by Matthew Smith
A University of North Carolina at Chapel Hill School of Social Work researcher will be part of a more than $15 million grant awarded by the National Institutes of Health’s National Institute on Aging.
The $15.5 million grant, awarded to a lead team of research scientists from Indiana University’s School of Medicine and the Regenstrief Institute, will establish a national network structure — named NEXT STEPs —to include more nursing home residents in clinical trials.
“The National Institute on Aging specifically requested proposals to increase clinical trials in nursing homes,” Zimmerman said, “Despite the fact that 1.2 million people receive nursing home care at any given time, they are underrepresented in clinical trials. This is an important oversight because nursing home residents have numerous care needs, including in areas in which care can be improved with better evidence to guide care.”
The NEXT STEPs network will enable researchers to increase the number and quality of clinical trials conducted in nursing homes, including those “focusing on prevention, medical therapeutics, and behavioral and health services interventions,” according to the Regenstrief Institute. The network will also foster partnerships between researchers, industry members and collaborations to foster evidence-based innovations to improve resident care.
The infrastructure will be built on three core areas, including:
- Recruitment and retention;
- Methods, measures and data; and
- Training and projects.
Zimmerman will lead the recruitment and retention core, which will “focus on developing and disseminating strategies to engage individuals and organizations” to conduct equitable trials in nursing homes.
“(This network) will promote clinical trials to better improve care and resident outcomes,” she said.
The second and third core aims will develop a sustainable, collaborative community of engaged nursing home researchers and partners, as well as build research capacity for high-quality, high-impact clinical trials in nursing homes.
Zimmerman noted some of the challenges that have led to nursing home residents being underrepresented in clinical trials.
“Two key barriers come to mind,” she said. “One is that nursing home residents often have cognitive and physical impairments that limit their ability to respond for themselves; obtaining consent from their family members can be laborious.
“Another is the process to obtain data. Although some data are included in medical records, it’s not usually sufficient to address key issues. Asking staff to complete research forms is time-consuming for a workforce that is already insufficient in numbers.”
Carolina will be subcontracted for $1.3 million over the five-year grant.
Other universities and institutions involved in the grant include Brown University, University of Maryland, Baltimore, University of Utah, Hebrew Rehabilitation Center, University of California, Los Angeles, University of Colorado, Denver, Institute for Healthcare Improvement, Rhode Island Hospital, Duke University, and New York University.
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