NADSA Research Positioning Statement and 5 Year Plan

Research Positioning Statement

This report was prepared by the Research Committee (formerly the Research Task Force) of the National Adult Day Services Association (NADSA), the nonprofit trade association of Adult Day Services providers operating in the U.S. NADSA advances the national development, recognition and use of Adult Day Services. The NADSA Research Committee is an ad hoc committee of researchers, providers, and other stakeholders who are committed to facilitating the development, utilization and dissemination of research to improve the delivery of Adult Day Services and the quality of life of adult day participants and their caregivers. In June 2011, NADSA’s Research Committee convened with the intent to discuss recent research-related efforts focused on Adult Day Services and make recommendations about future research endeavors that might support furthering the mission and goals of NADSA, expanding the successes of its member organizations, enhancing the quality of care of adult day participants, and improving the quality of life of participants and their caregivers. The committee submitted its first report in 2015 and met again in 2018 to develop and submit the following updated report in August 2019. The purpose of this report is to outline the recommended approach of NADSA with respect to how research in the field of Adult Day Services (ADS) should be positioned and developed in the coming years.

  • A research agenda is defined as “a set of properly selected themes or topics that have been prioritized for research purposes” (Msuya, 2002, p. 251). For a scientific field, such an agenda provides a framework for organizing the constellation of research studies conducted by independently operating research funders and researchers. The NADSA Research committee sees research as a crucial element in increasing awareness of Adult Day Services among key stakeholders in elder and dementia care. Research produces the demonstrated impacts that raise awareness. In recent years, there has been a surge in adult day service research-related activities both within the ADS community, as well as with academic institutions and government institutions.

To meet the demands of their consumers, Adult Day Services are providing increasingly more comprehensive skilled health care, chronic disease management, and care for persons with Alzheimer’s disease and other dementias (MetLife, 2010). Indeed, nearly 80% of adult day centers have a nursing professional on staff, and roughly 60% offer case management services (MetLife, 2010). Awareness of Adult Day Services can be raised by positioning Adult Day Services as an alternative health care provider in relation to the better-known options in the elder care spectrum, e.g., assisted living facilities, nursing homes, and home health, and by extension, health care providers, such as hospitals, physicians, health plans, and hospice.

NADSA leverages this ongoing momentum in research and the provision of innovative health care services and is proud to submit the following:

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Purpose

  • To facilitate translation and dissemination of relevant research to improve the delivery of adult day services (ADS) and the quality of life of people supported in ADS and their caregivers.
  • To identify research focus areas in ADS in collaboration with providers and research partners
  • To promote research that quantifies impact of ADS and supports increased utilization and expands the role of ADS in the care continuum.
  • To continually evaluate and update the actions and recommendations herein to demonstrate the evolving interdependence of ADS and research

Vision

The NADSA research committee envisions a collaborative environment where ADS stakeholders can participate and promote research opportunities and benefit from the resulting data, in order to continually improve the services provided and utilization of ADS across the industry.

This collaborative environment involves providers, participants, caregivers, payors, research institutions, government agencies, academic partnerships, and grant funding organizations among others, to facilitate the standardized data collection, analysis, and distribution as well as educate stakeholders and the public on the benefits of ADS.

These results will show the value and effectiveness of ADS, both quantitatively and qualitatively; highlight the evolution and innovation across the industry; influence policy makers and stakeholders; and challenge the long-term care continuum to continually improve for the benefit of all those involved.

Definitions

Stakeholders: Families, caregivers, participants, providers, practitioners, policy makers, researchers, institutions, government agencies, advocates, partners, NADSA members, state associations and others sharing a common vision.

Research Priorities

The NADSA research committee has prioritized the following 5 domains in ADS research:

  1. Standardized ADS Outcomes Measures
  2. Metrics and Data Collection
  3. Data Utilization by ADS Stakeholders
  4. Translational Research and Innovation in ADS
  5. Implementation and Evaluation of Best Practices

1. Standardized ADS Outcomes Measures

Definition: By promoting the collection, interpretation and dissemination of ADS outcomes data using standardized measures (Anderson, K. et. al. JAG 2018)—as well as additional measures where appropriate—consistent and trustworthy indicators of program impact can be obtained, which is essential to stakeholders’ decisions about ADS.

