Abraham A Brody

Faculty

Ab Brody headshot

Abraham A Brody

Associate Professor, Nursing & Medicine
Associate Director, Hartford Institute for Geriatric Nursing

1 212 992 7341

433 First Ave
Room 504
New York, NY 10010
United States

Accepting PhD students

Abraham A Brody's additional information

Abraham Brody, PhD, RN, FAAN is associate director of the Hartford Institute for Geriatric Nursing and associate professor of Nursing and Medicine at NYU Meyers College of Nursing. He is also the founder of Aliviado Health and the Pilot Core Lead of the NIA IMPACT Collaboratory. His work focuses on the intersection of geriatrics, palliative care, quality, and equity. The primary goal of his research, clinical, and policy pursuits is to improve the quality of care for older adults with serious illness wherever they reside. His primary mode for doing so is through the development, testing, and dissemination of real-word, technology, and informatics supported quality improvement interventions. He is currently the principal investigator of two NIH-funded large-scale pragmatic clinical trials to improve the quality of care and quality of life for persons living with dementia and their caregivers in the community and a co-investigator on several other pragmatic trials and health services research projects in geriatrics and palliative care.

From a leadership perspective, Brody works across disciplines to help advance geriatrics and palliative care nationally. As pilot core lead of the $53.4 million nationwide Collaboratory, he is responsible for heading the pilot program, which, in collaboration with the National Institute on Aging, reviews and awards funds to help investigators prepare for large-scale pragmatic clinical trials for persons living with dementia and their caregivers. He also serves on the Steering Committee of the NINR Funded Palliative Care Research Cooperative, the policy-setting body for the organization. 

In addition to his research and national leadership responsibilities, Brody is passionate about mentoring and developing a diverse nursing and scientific workforce. To this end, he developed and the Hospice and Palliative Nurses Association Leadership Development Program and is the technology core director of NYU Meyer’s P20 Exploratory Center for Precision Health in Diverse Populations, and serves on the Executive Committee of the Training, Research, and Education Core of the NYU-HHC Clinical Translational Sciences Institute. He mentors faculty, post- doctoral scholars, and PhD students across multiple disciplines and institutions. Brody also maintains an active practice in the Geriatric and Palliative Consult Services at NYU Langone Health.
 
Home Health Study
HAS-QOL Study

PhD - University of California, San Francisco (2008)
MSN - University of California, San Francisco (2006)
BA - New York University, College of Arts and Sciences (2002)

Home care
Palliative care
Non-communicable disease
Health Policy
Gerontology
Interprofessionalism
Chronic disease
Community/population health
Neurology
Research methods
Underserved populations

American Nurses Association
American Geriatrics Society
Eastern Nursing Research Society
Gerontological Society of America
Hospice and Palliative Nurses Association
International Home Care Nurses Organization
Palliative Care Research Cooperative
Sigma Theta Tau, Upsilon Chapter

Faculty Honors Awards

Fellow, Palliative Care Nursing, Hospice and Palliative Nurses Association (2017)
Fellow, American Academy of Nursing (2017)
Fellow, Gerontological Society of America (2016)
Fellow, New York Academy of Medicine (2016)
Sojourns Scholar, Cambia Health Foundation (2014)
Nurse Faculty Scholar, Robert Wood Johnson Foundation (2014)
Goddard Fellowship, NYU (2013)
Medical Reserve Corps, NYC, Hurricane Sandy Award (2013)
Research Scholar, Hospice and Palliative Nurses Association (2010)
Finalist, SRPP Section Young Investigator, Gerontological Society of America (2008)
Edith M. Pritchard Award, Nurses' Education Funds (2006)
Scholar, Building Academic Geriatric Nursing Capacity, John A Hartford (2006)
Finalist, Student Regent, University of California, San Francisco (2005)
Inducted into Sigma Theta Tau, Nursing Honor Society (2004)

Publications

Aliviado Mobile App for Hospice Providers: A Usability Study

David, D., Lin, S. Y., Groom, L. L., Ford, A., & Brody, A. A. (2022). Journal of Pain and Symptom Management, 63(1), e37-e45. 10.1016/j.jpainsymman.2021.07.019
Abstract
Abstract
Context: Evaluation of usability and mobile health content is critical for ensuring effective implementation of technology utilizing interventions tailored to the needs of hospice care providers for people living with dementia in community-based settings. Objectives: To evaluate the usability, content, and “readiness to launch” of the Aliviado mobile health app for interdisciplinary team members participating in the Hospice Advanced Dementia Symptom Management and Quality of Life. Methods: Usability of the Aliviado app was assessed in 86 respondents with an adapted IBM Computer Usability Satisfaction Questionnaire following Hospice Advanced Dementia Symptom Management and Quality of Life training and implementation of the mobile app. Results: More than half of users receiving training employed the mobile app in practice. Users reported use as: Daily-6.3%, Weekly-39.6%, monthly-54.2%. The highest measured attributes were usefulness, value, and effectiveness. Over 90% deemed the app “ready to launch” with no or minimal problems. Conclusion: This study shows that a newly-developed mobile app is usable and can be successfully adopted for care of people living with dementia.

