Community-Academic Aging Research Network

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Community-Academic Aging Research Network

• Jane Mahoney, MD

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Demographic Imperative

• Population of older adults in the United States
  is expected to nearly double in size over the
  next 25 years.
• The burden of disease and medical costs of caring
  for older adults are expected to rise sharply
  over the next two decades.
• The Institute of Medicine stated in 2008 that
  there is a nationwide lack of preparedness to
  meet the health care needs of aging boomers .

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Wisconsins Graying Counties
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Wisconsins Graying Counties
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Challenges for Improving Health

• The average American receives only 55 of
  recommended prevention and healthcare services
  larger gaps for poor and minority persons.
• Almost 40 billion in Medicare spending for the
  chronically ill is unnecessary.
• On average, it takes 17 years for 40 of
  knowledge from research to be translated into
  practice.
• Slide courtesy of Maureen Smith, ICTR-CAP

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RFA R24, NIH 2010

• This NIH Funding Opportunity Announcement (FOA)
  solicits applications to support the development
  of infrastructures needed to facilitate
  collaboration between academic health centers and
  community-based organizations for health science
  research.
• Such collaboration should transform the way in
  which health science research is conducted in
  communities, and accelerate the pace,
  productivity, dissemination, and implementation
  of health research.

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RFA cont

• NIH recognizes that communities must be
  actively engaged in the research enterprise,
  including
• formulating research questions, designing, and
  conducting research
• Translating and applying research findings to
  community-based practice and public health
  initiatives
• using research-generated evidence to support
  public health policy decisions.

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Building Wisconsins Infrastructure for
Community-Academic Aging Research

• State of Wisconsin Aging Network as community
  partner
• Building on history of partnering in research and
  dissemination
• Priorities based on State Public Health Plan,
  State Aging Plan, and UW research strengths
• Falls, physical activity and musculoskeletal
  health, dementia, chronic disease management

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History of partnering in research and
dissemination falls

• Pilot to assess feasibility of multifactorial
  falls intervention. 2001
• RCT of multifactorial falls intervention with
  Kenosha County. 2001-4
• Wisconsin Partnership Program Grant to
  disseminate evidence-based falls interventions
  2005-8
• Stepping On dissemination grants from AoA and
  CDC, 2006-10
• CDC grant to Mahoney Dissemination research in
  Stepping On, 2007-12

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Impact

• Stepping On in 40 of 72 counties in WI
• Over 3000 older adults enrolled
• 50 reduction in falls pre-post
• Package developed for national dissemination
• Now providing training for 12 other states
• Creation of Wisconsin Institute for Healthy Aging
  to house Wisconsins EBPP

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History of Partnering Chronic Disease
Self-Management Program

• Introduced CDSMP (evidence-based from Stanford)
  through State of Wisconsin funding 2003-5
• Disseminated CDSMP across Wisconsin, CDC and AoA
  funding 2006-12.
• Impact
• Over 3000 people enrolled in workshops
• Leaders available in 80 of Wisconsin counties

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Aging Network

• Federal funding for titled services through
  Older Americans Act, PLUS
• State funding through Elders Act, in Wisconsin
  Statute
• Services
• Supportive (legal, financial, information and
  assistance)
• Congregate and home delivered nutrition
• Health promotion programs
• Caregiver support

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Aging Network Overview
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Stages of partnerships supported by CAARN
CAARN Executive Committee Community Academic
State

• CAARN Activities
• Training
• Networking
• Infrastructure
• Resources
• Pilot funding
• Evaluation

Stages of Partnership by Maureen Smith
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Community-Academic Research Partnership
Theoretical model

• Integrative, interactive model of knowledge
  translation
• Integrative must fit in problem-solving cycle
  of each partner
• Interactive dynamic process of research design
  and conduct
• Chunharas, WHO Bulletin, 2006

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Current Status

• 11 active projects
• 8 funded
• 3 match made and discussions occurring, plans to
  apply for funding

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Research projects

• Medication management and falls prevention in
  community setting
• Increasing older adults ability to communicate
  with pharmacists
• Bone health small group program to decrease
  presence of risk factors for bone loss
• Dissemination research on functional balance and
  strength program to decrease falls
• Well-being small group therapy in senior centers
• Technology and older adults (multiple projects)
• Increasing community uptake of evidence-based
  programs for older adults
• Improving screening for cognitive impairment
  among African Americans

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• CAARN Projects
• Funded (blue)
• Active project planning (brown)

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Match with aging unit

• Aging Units assessment of need
• Aging Units readiness to engage in research
• Past history of research
• Strong history of academic collaboration
• Local capacity for recruiting seniors, providing
  oversight, etc.
• Fit with research topic (demographics, etc)

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Areas of need identified by Aging Network focus
group

• Falls
• Talking with your doctor
• Bone health
• Medication management
• Caregiver support to manage health of older adult
  with dementia.
• Mental health

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Research Gap is it closing?
Academic
Cross-sectional
Prospective
Pilot intervention
Randomized trial
Dissemination Research
Community
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Community Advisory Board Concerns How to Address

• Helicopter researcher
• Hidden costs
• Research constraints overwhelming

• Long term commitment
• Provide results
• informed consent to partner in research
• Start with the goal
• Simplify explanations

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Challenges and Successes
Challenges Strategies for Success
Educating partners 11 education, presentations
Facilitating long-term relationship Frequent and regular contact
Selecting community partners Application and selection process
Prioritizing Executive Committee prioritization tool
Finding partners Use Aging Network partnership, build on good name
Assisting in design of effective health behavior change interventions Hired Researcher/Community Health Program Developer
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Long-term goal

• Develop a sustainable Community-Academic Aging
  Research Network to facilitate partnerships
  between University of Wisconsin researchers and
  State of Wisconsin aging network
• in order to expand and accelerate transformation
  of aging research into practice in community
  settings.

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Thank you

• ICTR-CAP
• Dept of Medicine
• Dr. Sanjay Asthana, Head of Geriatrics Division
• Gail Schwersenska, DHS Office on Aging
• John Schnabl, GWAAR New Programs Director
• Jill Ballard, Community Research Associate,
  CAARN, and Health Promotion Team, GWAAR
• CAARN Team
• Vicki Gobel
• Karen Kedrowski
• Rachel Smedley
• Kathy Purcell

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Questions

• What made it work?
• Were there any surprises?  good or challenging
• What are the lessons you learned from this
  partnership?