Policy and Research Initiatives
This project is designed to strengthen and support interdisciplinary health care research and training, and promote collaboration between Geriatrics at the University of Massachusetts Medical School, and Gerontology at the University of Massachusetts Boston campus.
Principal Investigators: Jan Mutchler Co-investigator with J. Gurwitz, Geriatric Medicine, and K. Miller, Graduate School of Nursing, University of Massachusetts Medical School, Worcester
Sponsor: Hartford/RAND Foundation
Project Timeline: November 2006 - September 20008
The Lift Up Your Voice! (LUYV) training, a component of Community Catalyst’s effort to support the Campaign for Better Care (CBC), is designed to mobilize grassroots advocacy structures of vulnerable older adults by directly engaging and empowering older adults and their caregivers. The goal of the evaluation is to assess the effectiveness LUYV in recruiting potential advocates, educating them about the health care reform, empowering them via advocacy skills training, and engaging them in state-based CBC activities.
Principal Investigators: Nina Silverstein and Alison Gottlieb
Sponsor: Community Catalyst and Atlantic Philanthropies
Project Timeline: May 1, 2011 - April 30, 2012
The Elder Economic Security Standard Initiative is a collaborative project with Wider Opportunities for Women (WOW) to measure on a geographically specific basis the income elders need to live modestly in their communities throughout the United States. The goal of the Elder Economic Security Initiative is to enable policy makers, aging advocates and others develop policies and programs to help seniors age with dignity while promoting their economic independence.
Principal Investigators: Ellen Bruce and Jan Mutchler
Project Director: Alison Gottlieb
Sponsor: Wider Opportunities for Women, Atlantic Philanthropies, and Retirement Research Foundation
Funding: possibly up to $1 million over 5 years
Previous sponsors: The Boston Foundation, Farnsworth Foundation, Retirement Research Foundation, and a public service grant from UMass Boston.
This study is comparing driving assessment modes (self, family, and occupational therapist/driving rehab specialist) with naturalistic driving through instrumentation of the driver’s own vehicle developed to measure impairments in critical driving behaviors associated with dementia.
Principal Investigator: Nina Silverstein (co-Investigator with UMTRI and UH)
Sponsors: Alzheimer’s Association and the National Highway Traffic Safety Administration
Funding: 2006-2009 subcontract from University of Michigan (currently have two subcontracts totaling $35,000 with one more pending).
The Tufts Health Plan Foundation (THPF) has awarded a grant to a team of researchers at the Gerontology Institute being led by Beth Dugan to conduct a project on healthy aging.
The aim of the project is threefold:
- to report indicators of healthy aging across Massachusetts,
- to conduct an environmental scan of current healthy aging programs in the state,
- to provide leadership to a healthy aging coalition in Massachusetts.
The researchers are developing the methodology for reporting on key indicators of healthy aging in the Commonwealth. Preliminary research involves establishing feasibility, acquiring data, and querying key stakeholders on what information is most needed to advance healthy aging in the state
Principal Investigator: Beth Dugan
Sponsor: Tufts Health Plan Foundation
Project Timeline: September 12, 2013 - November 30, 2013
This project aims to encourage state policymakers to seek informed consumer input when developing and modifying nursing home reimbursement methods and to give consumer representatives necessary information in order that they may make a meaningfully contribution. First, the team will study New York and Minnesota, describing in two case studies the positive impact knowledgeable consumer involvement has had in the development and modification of those state’s nursing home reimbursement systems. Second, based on the numerous questions they have received from consumer representatives for information on nursing home payment policy, a literature review, and insights gained from the case studies, they will develop and present a half-day seminar and a series of web-modules to educate consumer representatives on the principles of nursing home reimbursement and its relationship to quality, access, costs and other outcomes.
Principal Investigator: Edward Alan Miller
Sponsor: The Commonwealth Fund
Project Timeline: November 1, 2010 - October 31, 2011
The project is designed to assess changes in family care systems over time, to examine the predictors of such changes both at the level of the caregiver and of the care system as a whole, and to investigate the impact of such changes on selected outcomes, including well-being of the caregivers and care recipients, the extent of unmet care needs, the use of formal services, and nursing home placement. Using data from the Health and Retirement and Assets and Health Dynamics of the Oldest Old surveys, our results can inform policies and programs designed to enhance the care systems of frail and cognitively impaired elders as well as policies and programs targeting the well-being of families and caregivers. Our analysis will also speak to the future availability of family caregivers in response to changing family structures and caregiving requirements.
Principal Investigator: Maximiliane E. Szinovacz
Sponsor: National Institute of Aging (NIA)
This project examines the ways in which older immigrants are enmeshed in households and communities in the U.S.
Principal Investigators: Jeff Burr and Jan Mutchler
Sponsor: National Institute on Aging (NIA)
Project timeline: September 2004 - August 2008
The goal of this project is to estimate patient-, provider-, and institution-level effects on Latino-white disparities in end-of-life care and treatment goal attainment.