Findings of Sequential Pilot Trials of Aliviado Dementia Care to Inform an Embedded Pragmatic Clinical Trial

Lin, S. Y., Schneider, C. E., Bristol, A. A., Clancy, M., Sprague, S. A., Aldridge, M., Cortes, T., Goldfeld, K. S., Kutner, J. S., Mitchell, S. L., Shega, J. W., Wu, B., Zhu, C. W., & Brody, A. A. (2022). Gerontologist, 62(2). 10.1093/geront/gnaa220
Abstract
Abstract
Background and Objectives: Many investigators of Alzheimer's disease and related dementias (AD/ADRD) are unfamiliar with the embedded pragmatic clinical trials (ePCTs) and the indispensable pilot phase preceding ePCTs. This paper provides a much-needed example for such a pilot phase and discusses implementation barriers and additional infrastructure and implementation strategies developed in preparation for a nationwide AD/ADRD ePCT. Research Design and Methods: Two pilot trials were conducted in 2 hospices sequentially to refine and test Aliviado Dementia Care - Hospice Edition, a complex quality improvement intervention for advanced dementia symptom management. Readiness for the subsequent full-scale ePCT was assessed by three milestones: ≥80% training completion rate ("feasibility"), ≥80% posttraining survey respondents indicating intention for practice changes ("applicability"), and at least 1 Aliviado care plan/assessment instrument administered in ≥75% of dementia patients admitted to home hospice within 1-month posttraining ("fidelity"). Results: Participants included 72 interdisciplinary team members and 11 patients with AD/ADRD across the pilots. Feasibility, applicability, and fidelity outcomes (92%, 93%, and 100%, respectively) all surpassed the preestablished milestones (80%, 80%, and 75%). Main implementation challenges were related to hospice staff turnover, integration of the Aliviado toolbox materials within the electronic health records, and hospices' limited research experience and infrastructure. Discussion and Implications: This pilot phase demonstrated feasibility, applicability, and fidelity required to proceed to the full-scale ePCT. Our study findings and discussions of additional infrastructure and implementation strategies developed following the pilot phase can inform researchers and clinicians interested in conducting AD/ADRD-related pilot studies for ePTCs or quality improvement initiatives. Clinical Trials Registration Number: NCT03681119.

Hospice interventions for persons living with dementia, family members and clinicians: A systematic review

Lassell, R. K., Moreines, L. T., Luebke, M. R., Bhatti, K. S., Pain, K. J., Brody, A. A., & Luth, E. A. (2022). Journal of the American Geriatrics Society. 10.1111/jgs.17802
Abstract
Abstract
Background: Hospice care was initially designed for seriously ill individuals with cancer. Thus, the model and clinicians were geared toward caring for this population. Despite the proportion of persons living with dementia (PLWD) receiving hospice care substantially increased over the past 10 years, and their longer lengths of stay, established hospice interventions for this population are scarce. No systematic review has previously evaluated those interventions that do exist. We synthesized hospice intervention studies for PLWD, their families, and hospice professionals by describing the types of interventions, participants, outcomes, and results; assessing study quality; and identifying promising intervention strategies. Methods: A systematic review was conducted using a comprehensive search of five databases through March 2021 and follow-up hand searches. Included studies were peer-reviewed, available in English, and focused on hospice interventions for persons with dementia, and/or care partners, and clinicians. Using pre-determined inclusion and exclusion criteria, data was extracted guided by the Cochrane Checklist, and quality was assessed using a 26-item Consolidated Standards of Reporting Trials (CONSORT) Checklist. Results: The search identified 3235 unique studies in total, of which 10 studies met inclusion criteria. The search revealed three types of interventions: clinical education and training, usual care plus care add-on services, and “other” delivered to 707 participants (mostly clinicians). Five studies included underrepresented racial and ethnic groups. Outcomes measured knowledge and skills, psychosocial and health outcomes, feasibility, and acceptability, with significant improvements in six studies. Study quality was reflective of early-stage research with clinical education and training strategies showing deliberate progression towards real-world efficacy testing. Implications: Hospice interventions for PLWD are sparse and in early-phase research. More research is needed with rigorous designs, diverse samples, and outcomes considering the concordance of care.

