Abstract

ThisproposedK24combinesmentoringtotrainthenextgenerationofpatient-orientedinvestigatorsin geriatricemergencycareresearch,careerdevelopmentinmentoringandimplementationscience,and researchtotranslatetheinnovativemodelofcommunityparamedicinetopractice,therebyprovidingsupportto community-dwellingpatientswithAlzheimer?sDisease(AD)andtheircaregivers. ThePI,Dr.ManishShah,isaleadinggeriatricemergencycareresearcherwitharecordofdeveloping andtestingnovelmodelsofcommunity-basedcaretoimprovethehealthofacutelyillolderadults.Hiswork hasenhancedacuteillnesscareforolderadultsaswellasidentifyingandaddressingolderadults?medicaland psychosocialneedsusingcommunity-basedparamedics,amodelnowcalled?communityparamedicine.?The nextstepofthiswork,reflectedinthescientificaimsofthisproposal,istorefinethecommunityparamedicine modelofcaretosupportcommunity-dwellingpatientswithADandtheircaregivers,amongthemostvulnerable olderadultpopulations.ThisworkwillbuildonhisNIA-fundedR01testingtheeffectivenessofparamedicsto supportcaretransitionsanddecreaseemergencydepartment(ED)visitsthroughmotivationalinterviewing, coaching,education,andin-homecare.UsingtheReplicatingEffectiveProgramsandRE-AIMframeworks,he willrefine,implement,andpilottestaspecificcommunityparamedicineprogramforpatientswithADthat includessimilarinterventionstopreventEDvisitsanddeliveracuteillnesscareinpatients?homes. Dr.Shahisalsoasoughtaftermentorfordevelopingresearchers.Hewillusethisawardtobuilda robustpipelineofagingresearchersfocusedonimprovingacuteillnesscareforvulnerableolderadults.This proposaltakesadvantageofexceptionalresourcesatUW,includingthesuccessfulCTSA,whichiscommitted tomentoring,teamscience,implementationscience,theKL-2program(Dr.ShahisAssistantDirector), numerouspotentialmentees,andoneoftheleadingagingresearchprograms.Thisawardwouldprovidethe releasetimetobuildtheformalmentoringprogramandmentoraninitialcohortofpatient-orientedresearchers. Uponcompletionofthisaward,Dr.Shahwillhavedevelopedarobustplatformtomentoradiversepool ofpatient-orientedresearchers,acquiredadditionalknowledgeandskillstoexpandhisresearchtopatients withAD,andhelpedadvanceresearchintheemergingfieldofgeriatricemergencymedicine.Finally,hewillbe well-positionedtocompetefornewR01-levelawardstoperformhybrideffectiveness-implementationstudiesto definitivelytestthisapplicationofcommunityparamedicineforolderadultswithAD.

Public Health Relevance

Theemergencydepartment(ED)isacommonsourceofacuteillnesscareforolderadults,particularlythe mostvulnerableindividualssuchasthosewithAlzheimer?sDiseaseorwithbarrierstoaccessingprimarycare. Unfortunately,evidencesuggeststhatupto25%ofvisitscouldbepreventedandtheEDisasuboptimalplace forolderadultstoobtaincareforminorillnesses.Throughthisaward,Dr.Shahproposestoenhancehis researchandmentoringskillsandleverageextensiveUniversityofWisconsinresourcesto:1)developarobust platformtomentoradiversepoolofpatient-oriented,geriatricemergencycareresearchersand2)usethe principlesofimplementationsciencetorefineandpilottestthecommunityparamedicinemodelofcareto benefitcommunity-dwellingolderadultswithAlzheimer?sDiseaseandtheircaregivers.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AG054560-04
Application #
9934967
Study Section
Behavior and Social Science of Aging Review Committee (NIA)
Program Officer
Radziszewska, Barbara
Project Start
2017-06-15
Project End
2022-05-31
Budget Start
2020-06-01
Budget End
2021-05-31
Support Year
4
Fiscal Year
2020
Total Cost
Indirect Cost

  Institution

Name
University of Wisconsin Madison
Department
Emergency Medicine
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715

  Publications

Rosen, Tony; Shah, Manish; Lundebjerg, Nancy E et al. (2018) Impact of Jahnigen/GEMSSTAR Scholarships on Careers of Recipients in Emergency Medicine and on Development of Geriatric Emergency Medicine. Acad Emerg Med :
Patterson, Brian W; Repplinger, Michael D; Pulia, Michael S et al. (2018) Using the Hendrich II Inpatient Fall Risk Screen to Predict Outpatient Falls After Emergency Department Visits. J Am Geriatr Soc 66:760-765
Pulia, Michael; Kern, Michael; Schwei, Rebecca J et al. (2018) Comparing appropriateness of antibiotics for nursing home residents by setting of prescription initiation: a cross-sectional analysis. Antimicrob Resist Infect Control 7:74
Pulia, Michael S; Schwei, Rebecca J; Patterson, Brian W et al. (2018) Effectiveness of Outpatient Antibiotics After Surgical Drainage of Abscesses in Reducing Treatment Failure. J Emerg Med 55:512-521
Repplinger, Michael D; Bracken, Rebecca L; Patterson, Brian W et al. (2018) Downstream Imaging Utilization After MR Angiography Versus CT Angiography for the Initial Evaluation of Pulmonary Embolism. J Am Coll Radiol 15:1692-1697
Lau, Hunter Singh; Hollander, Matthew M; Cushman, Jeremy T et al. (2018) Qualitative Evaluation of the Coach Training within a Community Paramedicine Care Transitions Intervention. Prehosp Emerg Care 22:527-534
Bessey, Laurel J; Radue, Rebecca M; Chapman, Elizabeth N et al. (2018) Behavioral Health Needs of Older Adults in the Emergency Department. Clin Geriatr Med 34:469-489