Current Projects

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Predicting COVID Outbreaks in Ohio Nursing Homes

The Ohio State University, pass through funds from the Ohio Department of Health and the US Department of Treasury
Principal Investigator: Robert Applebaum
December 8, 2020 through June 30, 2021

This project will assemble data to develop a model to predict COVID 19 outbreaks in Ohio nursing homes. The project will combine data from an array of sources including CMS COVID web-site, Nursing Home Compare, Nursing Home Minimum Data Set, Medicaid and Medicare Cost Reports, and internal data collected by the Ohio Department of Health. In addition to helping to compile the data set, Scripps researchers will assist in building the model and in interpreting results.


Expansion of Dementia-Capable Communities Within Urban and Rural Settings in Ohio Using Evidence-Based and Informed Programming

Benjamin Rose Institute on Aging
Principal Investigator: Jennifer Heston-Mullins
October 1, 2020 through July 30, 2023

This project will evaluate interventions to increase community dementia capability and improve outcomes for community-dwelling individuals diagnosed with Alzheimer’s Disease and related dementias (ADRD), those at risk of developing ADRD, and their caregivers.


Population Survey of Greene County, Ohio: Older Residents' Perceptions of the Age-Friendliness of Their Communities and Desired Senior Center Programming

Greene County Council on Aging
Principal Investigator: Sara McLaughlin
January 1, 2021 through December 31, 2021

Age-friendly communities promote healthy and active aging. Given its growing older population, fostering age-friendly communities throughout Greene County, Ohio is an important goal. To that end, we will conduct a population survey of older Greene County residents. The primary objective of the survey is to gain an understanding of (1) older residents’ perceptions of the age-friendliness of their communities and (2) the kinds of programs they would like their local senior centers, which play a vital role in helping older adults remain actively engaged, to offer residents. The insights gained from this survey will serve to inform policy and programming aimed at building age-friendly communities throughout Greene County.


The Impact of Person-Centered Care on Nursing Home Quality

The Donaghue Foundation
Principal Investigator: Katherine Abbott
December 1, 2020 - November 30, 2022

In 2015, the Ohio Department of Medicaid mandated that all Medicaid certified nursing homes (NH)s use the Preferences for Everyday Living Inventory (PELI) to enhance person-centered care. The PELI is a valid and reliable evidenced-based tool that providers can use to learn about an individual’s most important preferences and integrate the information into personalize-care plans to improve the quality of care. However, there is a lack of evidence on whether using the PELI improves outcomes that are important to NH communities. The goal of this proposal is to use data collected from six different sources to explore the impact of the state-wide initiative. We seek funding for longitudinal analyses (i.e., multi-level modeling) regarding three key questions:

  1. Resident and Family Satisfaction.  Is provider use of the PELI a predictor of resident and family satisfaction? 
  2. Clinical and Care Process Outcomes.  Is provider use of the PELI a predictor of clinical (e.g., pressure ulcers, falls) and care process outcomes (e.g., physical restraints, antipsychotic medication use)?
  3. Measures of Quality. Is provider use of the PELI a predictor of quality ratings (e.g., overall star rating, health inspection rating, staffing rating, quality rating, number of complaints)?

The highly productive research team will partner with the Ohio Person-Centered Care Coalition to interpret empirical results and develop practice-based recommendations for long-term care providers.  Findings will be disseminated through conferences and publications to help inform the use of evidence-based initiatives like the PELI in practice and policy.  


Long-Term Services Use in Ohio in a COVID 19 World

Ohio Department of Aging
Principal Investigators: Robert Applebaum and Matt Nelson
November 1, 2020 - June 30, 2021

This study examines the impact of state level changes on Ohio’s long-term services system. The study is the continuation of a longitudinal survey collected over the past 28 years. The study tracks long-term services system changes, with previous results showing that despite a continued and dramatic increase in Ohio’s older population, nursing home use dropped and in-home service use has increased. In addition to tracking long-term utilization, this year’s study will focus heavily on the impacts of COVID 19 on the long-term services system.