Nurse-Led Telephonic Palliative Care: A Case-Based Series of a Novel Model of Palliative Care Delivery

Yamarik, R. L., Tan, A., Brody, A. A., Curtis, J., Chiu, L., Bouillon-Minois, J. B., & Grudzen, C. R. (2022). Journal of Hospice and Palliative Nursing, 24(2), E3-E9. 10.1097/NJH.0000000000000850
Abstract
Abstract
Americans near the end of life experience high rates of nonbeneficial, burdensome, and preventable hospital-based care. If patients' goals of care are unknown or unclear, they have higher rates of hospitalization at the end of life. The demand for palliative care has grown exponentially because of its impact on quality of life, symptom burden, and resource use, requiring the development of new palliative care models. Nurses' holistic outlook and patient-centered focus make them ideal to deliver telephonic palliative care. This article discusses 4 cases delivered by a nurse-led telephonic palliative care program, a part of the Emergency Medicine Palliative Care Access project, which is a randomized controlled trial comparing outpatient palliative care with nurse-led telephonic case management after an emergency department visit. Telephonic nurses discuss patients' goals, fears, hopes, and concerns regarding their illness and its trajectory that inform decisions for future interventions and treatments. In addition, they share this information with the patients' surrogate decision-makers and clinicians to facilitate care coordination and symptom management. For seriously ill patients, nurses' abilities and expertise, as well as the difficulties of providing care through in-person models of palliative care delivery, make a nurse-led telephonic model an optimal option.

A Pilot Observational Exploratory Study of Well-Being in Hospice Interdisciplinary Team Members

Schneider, C., Bristol, A., Ford, A., Lin, S. Y., Brody, A. A., & Stimpfel, A. W. (2022). American Journal of Hospice and Palliative Medicine, 39(3), 264-269. 10.1177/10499091211023480
Abstract
Abstract
Introduction: Well-being and turnover intent represent key aspects to the promotion of a healthy workforce. Alarming levels of burnout and low levels of well-being have been documented in health professionals across care settings. Not only do high levels of burnout, low well-being and high turnover affect health professionals, but they are associated with poor patient care. However, limited research has investigated this topic specifically in hospice interdisciplinary team (IDT) members, nurses, chaplains, social workers. Thus, the purpose of this study was to explore hospice IDT members’ well-being, and turnover intent. Methods: This observational, pilot study used quantitative surveys to examine the well-being, and turnover intention at baseline and at 3 months. Twenty-five hospice IDT members at one site participated. Results: Paired t-tests and percent change demonstrated significant decreases in compassion satisfaction (44.5 vs. 42.1, p = 0.04) and secondary traumatic stress score (18.5 vs. 13.3, p = 0.0001) and a significant increase in burnout score (17.6 vs. 20.5, p = 0.03) from baseline to follow up. Employee turnover slightly decreased from baseline to follow-up. Conclusions: In this pilot study, hospice IDT members had low levels of well-being at baseline that worsened over 3-months indicating a higher potential risk for burnout. Moreover, given the COVID-19 pandemic, this may be an ominous sign of what lies ahead for hospice providers regarding turnover, leading to significant long-term staffing problems in the field. If these results hold true in a larger sample, it could necessitate developing and testing further strategies to ensure a healthy and stable workforce.

A qualitative analysis of communication workflows between adult day service centers and primary care providers

Zhong, J., Boafo, J., Brody, A. A., Wu, B., & Sadarangani, A. T. (2022). Journal of the American Medical Informatics Association, 29(5), 882-890. 10.1093/jamia/ocab284
Abstract
Abstract
Objectives: Our study documented communication workflows across adult day care centers (ADCs) and primary care providers (PCPs) around complex needs of persons living with dementia (PLWD). We also identified barriers and facilitators to productive communication in clinical decision support and clinical information systems. Materials and Methods: We conducted 6 focus groups with ADC staff (N=33) and individual semistructured interviews with PCPs (N=22) in California. The eHealth Enhanced Chronic Care Model was used to frame the directed qualitative content analysis. Results: Our results captured cumbersome and ineffective workflows currently used to exchange information across PCPs and ADCs. Stakeholders characterized current communication as (1) infrequent, (2) delayed, (3) incomplete, (4) unreliable, (5) irrelevant, and (6) generic. Conversely, communication that was bidirectional, relevant, succinct, and interdisciplinary was needed to elevate the standard of care for PLWD. Discussion and Conclusion: ADCs possess a wealth of information that can support clinical decision-making across community-based providers involved in the care of PLWD, especially PCPs. However, effective information exchange is mired by complicated workflows that rely on antiquated technologies (eg, facsimile) and standard templates. Current information exchange largely focuses on satisfying regulatory guidelines rather than supporting clinical decision-making. Integrating community-based services into the health care continuum is a necessary step in elevating the standard of care for PLWD. In the absence of interoperable electronic health records, which may not be financially viable for ADCs, other options, such as mobile health, should be explored to facilitate productive information exchange of personalized relevant information.

