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Leveraging mobile health technology to reduce avoidable healthcare utilization in persons with Alzheimer's Disease and Related Dementias in adult day centers

Award Number: K23AG071948
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 06/01/2021
PERIOD OF PERFORMANCE END DATE: 03/31/2027

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Leveraging mobile health technology to reduce avoidable healthcare utilization in persons with Alzheimer's Disease and Related Dementias in adult day centers - Project Summary. Community-dwelling persons living with dementia (PLWD) are highly susceptible to avoida- ble emergency department (ED) visits and hospitalizations. Adult day service centers (ADCs) provide commu- nity-based care to a growing number of racially diverse PLWD, the majority of whom are low-income. Daily as- sessment and serial observations by an ADC’s interdisciplinary staff (which includes registered nurses, social workers, and program directors) support early detection of clinical problems in PLWD. However, when acute changes in health status occur, ADC staff who wish to provide timely notification to primary care providers (PCPs) frequently cannot do so effectively. In my prior research, I found that ADC staff relied on facsimile or voicemail message to communicate urgent information. This resulted in delayed or non-responses from PCPs and allowed minor health issues to escalate into medical emergencies. As the number of PLWD in ADCs grows, there is a critical need to strengthen communication of salient clinical information between ADCs, PCPs, and caregivers to reduce costly hospitalizations and ED visits. Mobile health (mHealth) interventions have been shown to improve communication and clinical information exchange across a variety of health care settings, but they have not been designed for ADCs. My goal in seeking a K23 award is to become an inde- pendent scientist who leads a research program that integrates care from ADCs and PCPs using mHealth in- terventions to reduce avoidable health care utilization disparities in PLWD. With support from an experienced interdisciplinary mentorship team, I will acquire training in three areas: using integrated health systems to ad- dress health care utilization disparities, developing mHealth interventions using user-centered design princi- ples, and designing and testing behavioral interventions. With the requisite training, I will execute the following specific aims: (1) identify the key domains of an mHealth application intended to support communication be- tween ADCs, PCPs, and informal caregivers regarding the health-related needs of PLWD; (2) design and test the visual layout of an mHealth application intended to support communication between ADCs, PCPs, and in- formal caregivers of PLWD; and (3) develop and examine the feasibility and acceptability of mHealth applica- tion use among ADC staff, PCPs, and informal caregivers in reducing hospitalizations and ED visits in PLWD over a 6-month period. My findings will inform a future R01 proposal to test the efficacy of an intervention using a fully operational mHealth application. This study is significant because the findings will be used to improve standards of care and reduce costly and traumatic outcomes in PLWD. It also advances legislation from the Office of the National Coordinator for Health Information Technology requiring that patients be able to access information from their medical records using their preferred smartphone application. This study is innovative because it leverages ADCs’ strengths and incorporates frontline provider perspectives to inform the develop- ment of a pragmatic user-centered mHealth application to integrate care and reduce disparities in PLWD.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2025	NEW YORK UNIVERSITY	70 WASHINGTON SQ S FL 11	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	5	2/11/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $270,000 )
2025	2025	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	5	7/16/2025	NON-COMPETING CONTINUATION	$194,400
2025	2025	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	001	5	7/30/2025	SUPPLEMENT FOR EXPANSION	$75,600
														Subtotal = $270,000

Issue Date FY: 2024 ( Subtotal = $194,400 )
2024	2024	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	4	4/12/2024	NON-COMPETING CONTINUATION	$194,400
														Subtotal = $194,400

Issue Date FY: 2023 ( Subtotal = $246,224 )
2023	2023	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	3	4/21/2023	NON-COMPETING CONTINUATION	$246,224
														Subtotal = $246,224

Issue Date FY: 2022 ( Subtotal = $219,224 )
2022	2022	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	2	4/11/2022	NON-COMPETING CONTINUATION	$167,400
2022	2022	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	001	2	8/23/2022	SUPPLEMENT FOR EXPANSION	$51,824
														Subtotal = $219,224

Issue Date FY: 2021 ( Subtotal = $167,400 )
2021	2021	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	1	5/31/2021	NEW	$167,400
														Subtotal = $167,400

Grand Total All Awards = $1,097,248

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Leveraging mobile health technology to reduce avoidable healthcare utilization in persons with Alzheimer's Disease and Related Dementias in adult day centers

Award Number: K23AG071948

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 06/01/2021

PERIOD OF PERFORMANCE END DATE: 03/31/2027

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