Encore Gen2Gen Innovation Fellowship

Encore.org
Principal Investigator: Elizabeth Lokon
October 1, 2020 - June 30, 2021

Intergenerational innovators have been selected to “advance and disseminate the work of 15 practical visionaries of all ages with ambitious initiatives to bridge generational divides.” Elizabeth Lokon was selected and will be working on developing ScrippsAVID (Arts-based, Virtual, Intergenerational, and Dementia-friendly) application to build virtual connections across generations around the arts.


The Older Adult Population of Greene County Ohio

Greene County Council on Aging
Principal Investigator: Matt Nelson
November 1, 2020 - January 31, 2021

The Greene County Council on Aging is interested in planning for the current and future needs of the older adults of Greene County. Scripps will provide a report on the population characteristics of older adults in Greene County such as gender, income, disability and internet usage with an emphasis on geographic (city/township) and age-group differentiation (age 60 and over) where possible. Data will come from the American Community Survey (ACS) five-year summaries. A final report will be delivered in January 2021.


AARP COVID-19 State Long-Term Care Dashboard Phase 2

American Association of Retired Persons (AARP)
Principal Investigators: Matt Nelson & Jane Straker
January 1, 2020 - December 31, 2021

This project will develop state-level metrics on COVID-19 prevalence, protection and testing, visitation policies, and oversight and monitoring in long-term care facilities. Existing federal and state data will be aggregated or otherwise combined to create a dashboard useful to consumers and long-term care advocates.


Improving the Education and Labor Market Outcomes of Students in Subbaccalaureate Postsecondary Institutions: What can we learn from Ohio's system of public career and technical centers?

The Regents of the University of Michigan, pass-through from the Institute of Educational Sciences (IES)
Co-Principal Investigator: Phyllis Cummins
July 1, 2020 - June 30, 2023

Access to postsecondary training and short-term credentials has never been more important in the U.S. than it is now. Increasing the number of individuals holding high quality postsecondary certificates in occupational fields is a key avenue for reestablishing and maintaining economic vitality. To that end, a number of states have built systems of public career and technical centers (CTCs) that offer education leading to postsecondary certificates and that operate alongside the more well known community colleges (CCs). Research indicates that CTCs have student completion and employment rates that are notably higher than CCs, but we know little about the factors that contribute to the favorable educational and labor market outcomes of CTC students. This three-year study, funded by a $1,400,000 federal grant from the Institute for Education Sciences, aims to pinpoint the institutional policies, strategies, and practices that contribute to the success of CTC students and can be adapted to improve outcomes nationwide for students in community college career and technical programs, especially those in short-term credential programs. Peter Bahr (University of Michigan) leads the project as Principal Investigator. Phyllis Cummins (Miami University) serves as co-Principal Investigator, and Matthew Regele (Xavier University) serves as co-Investigator.


Basic Skills and Problem-Solving Skills in Technology-Rich Environments in the STEM-Related Workforce Development Programs in the U.S.

University of Maryland Baltimore County, pass-through from the Institute of Educational Sciences (IES)
Co-Investigator: Phyllis Cummins
July 1, 2020 - June 30, 2023

This project will examine basic skills including literacy, numeracy and problem-solving skills as academic readiness indicators in STEM (Science, Technology, Engineering and Mathematics)-related workforce development programs of postsecondary education institutions in the U.S. We will conduct a series of (1) secondary data analyses, (2) primary data collection and analyses, and (3) qualitative review of the workforce development programs and interviews with the key stakeholders. Given the importance of STEM-related occupations in the context of global competitiveness, national economic development and existing employment issues (e.g., job replacement due to the automation), the postsecondary STEM-related workforce development programs play a critical role to prepare future workforce. However, little is known about basic skills distribution and the roles of basic skills for the education/training outcomes in postsecondary workforce development program settings. Takashi Yamashita (University of Maryland Baltimore County) leads the project as Principal Investigator. Rita Karam (RAND) is a Co-Principal Investigator and Phyllis Cummins (Miami University) serves as a Co-Investigator.