Actions:

  • Disseminate ADS outcomes publication, Anderson et.al. 2018, Journal of Applied Gerontology, to NADSA membership and stakeholders
  • Educate and assist providers to utilize the standard outcomes measures and tools delineated in Anderson et. al. 2018

Recommendation/Goals:

  • Establish beta testing panel – establish a cohort of ADS providers who are willing to commit to collecting ADS outcomes as described in the published paper
  • Create an advisory group of researchers and stakeholders who are willing to support the beta testing panel in collection and analysis
  • Evaluate and identify additional outcome measures not listed above and include in future standardized outcomes
  • Investigate and pursue special issue of ADS outcomes to relevant journal (JAG or similar practitioner focused journal)

2. Metrics and Data Collection

Definition: By using standard key metrics, or quantitative measures, indicative of the above ADS outcomes, as well as qualitative research, stakeholders can develop a shared language for discussing the implementation and means to aggregate and interpret the shared data reflecting diverse ADS models.

Actions:

  • Create working group of practitioners and stakeholders to review recommendations from Anderson, et. al., and the National Study of Long-Term Care Providers (NSLTCP)/National Post-Acute and Long-Term Care Study (NPALS) and identify actionable steps toward piloting a system of metrics at representative ADS models.
  • Update and disseminate NADSA’s recommended core outcomes matrix (using Anderson frame)
  • Create google or Excel sheet template for data collection of recommended measures and distribute to NADSA member providers.

Recommendation/Goals:

  • Develop written strategic plan of ‘what to do with the data’ and ‘what’s in it for them’ for providers
  • Develop glossary and process ‘briefs’ defining types of statistics (e.g. qualitative vs quantitative, descriptive, etc.) and ‘what to do’ with the data for providers
  • Collect and analyze known qualitative measures of ADS success for inclusion in standard outcomes
  • Create collection and analysis platform for ADS Outcomes data for NADSA members

Or

  • Utilize existing app for ADS outcomes
  • Embed cursory analysis tools in data collection template and platform
  • Collaborate with ADS E-record organizations to comment and implement standardized outcomes data collection on ADS platforms where possible

3. Data Utilization by ADS Stakeholders

Definition: Promoting collaboration among ADS stakeholders to gather, interpret, and act on empirical evidence in ADS in order to improve funding, organization, implementation, and impact across diverse models of ADS service delivery.

Actions:

  • Highlight ongoing studies and initiatives in data collection and industry benchmarks (NSLTCP/NPALS and other research partners) and disseminate to NADSA membership through quarterly Research Roundups via newsletter, The Voice, email, and website
  • Connect with researchers who have recently published studies on ADS, but who are not currently involved with NADSA
  • Educate researchers on NADSA’s efforts to summarize and disseminate their work
  • Organize annual state of the science in ADS session/summit during NADSA’s Fall Conference and invite potential new collaborators

Recommendation/Goals:

  • Engage with new researchers and expand research partnerships
  • Assist providers and state associations to collaborate for large scale data collection, analysis, and publication
  • Engage practitioners and stakeholders to garner input on topics for empirical research (what ADS accomplishes where it can grow and improve, practices, participant goals, etc.)
  • Communicate findings to stakeholders in effective and appropriate formats, and provide access to collective data via NADSA web portal (different for stakeholder groups – will need to ask what format suits the specific needs, and design future research accordingly)
  • Promote research summit (poster sessions, multiple presentations, or pre-conference sessions) during annual meeting to include representation from current researchers, participants, and partners

4. Translational Research and Innovation in ADS (Translating Research to Practice)

Definition: Research findings may stem from large scale studies, or small, innovative pilot programs. Reliable, valid research and outcomes data in areas that derive directly from ADS or that ADS can directly impact have implications for both policy and practice, whether promoting replication or recommending changes to practice and utilization. Translating research findings and outcomes data into ‘lay language’ makes research more accessible to stakeholders and more likely to be adopted and/or implemented within ADS, thus supporting the research to practice continuum and advancement of ADS. Collective effort by varied ADS stakeholders is essential to translate data and findings into innovative models to improve, expand, and sustain ADS.