Transitioning to Remote Recruitment and Intervention: A Tale of Two Palliative Care Research Studies Enrolling Underserved Populations During COVID-19

Brody, A. A., Convery, K. A., Kline, D. M., Fink, R. M., & Fischer, S. M. (2022). Journal of Pain and Symptom Management, 63(1), 151-159. 10.1016/j.jpainsymman.2021.06.017
Abstract
Abstract
Context: During the COVID-19 pandemic, community-based research studies experienced prolonged shutdowns unless able to pivot to remote study procedures. Objectives: To describe the revision of two National Institutes of Health funded community-based palliative-focused clinical trials serving underserved populations to accommodate remote subject enrollment and examine its impact. Methods: Transitioning to remote processes required multiple protocol and procedural changes including: altering informed consent processes; reducing the number of surveys administered; adding internet access as an inclusion criterion. To understand technological challenges, a screening tool was developed for one study to identify potentially eligible subjects’ technology abilities and accessibility. Results: Subjects’ limited access to the internet and internet-enabled devices and discomfort with technology led to changes in recruitment patterns. Lack of familiarity with technology increased the amount of time it took research team members and subjects to connect remotely. Patients with significant cognitive and/or sensory deficits were at higher risk of experiencing fatigue during remote study visits leading to streamlining of data collection. A researcher-developed technology screening tool found that potential subjects were not comfortable with videoconferencing through Zoom expressing a preference for phone visits. Reduced travel time made scheduling remote study visits more efficient. Conclusion: Future community- and home-based palliative care trials must consider the best way to utilize remote recruitment, enrollment, and data collection processes to increase efficiency and reduce costs. Researchers should consider technology accessibility and train staff to ensure the greatest possible opportunity to recruit underserved populations who have traditionally been underrepresented in research studies.

Adaptation and Piloting for Hospice Social Workers of Aliviado Dementia Care, a Dementia Symptom Management Program

Jones, T. M., & Brody, A. A. (2021). American Journal of Hospice and Palliative Medicine, 38(5), 452-458. 10.1177/1049909120962459
Abstract
Abstract
Background: Forty-five percent of hospice patients currently have a primary or secondary diagnosis of Alzheimer’s disease or related disorders. However, few programs have focused specifically on assisting hospices in providing evidence-based symptom management to persons living with dementia (PLWD). Objective: To adapt and pilot the training component of Aliviado Dementia Care, a dementia symptom management quality improvement program originally developed for home healthcare, for use by social workers as part of the hospice interdisciplinary team. Design: A prospective pre-post design was utilized, measuring knowledge, confidence, and attitudes at baseline, and immediately and 1-month post-training. Analysis was performed using paired t-tests and repeated measures ANOVA. Subjects: Hospice social workers currently practicing in the United States with at least 1 year of experience. Measurements: The Dementia Symptom Knowledge Assessment and a post-training continuing education evaluation form. Results: Forty-six subjects were enrolled, of whom 26 completed the first post-test and 23 both post-tests. There was a poor baseline level of knowledge and confidence in caring for PLWD. Significant improvements occurred following training, particularly in implementing non-pharmacologic interventions for behavioral and psychological symptoms of dementia (BPSD) (16.64% increase, p <.0001) and confidence in managing behavioral symptoms (16.86%, p =.01) and depression (25.18%, p <.0001). Changes were maintained over time. All respondents were either very satisfied or satisfied with the quality and content of the program. Conclusions: The training modules of Aliviado Dementia Care were successfully tailored for use by hospice social workers, showing significant improvement in knowledge and confidence in caring for behavioral symptoms in PLWD. Future work will examine whether the larger program, including this training, can subsequently improve patient outcomes in hospice.