System Factors and Racial Disparities in Nursing Home Quality of Life and Care

The Regents of the University of Minnesota, pass-through funds from the Department of Health and Human Services
Principal Investigator: John Bowblis
May 1, 2020 - April 30, 2021

Over half of Americans aged 57-61 will stay in a nursing home (NH) at least once in their lifetime. Meanwhile, the growing proportion of NH residents with serious mental illness (SMI) has led some to call NHs “de facto mental health care. In fact, those with SMI are 3.5 times more likely than those without to become NH residents, with this number even higher for those with diagnoses of Alzheimer’s disease or related dementias (AD/ADRD). The goal of our original grant is to comprehensively examine organizational structures and processes of care that underlie racial disparities in quality of life (QOL) and quality of care (QOC) for NH residents. This supplement seeks to expand our study to focus on QOL and QOC of racially/ethnically diverse NH residents with SMI and AD/ADRD vs SMI alone. Racial/ethnic minority older adults are at increased risk of both AD/ADRD compared to white adults and having SMI diagnosis.


Aging and Disability Business Institute Phase 2: Advancing Integration, Partnerships and Payment Models Between Social Services and Health Systems

National Association of Area Agencies on Aging (n4a), pass-through funds from the John A. Hartford Foundation, Inc.
Principal Investigator: Suzanne Kunkel
April 2019 - March 2022

The National Association of Area Agencies on Aging (n4a) is creating and implementing a series of business tools and resources to support formal contracting arrangements between community-based organizations and the health care system. Scripps Gerontology Center is working with the n4a to evaluate the effectiveness and overall impact of the resources and interventions offered through this project. 


Building Evidence for the Our Family, Our Way Communication and Care Coordination Process for Caregiving Families

The Retirement Research Foundation
Principle Investigator: Jennifer Heston-Mullins
January 2020 - June 2021

The goal of this study is to provide evidence of the impact of the Our Family, Our Way, a communication and care coordination process for caregiving families developed by researchers at Scripps Gerontology Center. Our Family, Our Way is designed to be used by families without the involvement of a professional and provides highly-structured and scripted materials to help address the communication challenges and unequal care and support arrangements that occur in some caregiving families.


Creating a Dementia Inclusive Community in Northwest Ohio through the Expansion of Supports and Services

MemoryLane Care Services, pass-through funds from the Department of Health and Human Services
Principal Investigators: Jennifer Heston & Suzanne Kunkel
September 2018 - September 2021

This project is a three-year collaborative project to build a dementia-inclusive community in the greater Toledo community of Northwest Ohio. Funded by the Administration for Community Living, the project is designed to improve the quality of life for individuals diagnosed with Alzheimer’s Disease and related dementias (ADRD), those who are exhibiting symptoms but lack a diagnosis, and their caregivers. This project is a partnership with MemoryLane Alzheimer’s and Dementia Care Services, Benjamin Rose Institute, and the Ohio Council for Cognitive Health in which Scripps will provide third-party evaluation.


Effective Partnership Strategies Among Area Agency on Aging Healthy Communities

Yale University, pass-through funds from The Retirement Research Foundation 
Principal Investigator: Suzanne Kunkel
September 2019 - August 2021

Strong coordination among health care and social services providers has been linked with lower levels of avoidable health care use and spending for older adults. The nationwide network of Area Agencies on Aging (AAAs) — which provide and coordinate social services for older adults in local communities — could be ideally positioned to convene such cross-partnerships. Evidence is needed, however, to demonstrate how AAA partnerships and programs influence health care use and spending among older adults.

We are therefore proposing a longitudinal study to examine how changes in AAA partnerships and programs over eight years, reported through detailed national surveys in 2008, 2010, 2013, and 2016, correspond with changes in potentially avoidable health care use and spending for older adults in counties covered by the AAAs. Multivariate regression modeling with a difference-in-difference approach will be used to identify the impact of changes in AAA partnerships and programs in individual counties. In addition, we will undertake an in-depth qualitative study of AAAs that have established the most advanced and effective partnership networks supporting the health of older adults, to uncover comprehensive information on how AAAs establish and maintain such networks.
This project will produce the first evidence regarding potential causal links between activities of the AAAs, which are in nearly every region of the U.S., and avoidable health care use and spending for older adults. As hospitals, health care providers, and policymakers search for opportunities to improve health for high cost, high-need populations such as older adults with multiple chronic conditions, this research could offer evidence to support new solutions.Of particular practical value will be the collaboration with the Aging and Disability Business Institute (ADBI) for national dissemination efforts; ADBI is expressly designed to share capacity-building tools and resources with AAAs across the country.


