Care Workers in Care Delivery for PLWD in the Community
Dr. Fabius is an assistant professor in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health. Dr. Fabius a gerontologist and health services researcher whose work informs aging and disability policies to reduce health care disparities and improve health equity for older adults and people with disabilities using long-term services and supports. Her current research focuses on strengthening the direct care workforce that provides services and supports to vulnerable older adults living in the community, such as those with complex conditions like dementia. Dr. Fabius’ interests are informed by her applied care management experience, where she helped older adults remain at home and delay the need for nursing home care.
Direct care workers are paid health care professionals who provide hands on assistance with daily activities to people with disabilities. Direct care workers often work alongside family and unpaid care partners to support people living with dementia (PLWD) in the community. Despite direct care workers being well positioned to recognize and report changes in function and behaviors, they are frequently excluded from interdisciplinary clinical care teams, which may detract from care quality and health outcomes. Embedded pragmatic clinical trials offer a promising approach to test strategies to better engage and integrate direct care workers in the care of PLWD, though the feasibility and effect will vary by care delivery setting. The Career Development Award will provide Dr. Fabius with necessary training in dementia, dementia caregiving, medical communication, and pragmatic clinical trial design to become an independent investigator conducting high-impact embedded pragmatic clinical trials directed at testing policies and programs to better support direct care workers and improve quality of care among those receiving services, including PLWD and their family care partners. The training will support the following Specific Aims: (1) To elucidate barriers and opportunities to purposefully engage and integrate direct care workers in the care of PLWD in the community, and (2) To assess potential care delivery settings and partnerships for embedding a pragmatic clinical trial to more effectively engage and integrate direct care workers in the care of PLWD in the community.