Currently Funded Research Projects

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Advance Planning for Home Services for Seniors
Patient Centered Outcomes Research Institute (PCORI) funded Study.
Partnership with Northwestern University

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Background: Remaining in their own home is one of the highest priorities of most seniors. Seniors often do not have an understanding of home care services. Likewise, seniors do not understand their health trajectory or plan accurately for future needs, which lead to them not remaining safely in their homes as long as they could. Seniors rarely believe that they will be hospitalized, although people aged 65 years account for 35% of hospitalizations annually. As a result of hospitalizations, seniors experience functional decline with placement in nursing homes. Seniors are often left out of critical decision making on their long-term care. Stressed family members choose nursing facilities while the senior is hospitalized and, in many cases, make decisions to move seniors out of their homes. If seniors and their families understand home care services and plan for health events (e.g., hospitalizations, functional loss), then seniors could potentially remain safely in their homes longer. The goal of this proposal is to develop and test an advance planning tool to help seniors understand projected health needs and plan ways to remain in their own homes when these crises occur.

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Aims:

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Aim 1: Develop, pilot test, and refine an Advanced Planning for Home Services (APHS) Tool to assist seniors in making informed choices about issues in their health trajectory that influence their ability to remain in their own home.

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Aim 2: Conduct a randomized controlled trial of the APHS Tool intervention to determine subject understanding of home care services and health trajectory and other patient-centered outcomes.

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Aim 3: Disseminate the APHS Tool nationally through senior focused organizations (Home Care Association of America, Village to Village Network).

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Collaborative Goal Setting for Diabetes
The University of Iowa, College of Nursing funded pilot project
Partnership with UI College of Nursing

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Background: Patient self-management plays an important role in preventing adverse clinical outcomes from diabetes. Because goal setting with, and follow-up support from, health care providers increases patients’ self-efficacy and motivation toward developing and maintaining self-management behaviors4-6, collaborative goal setting (CGS) is a key element of diabetes self-management education curricula1 and chronic illness care quality measures. However, while education and ongoing support for patients with diabetes usually occurs during primary care visits, research has yet to establish whether there is any benefit to having primary care providers (PCPs) involved in the CGS process.

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Aims:

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Aim 1: Determine the feasibility of PCP reinforcement in the CGS process.

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Aim 2: Obtain data to estimate effects of PCP reinforcement on outcomes of patients receiving CGS intervention and determine sample size for a future study. Using an experimental trial with repeated measures with up to 100 patients with diabetes, this study will determine whether the effectiveness of the model most commonly adopted for delivering CGS (i.e., nurse care coordinators via a call center) is improved when PCPs reinforce patients’ health goals. Data analysis will rely on descriptive analyses and linear mixed modeling for repeated measures. Results of this study will be used to inform translational efforts and resource allocation in primary care settings regarding how to integrate CGS into the care they provide patients with diabetes.

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Pending Proposals & Projects

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Preservation of mobility in rural older adults through exercise (the PROMOTE study)
National Institute on Aging (NIA):
Partnership with Tufts University, Boston

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5 year randomized control trial to translate an evidence-based exercise intervention that has been shown to improve mobility in older adults with chronic conditions.

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Collaborative Goal Setting for Diabetes
National Nursing Research Institute (NINR):
Partnership with University of Iowa, College of Nursing

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5 year randomized control trial builds on the work of the pilot study listed above.