Enhancing Caring Communities: Strategies to Help Locally Funded Senior Service Programs Better Support Caregivers

The Retirement Research Foundation
Principle Investigators: Robert Applebaum & Jennifer Heston-Mullins
June 2019 - February 2021

National and state programs that support caregivers assisting older people are limited. The lone federal program with dedicated funding to support caregivers, The National Family Caregiver Support Program, housed in the Administration for Community Living, had a 2016 budget of less than $160 million in comparison to $672 billion spent on Medicare (.2 of 1%). There are no federal policies on the horizon to support caregivers to elders with chronic disability. A number of states have taken a different path to generate resources necessary to support older people with disability who reside in the community: local tax levies. Although the local funding model has proven to be a successful political strategy that could expand to other states, these programs typically do not focus directly on caregiver support. In this work, our major purpose is to gain a better understanding of current approaches and to assist locally funded programs to better support caregivers as an intentional component of their strategy to support elders to remain independent in their communities.


Evaluation of Ohio’s MyCare Demonstration

The Ohio State University, pass through funds from the Centers for Medicare and Medicaid Services
Principal Investigator: Robert Applebaum
March 2020 - December 2021

In 2014, Ohio implemented a demonstration designed to integrate Medicare and Medicaid services for older adults. This study is an evaluation of the MyCare demonstration effort to assist state policy makers in determining program effectiveness.


Information and Planning: Understanding the Capacity of the Aging Network

National Association of Area Agencies on Aging (n4a), pass-through funds from the Department of Health and Human Services
Principal Investigator: Suzanne Kunkel
April 2016 - September 2021

For more than a decade, Scripps Gerontology Center has been working with n4a to collect information about, report on, and support the roles and activities of the Aging Network which is comprised of Area Agencies on Aging (AAAs) and Tribal Organizations (TOs). In this round of funding the sixth comprehensive survey of these organizations will be conducted, culminating in presentations and reports focusing on the progress of the Aging Network over the past decade. Scripps works with n4a to identify and respond to their data needs based on the national surveys.


Long-Term Care Research

Ohio Department of Higher Education (formerly known as the Ohio Board of Regents)
Principal Investigator: Suzanne Kunkel
1988 - June 2021

The Ohio Long-Term Care Research Project was established by the legislature in 1988. The goal of this project is to provide information needed for effective planning, program development, and policy-making.

Resource:
Ohio Long-Term Care Research Project webpage


A Mixed-Methods Study of Middle-Aged and Older Adults: Lifelong Learning, Skill Proficiencies, and Employment in the U.S. and Selected OECD Countries

U.S. Department of Education
Principal Investigator: Phyllis Cummins
July 2017 - June 2021

This research project will examine the relationships among skill proficiencies, employment, labor force participation, lifelong learning, and educational attainment for adults in the U.S. aged 40 to 74. U.S. results will be compared with several other countries. In addition, the project will examine lifelong learning and labor market policies in the U.S. and several other countries and interview key people in other countries.


Opening Minds through Art (OMA) II: A Quality Improvement Project

Ohio Department of Medicaid
Principal Investigator: Like Lokon 
October 2019 - June 2021

Opening Minds through Art (OMA) is an intergenerational art-making program for people with dementia and provides opportunities for creative self-expression and social engagement for people with Alzheimer’s disease and other neurocognitive disorders. The purpose of this project is to put OMA in more long-term care facilities in Ohio so that Ohio can serve as the national model for quality of care improvement through creative arts. Because OMA has been designated as a Quality Improvement Project by the Ohio Department of Aging, implementing OMA will meet nursing home licensing requirements. Thanks to funding from the Ohio Department of Medicaid, OMA will be offered at 36 additional nursing homes throughout Ohio by 2022.