Actions:

  • Translate research data and disseminate to NADSA members as means for continuous improvements and expansion of novel and innovative services

Recommendation/Goals:

  • Establish an ADS Outcomes Project tab for reporting progress updates via NADSA website and The Voice
  • Update NADSA website research tabs
  • Utilize NADSA website as repository of research papers, data, presentations, and more
  • Highlight research related to business practices as well as ADS effectiveness and impacts
  • Build connections between researchers and practitioners to identify actionable steps and develop intervention research around those steps. (utilize previously mentioned partnerships and panels)

5. Implementation and Evaluation of Best Practices

Definition:   Best practices in ADS are those that are shown through ongoing evaluation to maintain or improve effectiveness and efficiency of ADS and ultimately improve the quality of life of participants and their caregivers.  Best practice evolve as innovative models are identified, tested, and evaluated through collaborative efforts. These practices can then be implemented into “real world” practices and demonstrated throughout the ADS sector and must be continually evaluated for their effectiveness and ability to push the boundaries of service delivery in ADS. Providers, participants, and stakeholders are essential for the continued evaluation and evolution of ADS.

Actions:

  • Publicize examples of Research in Motion/Best Practices and include in conference poster sessions
  • Assist Providers with access to innovators and collaborators to allow for easier implementation of innovation and Best Practices
  • Involve above ADS working group in the ongoing evaluation of innovative models and recommended adaptation and implementation of best practices

Recommendation/Goals:

  • Engage both ADS providers demonstrating current best practices, and innovators to become involved with NADSA (Members, Strategic Partners, conference speakers, etc.) and highlight at annual Conference/Research Summit

Benefits of Research Agenda

How does this benefit Providers?

  • Easy opportunities to get involved in data collection and research
  • Ways to access and implement new approaches and best practices

How does this benefit State Associations?

  • Opportunity for state associations to partner more closely with NADSA and other states
  • Ways for state associations to engage with members (data collection and dissemination of results and practices)
  • Opportunity for state associations to leverage large scale ADS data with policy makers and payors at a local level

How does this benefit multi-state providers?

  • Opportunity for multi-state providers to standardize data collection
  • Ways for multi-state providers to collaborate more deeply with state associations and NADSA
  • Ways for multi-state providers to disseminate new/best practices

Conclusion

This report was prepared by NADSA’s Research Committee, and approved by the Board of Directors in August of 2019. The following page outlines the ongoing process and cyclic nature of these research domains and NADSA commits to the actions listed, and to the pursuit of the recommendations listed within this statement.

NADSA Research Task Force Members

  • William Zagorski, CEO, American Senior Care Centers, Inc., Nashville, TN
  • Lisa Peters-Beumer, M.P.H, Aging and Disability Services Consultant, Chicago, IL
  • Lyn Geboy, Ph.D., Independent Research and Planning Consultant, Milwaukee, WI
  • Keith Anderson, Ph.D., MSW, Professor, Director, Montana Geriatric Education Center, School of Social Work, University of Montana, Missoula, MT
  • Shannon Jarrott, Ph.D., Professor, College of Social Work, Ohio State University, Columbus, OH
  • Lauren Harris-Kojetin, Ph.D., Chief, Long Term Care Statistics Branch, National Center for Health Statistics, Hyattsville, MD
  • Lauren Parker, Ph.D., MPH, Assistant Scientist, Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
  • Tina Sadarangani, Ph.D., RN, ANP-BC, GNP-BC, Assistant Professor, New York University, Rory Meyers College of Nursing, New York, NY
  • Jed Johnson, MSW, MBA, Managing Director of Aging Services, CARF International, Washington, DC
  • Lydia Missaelides, MHA, Executive Director, Alliance for Leadership and Education, Sacramento, CA
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