About
Center investigators have received over 60 million dollars in research and training grants from AHRQ, HRSA, NIC, NCI, NHLBI, NHGRI, NIA, NIDCR, NIMHD, NINR, NLM and NSF.
Funded research
Improving Medical Decision Making for Older Patients with End State Renal Disease
Description
It is imperative to develop scalable and effective approaches to supporting persons with advanced kidney disease and their family caregivers. By providing video education tools to better inform persons making decisions about medical care and offering evidence-based options for kidney care, there is an opportunity to improve quality of life throughout the care trajectory.
Principal Investigators
Funding
- April 2020 – present
- National Institute on Aging
I Kua na’u “Let Me Carry Out Your Last Wishes” Advance Care Planning for Native Hawaiian Elders
Description
Despite the rapid expansion of advance care planning (ACP) services in the health care system, Native Hawaiians consistently have negligible rates of ACP and low use of palliative and hospice care services. To address these shortcomings, our multi-disciplinary community and research group has partnered together to create the I kua na'u "Let Me Carry Out Your Last Wishes" ACP video intervention.
Principal Investigators
- Michael Paasche-Orlow, Tufts Medical Center
- Marjorie K Leimomi Mala Mau, University of Hawaii at Manoa
- Angelo Volandes, Massachusetts General Hospital
Funding
- May 2020 – present
- National Institute of Nursing Research
Description
We will develop and evaluate an Embodied Conversational Agent – Patient-Reported Outcome (ECA-PRO) smartphone system that engages patients with interactive communication and empathy, while delivering standard PROs in a way that minimizes missing data and enables user- friendly visual sharing of results. The ECA-PRO system will create a strong foundation for PRO- based clinical decision-making. This novel system will be tested as a means to monitor symptoms and adverse events in patients with cancer receiving chemo- and/or radiation therapy, and to monitor medication adherence in patients taking oral medication for breast cancer.
Principal Investigators
- Michael Paasche-Orlow, Tufts Medical Center
- Timothy Bickmore, Northeastern University
- James William Griffith, University of Chicago
Funding
- March 2022 – Present
- National Cancer Institute
Advancing Medical Illustration in Patient Education Materials: From Art to Science
Description
We will study different kinds of medical illustrations used in patient education materials to understand the impact these have on patient understanding and anxiety. We will also develop a conversational agent that can explain patient education documents to people, and evaluate different versions of the agent in an experiment to determine which version leads to the most learning.
Principal Investigators
Funding
- September 2023 – present
- National Library of Medicine
A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care
Description
Atrial fibrillation (AF) is a morbid condition with profound social and medical costs. The proposed research is relevant to public health by promoting self-care in individuals with AF. The project aims to improve patient- centered care in a vulnerable cohort of patients with AF as measured by quality of life, adherence to anticoagulation for stroke prevention, and health care utilization.
Principal Investigators
Funding
- April 2020 – present
- National Heart Lung and Blood Institute
Conversational Agents to Improve HPV Vaccine Acceptance in Primary Care
Description
Universal Human Papillomavirus (HPV) vaccination would significantly decrease cervical, vaginal, vulvar, anal, and oral cancers, and reduce racial disparities in these cancers. In this project we will further adapt our Embodied Conversational Agent for HPV system to produce an English and Spanish smartphone ECA-HPV system to provide vaccine recommendations and motivational interviewing to parents/guardians and vaccine-eligible adolescents and facilitate communication with clinic staff. If proven effective, this scalable approach can be broadly implemented and adapted to other childhood, adolescent, maternal, and adult immunizations.
Principle Investigators
- Michael Paasche-Orlow, Tufts Medical Center
- Timothy Bickmore, Northeastern University
- Rebecca B. Perkins, Boston Medical Center
Funding
- September 2022 – June 2027
- National Cancer Institute
Selected publications
Bickmore TW, Ólafsson S, O'Leary TK. Mitigating Patient and Consumer Safety Risks When Using Conversational Assistants for Medical Information: Exploratory Mixed Methods Experiment J Med Internet Res 2021;23(11):e30704.
Holland N. A Historical Overview of Language Access in Dentistry: The Impact of Language Access Protections on Oral Health Care Journal of the California Dental Association. 2021; 49(12):749-757).