Preference Based Living for People Living with Dementia in Ohio's Nursing Homes

Ohio Department of Medicaid
Principal Investigator: Katherine Abbott 
October 2019 - June 2021

Increasing the Preference-Based Care of People in Ohio’s Nursing Homes with a Special Focus on People Living with Dementia project is for all nursing home providers in Ohio who seek a sustainable way to provide preference-based, person-centered care. This project seeks to remediate a major barrier, expressed by 76% of Ohio providers, to providing preference-based care. Specifically, residents living with dementia who are unable to communicate their preferences. Individuals with cognitive impairment comprise half of all nursing home residents receiving Medicaid in Ohio. Therefore, remediating the barriers to preference assessment for individuals living with cognitive impairment in nursing homes is a critical need in Ohio and doing so is crucial to improving the quality of care for these residents.

In this project, we will build upon prior quality improvement materials to add a pragmatic audit trail for providers to track their process of Preferences for Everyday Living Inventory (PELI) assessment to the integration of preferences into care plans. We will develop and offer quality improvement projects (QIPs) that will focus on assessing preferences for people with moderate to severe dementia, as well as communicating those preferences across different care team members and shifts. We propose to develop materials from an evidence-based program for easy-to-use interventions that direct care staff can implement in their work with people living with dementia. We plan to augment the PELI assessment with visual cues to support individuals with dementia in expressing their preferences. Additionally, we will turn an existing in-person Leadership Communication Training into an on-line program that focuses on increasing care team members’ emotional intelligence to build relationships and enhance person-centered care. We will also develop and disseminate new education and training materials throughout the project in the form of newsletters, webinars and training videos. Finally, through a partnership with Linked Senior, we will scale up the mobile responsive Care Preference Assessment of Satisfaction (ComPASS-16) quality improvement website making it available to providers nation-wide.


System Factors and Racial Disparities in Nursing Home Quality of Life and Care

University of Minnesota, pass-through funds from National Institute on Minority Health and Health Disparities
Miami's Subcontract Principal Investigator: John Bowblis 
August 2016 - April 2021

Nursing homes with a higher proportion of minority residents tend to have lower quality, including quality of life. This project will examine how of life differs depending on the proportion of minority residents living in a nursing home. It will identify that cause these differences. It will also attempt to determine how much differences in quality of life can be improved if these factors are addressed.


Telomere Length Dynamics in Relation to Changes in Adiposity and Metaboilic Risk

University of Texas Health Science Center, pass-through funds from Department of Health and Human Services
Principal Investigator: Janardan Subedi
March 2019 - August 2021

Telomere length and telomerase activity have been posited as biomarkers for cellular aging, longevity, and age-related conditions such as cardiovascular disease and type 2 diabetes. Their role in the pathophysiology of chronic diseases, however, is still not well-defined, as they have been shown to also be influenced by adiposity. Moreover, information on the role of genetics in telomere biology is scarce. The objectives of the proposed study are to explore the phenotypic and genotypic relationship between body composition measures (e.g., obesity) and telomere length and telomerase activity, and to investigate the role of telomere length and telomerase activity on metabolic risk factors and disease in adults.

Using a longitudinal study design, we propose to measure serial leukocyte telomere length (LTL) from already existing stored (n=4204) and newly collected (n=885) buffy coat samples in 1794 Fels Longitudinal Study participants ranging in age from 18-93 years. Fels Longitudinal Study participants have been repeatedly measured over their entire lifetime for body composition and metabolic markers. Over time, more advanced measures of body composition such as visceral and subcutaneous abdominal adiposity using MRI, and novel blood chemistries such as inflammatory markers have been also been collected. Whole genome single nucleotide polymorphism (SNP) data are available on a large subset of these participants to search for genes influencing telomere biology. This uniquely valuable cohort presents a readily available, cost-effective, and powerful resource for understanding the relationship between telomere biology and cardiometabolic health.

The specific aims of the proposed study are: 1) to examine longitudinal associations between adiposity traits, telomere length, and metabolic risk in 1794 adults, 2) to examine cross-sectional relationships between newly collected telomerase activity, telomere length, adiposity traits, and metabolic risk factors in a subset (N=848) of participants, and 3) to identify genetic variants influencing telomere length and telomerase activity and to use Mendelian Randomization to examine causal associations among obesity, telomere biology and metabolic risk in a subset (N=1247) of study participants.
The results of this proposed study will provide important information about how telomere biology is linked to obesity, aging, and cardiometabolic disease risk. Further, this information will aid in the assessment of risk, prevention and treatment of accelerated aging and chronic disease.