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 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

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)
Medical Reserve Corps, NYC, Hurricane Sandy Award (2013)
Goddard Fellowship, NYU (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)

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.

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
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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.

COVID Challenges and Adaptations Among Home-Based Primary Care Practices: Lessons for an Ongoing Pandemic from a National Survey

Ritchie, C. S., Gallopyn, N., Sheehan, O. C., Sharieff, S. A., Franzosa, E., Gorbenko, K., Ornstein, K. A., Federman, A. D., Brody, A. A., & Leff, B. (2021). Journal of the American Medical Directors Association, 22(7), 1338-1344. 10.1016/j.jamda.2021.05.016
Abstract
Abstract
Objectives: Approximately 7.5 million US adults are homebound or have difficulty accessing office-based primary care. Home-based primary care (HBPC) provides such patients access to longitudinal medical care at home. The purpose of this study was to describe the challenges and adaptations by HBPC practices made during the first surge of the COVID-19 pandemic. Design: Mixed-methods national survey. Setting and Participants: HBPC practices identified as members of the American Academy of Homecare Medicine (AAHCM) or participants of Home-Centered Care Institute (HCCI) training programs. Methods: Online survey regarding practice responses to COVID-19 surges, COVID-19 testing, the use of telemedicine, practice challenges due to COVID-19, and adaptations to address these challenges. Descriptive statistics and t tests described frequency distributions of nominal and categorical data; qualitative content analysis was used to summarize responses to the open-ended questions. Results: Seventy-nine practices across 29 states were included in the final analyses. Eighty-five percent of practices continued to provide in-person care and nearly half cared for COVID-19 patients. Most practices pivoted to new use of video visits (76.3%). The most common challenges were as follows: patient lack of familiarity with telemedicine (81.9%), patient anxiety (77.8%), clinician anxiety (69.4%), technical difficulties reaching patients (66.7%), and supply shortages including masks, gown, and disinfecting materials (55.6%). Top adaptive strategies included using telemedicine (95.8%), reducing in-person visits (81.9%), providing resources for patients (52.8%), and staff training in PPE use and COVID testing (52.8%). Conclusions and Implications: HBPC practices experienced a wide array of COVID-19–related challenges. Most continued to see patients in the home, augmented visits with telemedicine and creatively adapted to the challenges. An increased recognition of the need for in-home care by health systems who observed its critical role in caring for fragile older adults may serve as a silver lining to the otherwise dark sky of the COVID-19 pandemic.

Defining Telepresence as Experienced in Telehealth Encounters: A Dimensional Analysis

Groom, L. L., Brody, A. A., & Squires, A. P. (2021). Journal of Nursing Scholarship, 53(6), 709-717. 10.1111/jnu.12684
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Purpose: Telehealth’s uptake has increased substantially in recent years, with an especially large jump in 2020 due to the emergence of COVID-19. This article provides background on and explores “telepresence” in healthcare literature. Telepresence strongly impacts the patient experience, but it is poorly defined in current research. The aim was to conceptually define telepresence using qualitative methods. Design: Dimensional analysis was used to analyze telepresence in clinical literature and create a clearer definition of telepresence as a concept. Multiple databases were searched for articles related to telepresence. Thirteen international articles related to telepresence were selected for analysis. Methods: Dimensional analysis allowed for multiple viewpoints to be explored within each distinct context and perspective. Findings: Twenty-five dimensions were discovered within the articles, which were synthesized to seven core dimensions of telepresence: connection, technological mediation, experienced realism, trust, being supportive, collaboration, and emotional consequence. Conclusions: Telepresence is highly impactful on the patient’s experience of telehealth care visits. The conceptual map produced by this dimensional analysis provides direction for clinicians to improve their ability to be present with patients during telehealth care. Potential implications include a starting point for future qualitative research, and the use of this dimensional analysis to inform clinical guidelines, improve clinician training, and assist in the development of new care models. Clinical Relevance: A telepresence definition brings clarity to an ill-defined concept. COVID-19 magnifies the need for a better understanding of telepresence, which allows clinicians to improve telehealth encounters.