Principal Investigator(s): Jan E. Mutchler, Holly G. Prigerson (DF/HCC), and Paul K. Maciejewski (DF/HCC).
Sponsor: National Cancer Institute, through the University of Massachusetts Boston & Dana-Farber/Harvard Cancer Center U54 Comprehensive Partnership to Reduce Cancer Health Disparities
Funding: $138,656 direct
Project Timeline: September 1, 2010 - August 31, 2013
The Institute is conducting an assessment of the legal needs of elders in Massachusetts for a legal hot-line being implemented by the Legal Advocacy and Resource Center.
Principal Investigators: Ellen A. Bruce, Allison Gottlieb, and Lauren Martin
Sponsor: Contract with Legal Advocacy and Resource Center (LARC)
This project has three main objectives:
- to identify the entire retirement processes of individuals and couples, defined by labor force exits and reentries, Social Security and pension receipt, and retiree self definitions.
- to assess the effects of choice (disability, job displacement, caregiving, spouse control), instrumental, and cognitive utilities (reflecting social, couple, family and personal expectations about the timing of the retirement transition) on retirement transition processes.
- to assess the outcomes (retirement plan implementation, benefit optimization, retirement satisfaction, change in income, food security, depressive symptoms, health risk behaviors, self-rated health, health insurance coverage, and life expectations) of specific retirement transition processes for individuals and couples.
The analyses will rely on secondary analyses of the Health and Retirement Survey (waves 1992-2004). Main analyses techniques employed will include multi state life tables, regression techniques for censored data and interdependent observations (couples), structural equation modeling, and general estimation procedures. The project has important health-related outcomes. It will demonstrate to what extent health limitations preclude choice over retirement transitions and whether such limited choice significantly reduces retirement benefits as well as emotional and physical well-being and access to health insurance. The project will further assess whether negative outcomes of initial retirement transitions can be reduced through subsequent processes such as reentry into the labor force. In addition to its importance for health-related outcomes, the project also provides theoretical and methodological contributions to the retirement literature. Major innovations include the identification of retirement processes, the emphasis on control and cognitive utility, the measurement of post-retirement financial well-being in terms of the difference between actual and optimal benefits, and the assessment of cross-spouse influences and outcomes.
Principal investigator: Maximiliane E. Szinovacz
Sponsor: National Institute of Aging (NIA)
The purpose of this project is to advance methods for collecting and analyzing data on perceptions, behavior, and well-being, and their variation across individuals and with age. At a broad, integrative level, the project proposes to organize an interdisciplinary network of scholars who are studying perception and decision processes, and their measurement in economic and health surveys. Within this network, the project will encourage the synthesis and extension of cognitive, experimental, and statistical results that can improve the accuracy of survey data in studies of aging and identify casual effects.
The project includes researchers at
University of California Berkeley
University of Munich
University of Michigan
The UMass Boston Gerontology Institute is involved with a component concerned with the use of factorial survey methods to measure the normative underpinnings of public policy. The substantive emphasis in the UMass Boston component is on residential choices of elders. We hope to develop a web site that provides interactive information for elders and their families on residential options of elders who are dealing with a range of issues ranging from downsizing to long-term care. Within that web site, we plan to conduct experiments on use of vignette techniques to understand residential preferences of elders. As a first step, qualitative research is being conducted on residential planning among elders in the Boston area. The pilot research funds have also been used to conduct secondary analysis of data on the association of subjective probabilities on longevity and need for long-term care with the purchase of long-term care insurance.
Principal Investigators: Frank Caro and Daniel McFadden, University of California Berkeley
Sponsor: National Institute on Aging (NIA)
NPLN is an ongoing referral service for people with pension problems throughout the country who are looking for attorneys to represent them.
Project Directors: Ellen A. Bruce and Jeanne Medeiros
Sponsor: Contract with the Pension Rights Center
Project timeline: ongoing
NEPAP is an ongoing service project that assists and educates individuals about their benefits and rights to retirement income. A secondary purpose is to identify issues affecting pension plan participants. The project has served over 5500 people in New England and recovered over $38 million in its 17 years of operation.
Principal Investigator: Ellen A. Bruce
Managing Attorney: Jeanne Medeiros
Sponsors (and awards) U.S. Administration on Aging ($200,000); private donation
Program Timeline: ongoing
This series of fact sheets presents demographic information about the older population in the state, focusing on economic security, family and household characteristics, and other compositional features. See the Demographics of Elders in Massachusetts web site.
Principal Investigator: Jan Mutchler
The Gerontology Institute, in collaboration with AARP and the Massachusetts Executive Office of Elder Affairs, convened a group of academics, public and private agencies, and employers to examine ways of increasing workforce development among workers over age 50 to maintain Massachusetts’ economic competitiveness.