Kurtz-Rossi S, Okonkwo IA, Chen Y, Duenas N, Bilodeau T, Rushforth A, and Klein A. Development of a new tool for writing research key information in plain language. HLRP, 2024:8(1):e29-e37.
Paasche-Orlow MK, Schillinger D, Weiss BD, Bickmore T, Cabral H, Chang P, Bailey SC, Dewalt DA, Fernandez A, Fransen M, Leung A, McCaffery K, Meade CD, McCormack LA, Protheroe J, Parker R, Rothman R, Rubin D, Rudd R, Sørensen K, Von Wagner C, Wolf MS, Yin HS, Ownby RL. Health Literacy and Power. Health Lit Res Pract. 2018;15;2(3):e132-e133.
Quintiliani LM, Kamaka M, Henault L, Antonio MCK, Sentell T, Spencer K, Akaka G, Honda LK, Hanakeawe D, Dillard A, Kekauoha BP, Davis AD, Seitz R, Cabral HJ, Volandes A, Mala Mau MKL, Paasche-Orlow MK. I kua na'u "Let me carry out your last wishes" Clinical trial protocol to promote advance care planning among native Hawaiian populations. Contemporary Clinical Trials, 2023 135:107365.
Volandes AE, Zupanc SN, Lakin JR, Cabral HJ, Burns EA, Carney MT, Lopez S, Itty J, Emmert K, Martin NJ, Cole T, Dobie A, Cucinotta T, Joel M, Caruso LB, Henault L, Dugas JN, Astone K, Winter M, Wang N, Davis AD, Garde C, Rodriguez PM, El-Jawahri A, Moseley ET, Das S, Sciacca K, Ramirez AM, Gromova V, Lambert S, Sanghani S, Lindvall C, Paasche-Orlow MK. Video Intervention and Goals-of-Care Documentation in Hospitalized Older Adults: The VIDEO-PCE Randomized Clinical Trial. JAMA Network Open. 2023 Sep 5;6(9):e2332556.
Completed studies
Description
The majority of patients aged 65 or over, and patients with Alzheimer's Disease and Related Dementias (ADRD), have never communicated their preferences to clinicians or completed advance care planning (ACP) documents. The novel Coronavirus Disease 2019 (COVID-19) acutely escalated the importance of integrating ACP and palliative care services into medical care. We aimed to improve ACP with an ACP Educator who promote ACP conversations with certified video decision aids in a model of care that is practical, scalable, and evidence-based, has the potential to mitigate communication barriers related to health literacy and limited English proficiency, and has the potential to improve the quality of medical care delivery to millions of Americans during the COVID-19 pandemic.
Principal Investigators
Funding
- May 2021 – April 2022
- National Institute on Aging
Publications
- Video Intervention and Goals-of-Care Documentation in Hospitalized Older Adults: The VIDEO-PCE Randomized Clinical Trial
- Study Protocol for Video Images and Decision to Improve Ethical Outcomes with Palliative Care Educators (VIDEO-PCD): A Pragmatic Stepped Wedge Cluster Randomized Trial of Older Patients Admitted to the Hospital
Description
We collaborated with the Black Ministerial Alliance TenPoint (BMATP) of Greater Boston to develop a smartphone-based Embodied Conversational Agent app that provides education about SARS-CoV-2 and influenza vaccination, and motivates vaccination completion, following public health guidelines. We evaluated the intervention in a clinical trial involving 600 congregants from 12 predominately African American churches.
Principal Investigators
- Timothy Bickmore, Northeastern University
- Michael Paasche-Orlow, Tufts Medical Center
- Andrea Parker, Northeastern University
Funding
- April 2021 – January 2023
- National Institute on Minority Health and Health Disparities
Testing a Medical Risk Communication and Surveillance Strategy: The EMC2Trial
Description
Nearly 10 million outpatient physician visits and 4 million emergency department admissions occur each year because of adverse drug events or serious drug side effects. A risk communication and surveillance strategy is needed in primary care to ensure that patients are adequately informed about medication risks and are taking high-risk drugs safely. In response, we assessed the effectiveness and fidelity of a primary-care based, technology-enabled strategy to improve patient-provider communication about drug risks, and to promote patient understanding and safe use.
Principal Investigators
Funding
- August 2015 – May 2017
- National Institute of Diabetes and Digestive and Kidney Diseases
Publications