Development and protocol for a nurse-led telephonic palliative care program

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Background: The COVID-19 pandemic has resulted in a profound transformation of health care delivery toward telemedicine models. Purpose: We present the structure of a nurse-led telephonic palliative program and operational metrics to influence further development of tele-palliative programs. Methods: The nurses engage with seriously ill patients for 6 months with the goal of discussing advance care planning (ACP) and addressing self-identified issues related to their illness. Findings: Of the first 100 program graduates, 78% were actively engaged and 51% named a health care agent and/or engaged in ACP. Of the 18 patients who died during the study, 13 (72%) were enrolled in hospice services. Discussion: Our preliminary results indicate that seriously ill patients are willing to engage with nurses and to participate with discussions on ACP. Conclusion: Given the gaps in health care exposed by the COVID-19 pandemic, this innovative program serves as an important model for bringing palliative care directly to patients.

Disruptions in Care and Support for Homebound Adults in Home-Based Primary Care in New York City During the COVID-19 Pandemic

Federman, A. D., Leff, B., Brody, A. A., Lubetsky, S., Siu, A. L., Ritchie, C. S., & Ornstein, K. A. (2021). Home Healthcare Now, 39(4), 211-214. 10.1097/NHH.0000000000000983
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Abstract
Homebound older adults are a highly vulnerable population, yet little is known about their experiences with healthcare during the COVID-19 pandemic. We interviewed patients in home-based primary care (HBPC) in New York City by telephone in May and June of 2020. Interviews covered social supports, household activities, self-care, and medical care, and asked participants to compare current with prepandemic experiences. Among 70 participants, 37% were Black and 32% were Hispanic. Disruptions in the home included greater difficulty accessing paid caregivers (13.9%) and food (35.3%) than before the pandemic, and unaddressed household chores (laundry, 81.4%; food preparation, 11.4%). Black study participants were more likely than White and Hispanic participants to report disruptions in accessing medical care (13 [50.0%] vs. 3 [14.3%] vs. 6 [27.3%], respectively, p = 0.02), as well as food preparation and medication taking. Black patients in HBPC are at risk of disparities in healthcare and social support during the COVID-19 pandemic.

Effectiveness and Reach of the Primary Palliative Care for Emergency Medicine (PRIM-ER) Pilot Study: a Qualitative Analysis

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Background: Palliative care interventions in the ED capture high-risk patients at a time of crisis and can dramatically improve patient-centered outcomes. Objective: To understand the facilitators that contributed to the success of the Primary Palliative Care for Emergency Medicine (PRIM-ER) quality improvement pilot intervention. Design: Effectiveness was evaluated through semi-structured interviews. Reach outcomes were measured by percent of all full-time emergency providers (physicians, physician assistants, nurses) who completed the intervention education components and baseline survey assessing attitudes and knowledge on end-of-life care. Participants: Emergency medicine providers affiliated with two medical centers (N = 197). Interviews conducted with six key informants at both institutions. Approach: Interviews were recorded, transcribed, and analyzed using deductive and inductive approaches. Descriptive statistics include reach outcomes and baseline survey results. Key Results: Both sites successfully implemented all components of the intervention and achieved a high level (> 75%) of intervention reach. Two themes emerged as facilitators to successful effectiveness facilitators of PRIM-ER: (1) institutional leadership support and (2) leveraging established quality improvement (QI) processes. Institutional support included leveraging leadership with authority to (a) mandate trainings; (b) substitute PRIM-ER education for normally scheduled education; and (c) provide protected time to implement intervention components. Effectiveness was also enhanced by capitalizing on existing QI processes which included (a) leveraging interdisciplinary partnerships and communication plans and (b) monitoring performance improvement data. Conclusions: Capitalizing on strong institutional leadership support and established QI processes enhanced the reach and effectiveness of the PRIM-ER pilot. These findings will guide the PRIM-ER researchers in scaling up the intervention in the remaining 33 sites, as well as enhance the planning of other complex quality improvement interventions in clinical settings. Registration Details: ClinicalTrials.gov Identifier: NCT03424109; Grant Number: AT009844-01.