NIA AD/ADRD Health Care Systems Research Collaboratory

Over 6 million Americans have Alzheimer's disease (AD) or an AD-related dementia (AD/ADRD). Health care systems (HCS) in all settings (e.g., nursing homes (NHs), community, hospitals, assisted living) struggle to provide high quality, coordinated care that meets the needs of people living with dementia (PLWD) and their care partners (CPs). Scalable and adoptable non-pharmacological interventions that are effective in improving the care delivered to this population are desperately needed. Meeting this challenge demands innovative approaches and robust infrastructures that bring together HCS, researchers, community partners, funders, and regulators focused on this common purpose. Established in September 2019, the National Institute on Aging (NIA) IMbedded Pragmatic Alzheimer's disease (AD) and AD-Related Dementias (AD/ADRD) Clinical Trials (IMPACT) Collaboratory’s mission is to build the nation’s capacity to conduct embedded pragmatic clinical trials (ePCTs) of interventions for PLWD and their CPs. Since its inception, IMPACT has actualized its original Aims to advance the conduct of ePCTs, develop and disseminate knowledge, build investigator capacity, and catalyze stakeholder collaboration. IMPACT also established an interdisciplinary and collaborative community of over 150 investigators at all career stages, contributing to its mission. IMPACT proved to be nimble; novel programs were conceived and launched during its initial years to address unanticipated needs to advance the field. These accomplishments and challenges inform its next steps and provide the rationale for its continuation. The overriding objective of this renewal proposal is to achieve IMPACT’s mission by building on the many successes established in IMPACT’s first funding cycle through 4 fundamental aims; Aim 1. Maintaining and enhancing the highly functional established infrastructure; Aim 2. Supporting the conduct of ePCTs to identify effective interventions that improve dementia care within HCS through grant funding and providing guidance and resources to investigators; Aim 3. Building investigator capacity to rigorously conduct this research by providing trainees with opportunities for career development funding, mentorship, scholarly projects, training workshops, and on-line learning curricula; and Aim 4. Advancing knowledge and methodology in the field. Central to IMPACTs mission is that its work will include, apply to, and strive to improve dementia care for all Americans. IMPACT: IMPACT’s bold vision is to transform the delivery, quality, and outcomes of care provided to PLWD and their CPs by accelerating the testing and adoption of evidence-based interventions within HCS. Its accomplishments to date provide a strong foundation for this vision, but realizing it will require more time, investment, and innovative approaches. Support for a 5-year renewal period is necessary to achieve the full potential of this remarkable national infrastructure and ultimately translate its resources to meaningfully improve the quality of care delivered to Americans living with dementia and their CPs.