PROJECT SUMMARY
Dr. Chanee Fabius is an Assistant Professor in the Department of Health Policy and Management at
the Johns Hopkins Bloomberg School of Public Health. Her career goal is to become an independent
investigator conducting high-impact embedded pragmatic clinical trials (ePCTs) directed at testing
interventions, policies and programs in real world settings to better support the home care workforce and
improve care quality and quality of life among those receiving services, including persons living with
Alzheimer’s Disease and related dementias (ADRD) and their family caregivers. This award will provide her
with the protected time and learning experiences to obtain the knowledge, skills, and capability to develop
ePCTs and translate findings into routine home care delivery. Dr. Fabius’s career development award
proposes five years of training in mixed methods, human factors approaches in home care research, and
applied experiences developing and conducting ePCTs. Dr. Fabius has assembled a stellar mentorship team
and advisory panel with expertise in the areas of her proposed training goals.
As a result of disease progression, high care needs, and limited financial resources, persons living with
ADRD often receive Medicaid Home and Community-Based Services, delivered by home care aides proving
hands on assistance with daily activities. Family caregivers and home care aides interact to provide care for
older adults, but their relationship is often fraught due to gaps in information, misalignment of role expectations,
and lack of shared understanding of each other’s roles in home care. The proposed K01 will: (1) leverage
nationally representative data to determine how role sharing between family caregivers and home care aides
differs among Medicare-Medicaid enrolled home care recipients with and without ADRD, and is associated with
older adults’ participation restrictions; (2) conduct a qualitative study to develop and refine a home care role
and preference guide to improve information sharing and clarify role expectations between family caregivers
and home care aides caring for older Medicaid HCBS recipients living with ADRD; (3) assess the feasibility and
acceptability of delivering a home care role and preference guide to family caregivers of older adults living with
ADRD and home care aides. The intervention will be piloted in up to five agencies within 10 triads of older
adults living with ADRD, family caregivers, and home care aides. The proposed work is aligned with recent
policy and research recommendations calling for interventions that support quality of life for older adults living
with ADRD, family caregivers, and home care aides. Findings will support the development and submission of
an R01 grant proposal to implement and test an ePCT in Medicaid HCBS to assess the effects of the role and
preference guide and quality of life outcomes for older adults, family caregivers, and home care aides.