Research Initiatives

The Center for Aging & Disability Education & Research (CADER) conducts research aimed to strengthen the workforce that provides health and long-term supports and services to older adults and people with disabilities.  We continue to look for ways to advance our research efforts through innovative partnerships with state and community-based organizations.  Please contact CADER  for more information or if you have a project in which you would like evaluation/research support. Some highlights of CADER’s workforce development, research, and policy efforts are the following:

Strengthening an Age Friendly Community through Capacity Building and Partnerships that Address Behavioral Health Concerns in Older Adults

Sponsor: Tufts Foundation

PI: Bronwyn Keefe, MSW, MPH, Ph.D., Director, Boston University School of Social Work’s Center for Aging and Disability Education (CADER), Boston, MA

This project is focused on field/capacity building in the area of behavioral health through a partnership with Age Friendly New Bedford, in particular between the New Bedford Council on Aging and the Center for Aging and Disability Education and Research at Boston University School of Social Work. In keeping with Tuft’s goals of developing communities that are responsive to the needs of older adults, promote healthy living, and focus on the most vulnerable older adults, this program will build on the collaboration among organizations in New Bedford that led to its designation as an Age Friendly city. In order for older adults to be fully engaged in community life, behavioral health concerns need to be addressed with a focus on social isolation, depression, and substance use. Many Age Friendly efforts don’t address these issues even though significant numbers of older adults are impacted. This grant will focus on capacity building in behavioral health through the diverse partnerships that make up the Age Friendly New Bedford coalition.

Integrating Behavioral Health in Primary Care

Sponsor: Health Resources and Services Administration (HRSA) for a Primary Care Medicine and Dentistry Clinician Educator Career Development Award

PI: Christine Pace, MD, MSc, Associate Medical Director, General Internal Medicine, Boston Medical Center and Assistant Professor of Medicine, Boston University School of Medicine

A grant to integrate behavioral health into primary care medicine at BMC. CADER’s role will be to provide guidance and support in developing clinical education and training for primary care providers in identifying behavioral health concerns in order to understand the appropriate steps necessary to ensure patients receive the care they need.

Acute Community Care to Avoid Unnecessary Emergency Department Visits

Sponsor: Patient-Centered Outcomes Research Institute (PCORI)

PI: Lisa I. Iezzoni, MD, MSc, Massachusetts General Hospital

This grant is to examine a new Massachusetts acute community care program – a collaboration between the EasCare ambulance service provider and Commonwealth Care Alliance, which serves adults who have both Medicare and Medicaid coverage. This acute community care program is mobile paramedic outreach program that responds to 911 calls to diagnosis and treat low income older adults and persons with disabilities in order to prevent unnecessary emergency department use. Working with an outstanding team of researchers from MGH, Harvard, University of Massachusetts, and BU School of Public Health (BUSPH), CADER’s responsibility focuses on developing measures of competency assessment for paramedics, interviewing patients, family members, paramedics and providers to collect patient-reported experiences and reactions.

Prevention and Identification of Behavioral Health Issues in Older Adults: Skill Development Among Clergy Members

Sponsor: Massachusetts Department of Public Health Suicide Prevention Program

PI: Bronwyn Keefe, MSW, MPH, Ph.D., Director, Boston University School of Social Work’s Center for Aging and Disability Education (CADER), Boston, MA

This program will focus on understanding and addressing the behavioral health needs of older adults by developing a blended training program (online and in-person) for diverse clergy in Massachusetts. This two year grant-funded program will include a pilot program during the first year, where a small group of selected clergy and faith leaders will review and provide suggestions on ways to revise existing CADER online courses in Behavioral Health and Aging. In the second year, CADER will deliver this revised training to a wider audience of faith leaders across Massachusetts. At the end of the program, clergy will be able to demonstrate significant increases in competencies related to their ability to: recognize the signs and symptoms of the common cognitive, substance use, and mental health conditions including suicidality in older adults; address the impact of stigma when working with older adults; understand how and where to make referrals for assistance; and identify the strengths and resources in immigrant and refugee communities that build resilience.