Advance Care Planning, Palliative Care, and End-of-life Care Interventions for Racial and Ethnic Underrepresented Groups: A Systematic Review

Jones, T., Luth, E. A., Lin, S. Y., & Brody, A. A. (2021). Journal of Pain and Symptom Management, 62(3), e248-e260. 10.1016/j.jpainsymman.2021.04.025
Abstract
Abstract
Context: Persons from underrepresented racial and ethnic groups experience disparities in access to and quality of palliative and end-of-life care. Objectives: To summarize and evaluate existing palliative and end-of-life care interventions that aim to improve outcomes for racial and ethnic underrepresented populations in the United States. Methods: We conducted a systematic review of the literature in the English language from four databases through January 2020. Peer-reviewed studies that implemented interventions on palliative care, advance care planning, or end-of-life care were considered eligible. Data were extracted from 16 articles using pre-specified inclusion and exclusion criteria. Quality was appraised using the modified Downs and Black tool for assessing risk of bias in quantitative studies. Results: Five studies were randomized controlled trials, and the remainder were quasi-experiments. Six studies targeted Latino/Hispanic Americans, five African Americans, and five, Asian or Pacific Islander Americans. The two randomized control trials reviewed and rated “very high” quality, found educational interventions to have significant positive effects on advance care planning and advance directive completion and engagement for underrepresented racial or ethnic groups. Conclusion: The effectiveness of advance care planning, end-of-life, and palliative care interventions in improving outcomes for underrepresented racial and ethnic populations remains uncertain. Randomized controlled trials and educational interventions indicate that interventions targeting underrepresented groups can have significant and positive effects on advance directives and/or advance care planning-related outcomes. More high-quality intervention studies that address racial and ethnic health disparities in palliative care are needed, particularly those that address systemic racism and other complex multilevel factors that influence disparities in health.

Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement

Gettel, C. J., Voils, C. I., Bristol, A. A., Richardson, L. D., Hogan, T. M., Brody, A. A., Gladney, M. N., Suyama, J., Ragsdale, L. C., Binkley, C. L., Morano, C. L., Seidenfeld, J., Hammouda, N., Ko, K. J., Hwang, U., Hastings, S. N., Bellolio, M. F., Biese, K., Binkley, C., Bott, N., Carpenter, C., Clark, S., Dresden, M. S., Forrester, S., Gerson, L., Gettel, C., Goldberg, E., Greenberg, A., Hammouda, N., Han, J., Hastings, S. N., Hogan, T., Hung, W., Hwang, U., Kayser, J., Kennedy, M., Ko, K., Lesser, A., Linton, E., Liu, S., Malsch, A., Matlock, D., McFarland, F., Melady, D., Morano, C., Morrow-Howell, N., Nassisi, D., Nerbonne, L., Nyamu, S., Ohuabunwa, U., Platts-Mills, T., Ragsdale, L., Richardson, L., Ringer, T., Rosen, A., Rosenberg, M., Shah, M., Skains, R., Skees, S., Souffront, K., Stabler, L., Sullivan, C., Suyama, J., Vargas, S., Camille Vaughan, E., Voils, C., Wei, D., & Wexler, N. (2021). Academic Emergency Medicine, 28(12), 1430-1439. 10.1111/acem.14360
Abstract
Abstract
Objectives: Individual-level social needs have been shown to substantially impact emergency department (ED) care transitions of older adults. The Geriatric Emergency care Applied Research (GEAR) Network aimed to identify care transition interventions, particularly addressing social needs, and prioritize future research questions. Methods: GEAR engaged 49 interdisciplinary stakeholders, derived clinical questions, and conducted searches of electronic databases to identify ED discharge care transition interventions in older adult populations. Informed by the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) framework, data extraction and synthesis of included studies included the degree that intervention components addressed social needs and their association with patient outcomes. GEAR convened a consensus conference to identify topics of highest priority for future care transitions research. Results: Our search identified 248 unique articles addressing care transition interventions in older adult populations. Of these, 17 individual care transition intervention studies were included in the current literature synthesis. Overall, common care transition interventions included coordination efforts, comprehensive geriatric assessments, discharge planning, and telephone or in-person follow-up. Fourteen of the 17 care transition intervention studies in older adults specifically addressed at least one social need within the PRAPARE framework, most commonly related to access to food, medicine, or health care. No care transition intervention addressing social needs in older adult populations consistently reduced subsequent health care utilization or other patient-centered outcomes. GEAR stakeholders identified that determining optimal outcome measures for ED–home transition interventions was the highest priority area for future care transitions research. Conclusions: ED care transition intervention studies in older adults frequently address at least one social need component and exhibit variation in the degree of success on a wide array of health care utilization outcomes.