Project Directors: Ellen A. Bruce and Frank Caro
Project timeline: 2007 - 2011
The Activity Motivation among Elders project uses survey methods to examine the motivational underpinnings of a variety of activities among older people. Paid employment, volunteering, education, exercise, and hobbies are among the activities being examined. Of particular interest is the extent to which there are motives that are common to more than one form of activity.
Principal Investigator: Frank Caro
The Residential Choices: Vignette Method project is developing hypothetical choice and vignette experiments that will provide the data required for the identification and estimation of econometric models for the joint analysis of diverse variables on health-related decisions of older people. The project explores the use of colorful, interactive vignette methods, adapting market research tools to accelerate information acquisition and monitor the information-gathering process, and testing the role of framing, context, and affect on judgments. The vehicle for this investigation is information-seeking on alternative living arrangements by elders in failing health.
Sponsors: National Institute on Aging (NIA), Subcontract from the University of Michigan
Principal Investigators: Frank Caro, with Daniel McFadden and Teck Ho (UC Berkeley)
Funding: estimated funding $80,000
Project timeline: 2 years
This project looks at retirement data through 2008 from the Massachusetts state retirement board to analyze benefits received by current retirees and future benefits of members of the state retirement system.
Principal Investigators: Ellen A. Bruce and Lauren Martin
Transitions to Residential Care among People with Multiple Sclerosis:
Decision Making, Preferences, and Needs
This project is intended to better understand the needs, concerns and preferences of people with multiple sclerosis (MS) who move to supportive residential care. Studies estimate that up to 10% of people with MS eventually live in some type of group care facility because of advanced disability. However, typical nursing homes are designed for the care of elderly people and may not be appropriate for younger people with disabilities. Through qualitative interviews of people with MS who are actively considering residential options or who have recently moved to a nursing home or assisted living, the study will explore the process by which people consider and choose a residential facility, including available information and options, facility characteristics (amenities, services), and financing options. Through survey questionnaires, the study will examine personal characteristics (physical disability, social support, financial resources) associated with choosing assisted living versus nursing homes. Interviews with nursing home and assisted living administrators will examine experience serving residents with MS. The study will generate indications of the kinds of issues; financial, social, psychological and medical that will require more attention in order to expand supportive housing options for people with Multiple Sclerosis.
Principal Investigators: Alison Gottlieb and Joan Hyde
Sponsor: National Multiple Sclerosis Society
The purpose of this study is to identify factors associated with the use of different types of nursing home care by veterans and the outcomes associated therewith. Specific goals include examining factors related to: (i) veterans' initial nursing home placement setting type, given their available choices: (ii) transfers among different nursing home settings both directly from one setting to another, and indirectly through a hospitalization following initial admission to nursing home; and (iii) newly admitted veterans remaining in nursing home settings for extended care. Goals also include: comparing initial type of nursing home utilization, transitions, and extended-care nursing home utilization among mandatory and non-mandatory veterans, paying particularly attention to demographic, geographic, and case-mix differences across veteran affairs medical centers.
Principal Investigators: Orna Intrator, PI, Providence VA and Edward A. Miller, co-PI
Sponsor: U.S. Department of Veterans Affairs Health Services Research and Development Service
Award: $868,783 (total), $116,644 (UMass Boston subcontract)
Project Timeline: June 1, 2010 - May 30, 2013
Using Video-Enhanced, Internet-Based Vignette Experiments to Study Patient Decisions Regarding Knee Replacement for Ostoarthritis
This project will examine how patients make difficult decisions about surgical treatment for knee osteoarthritis, a serious chronic condition affecting many middle aged and older people. We will be concerned specifically with the effects of 1) level of pain, 2) opportunity costs associated with treatment, 3) physician recommendations, 4) supplementary outcome projections, and 5) testimonials of other patients on patient decisions. The project builds upon pilot research that used fractional factorial survey design, a form of stated choice methods, to demonstrate the potential for using a general population sample to examine patient decision-making processes. The pilot research also demonstrated the feasibility and potential advantages of our innovative method of delivering information to respondents through video and audio techniques in a survey administered on the internet. The respondents (~ 1,500 middle aged and older adult members of the Rand Corporation’s American Life Panel) will be asked to make recommendations for vignette persons who describe their complex circumstances. The results will be useful for health care providers who assist patients in making informed decisions about treatment for knee osteoarthritis. The research will also provide insights about the potential use of our methods to evaluate the effects of decision guides on patient decisions.
Principal Investigators: Francis G. Caro (Co-PIs: Joachim Winter; Arie Kapteyn; Maria E. Suarez-Almazor; Alison Gottlieb)
Sponsor: Informed Medical Decisions Foundation
Project Timeline: Oct 1, 2011 to September 30, 2012