Completed Research

Building Healthier Communities: An Evaluation of the Kiosks for Living Well Program

Sponsor: Blue Cross/Blue Shield through Greater Lynn Senior Services

PI: Bronwyn Keefe, MSW, MPH, Ph.D., Director, Boston University School of Social Work’s Center for Aging and Disability Education (CADER), Boston, MA

Greater Lynn Senior Services, Inc. (GLSS) received funding from BCBSMA Foundation to fund the development and implementation of a robust evaluation framework for their Kiosk for Living Well program. The Kiosks are vibrant, mobile spaces embedded in community pulse-points that inspire consumers to participate in activities designed to promote healthier living routines, ranging from engaging self-assessments, educational and fun activities to health monitoring by appropriately and clinically trained staff around hypertension, stroke reduction, stress management, falls prevention, and depression. Consumers can connect with nurses, mobility counselors, social workers, community health workers, and advisors trained in problem solving supports to address the full range of health concerns and their social determinants. GLSS has subcontracted with BU to conduct this evaluation work.

Building Dementia-Capable Services And Supports Through Alzheimer’s And Dementia Training

Sponsor: Commonwealth of Massachusetts Executive Office of Elder Affairs

PI: Bronwyn Keefe, MSW, MPH, Ph.D., Director, Boston University School of Social Work’s Center for Aging and Disability Education (CADER), Boston, MA

This grant will improve the capacity of Massachusetts’ home and community-based service system to provide dementia-capable services and supports by providing advanced training to help home care staff identify individuals with dementia and provide services that promote independence and well-being, mitigate conflict and alleviate stress for families coping with dementia. Ultimately the training provided through this grant will have an impact on quality of life for thousands living with Alzheimer’s disease across the Commonwealth.

Behavioral Health in Aging: Building the Capacity of Providers in Massachusetts

Sponsor: Massachusetts Executive Office of Elder Affairs (supplement to grant listed above)

PI: Bronwyn Keefe, MSW, MPH, Ph.D., Director, Boston University School of Social Work’s Center for Aging and Disability Education (CADER), Boston, MA

With the growth of the aging population and its increasing diversity, it is imperative to examine what we can do to build healthy communities and address the relationship of mental wellness to overall health and well- being. It is estimated that one in four older adults will have a behavioral health concern. This program will enrich participants understanding of the major mental health conditions and substance use concerns facing older adults as well as the importance of promoting mental wellness and resilience. Attention will be paid to the importance of screening, assessment and evidence based interventions. This is a statewide capacity building program recommended for the following direct service positions: adult protective services; case managers; social workers; nurses and supervisors; council on aging staff and directors; options counselors; and housing staff.

Aging and Disability State Offices: Assessing the Feasibility on the Creation of a New York State Office of Community Living

Sponsor: The New York State Office for the Aging

PI: Bronwyn Keefe, MSW, MPH, Ph.D., Director, Boston University School of Social Work’s Center for Aging and Disability Education (CADER), Boston, MA

A project to work with The New York State Office for the Aging (NYSOFA) to conduct a feasibility study about the possibility of creating a state Office of Community Living. The purpose of this project was to seek public input about the creation of an Office of Community Living with the goal of providing improvements in service delivery and improved program outcomes that would result from the expansion of community living integration services for older adults and persons of all ages with disabilities.Strengthening Interdisciplinary Patient-Centered Care

Sponsor: Commonwealth Corporation

PI: Bronwyn Keefe, MSW, MPH, Ph.D., Director, Boston University School of Social Work’s Center for Aging and Disability Education (CADER), Boston, MA

CADER and the Commonwealth Care Alliance of Massachusetts (CCA) came together in 2014 to design and implement competency-based, standardized training for CCA’s rapidly expanding interdisciplinary workforce.  CADER conducted an assessment of workers’ skills and then developed a set of courses tailored to strengthen the clinical staff’s capacity for providing person-centered care as part of an interdisciplinary healthcare team. The approximately 200 workers who completed the program over the past two years showed significant gains in targeted skills. In addition, CCA experienced fewer grievances regarding care-management practices, and patient buy-in to care plans increased significantly for those sites trained. All course competencies, increases in mean scores for course participants from pre-test to post-test for each course completed, were statistically significant. Participants expressed appreciation for the CADER online courses and reported that they were highly applicable to their jobs and should be required for new staff and future team leaders. CCA staff have observed improvements in team interaction and communication. Workers have expressed feeling more empowered when advocating for clients.