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Worldwide Elements To Harmonize Research In long-term care liVing Environments (WE-THRIVE) Consortium

Worldwide Elements To Harmonize Research In long-term care liVing Environments (WE-THRIVE) Consortium

Project status
Michael Lepore
PI Name
Michael Lepore
Host institution
University of Massachusetts Amherst
Institution web page
Team members
Patrick Alexander Wachholz, Barbara Bowers, David Edvardsson, Kirsten Corazzini, Adam L Gordon, Julienne Meyer, Bei Wu, Charlene Chu, Chiei Fukui, Sandra Staudacher-Preite, Jing Wang, Katherine McGilton, Anette Fagertun, Franziska Zúñiga.



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Project Summary

We have developed the Worldwide Elements To Harmonize Research In long-term care liVing Environments (WE-THRIVE) as a basis for our long-term goal of developing an international long-term care (LTC) research measurement infrastructure that can support resilience and thriving among LTC residents, families and staff. The WE-THRIVE consortium is a growing, global consortium including researchers from low, middle, and high-income countries.

The consortium’s mission is rooted in identifying universally relevant measurement domains, prioritizing essential concepts within these domains, and defining a set of common data elements (CDEs) for comprehensive and comparative research endeavors. It pioneers the development of CDEs to bolster person-centered, residential long-term care globally. Anchored in the disciplines of medicine, nursing, behavioral, and social sciences, this initiative is at the forefront of harmonizing research efforts across diverse geographic and economic contexts. The collaborative undertakings of WE-THRIVE is underpinned by best practices from the US National Institutes of Health/National Institute of Nursing Research’s CDE initiative. WE-THRIVE’s work resonates powerfully with the World Health Organization’s mandate for comparative measurement as a cornerstone for transformative health system reforms. The consortium’s commitment to inclusivity and comprehensive stakeholder engagement is a testament to their dedication to reshaping the landscape of long-term care research. By bridging the gaps in empirical knowledge and aligning with international position statements, WE-THRIVE is setting the stage for a paradigm shift towards a more integrated, person-centered research infrastructure that cherishes and cultivates the wellbeing and quality of life for older adults and their caregivers.

Our active engagement and leadership within the interest group “‘Common Data Elements for International Research in Residential Long-term Care” for the Gerontological Society of America (GSA), currently has over 300 members across the world. It serves as a dynamic platform for bringing together researchers, practitioners, and policymakers. It fosters a rich exchange of ideas, resources, and best practices.

Outputs / expected Outputs

The WE-THRIVE consortium is poised to deliver impactful outputs across three critical dimensions: research, innovation, and the establishment of Common Data Elements (CDEs). Each of these outputs is expected to contribute significantly to the advancement of international research in long-term care homes, emphasizing a person-centered approach.
1. Empirical Studies: Conduct comprehensive empirical studies to explore and understand the multifaceted dynamics of long-term care homes across different countries. This involves examining the organizational context, workforce and staffing dynamics, the implementation and impact of person-centered care, and the measurement of care outcomes.
2. Cross-Cultural Insights: Generate cross-cultural insights by comparing and contrasting the long-term care practices, policies, and outcomes across the 21 participating countries. This includes understanding the unique challenges and best practices in both high-income and lower-income settings.

Develop and refine innovative research methodologies tailored for the study of long-term care homes. This may include novel approaches to data collection, analysis, and the integration of qualitative and quantitative data.

Common Data Elements (CDEs):
1. Development of CDEs: Establish a robust set of CDEs that are relevant, reliable, and applicable across various international long-term care settings. This involves a rigorous process of identification, prioritization, and consensus-building among the consortium members.
2. Data Sharing and Collaboration: Foster a culture of data sharing and collaboration among researchers and practitioners in the field of long-term care. By providing a common framework for data collection and analysis, the CDEs will enable more coordinated and comprehensive research efforts, paving the way for groundbreaking discoveries and innovations in the field.

Special Collection of Gerontology and Geriatric Medicine:

International research on long-term care (LTC) can valuably inform LTC policy and practice, but limited transnational collection of data on key LTC issues restricts the contributions of international LTC research. This special collection of Gerontology and Geriatric Medicine helps close the gap between the status quo and the potential for international LTC research by cultivating a transnational common ground of internationally prioritized measurement concepts and sowing the seeds of international LTC common data elements. The articles in this special collection address both adaptive and technical challenges to international LTC measurement, build on and complement existing LTC measurement systems, and provide diverse international perspectives on the measurement of LTC across four overarching domains: LTC contexts, workforce and staffing, person-centered care, and care outcomes. From large transnational teams of scholars specifying the meanings of central LTC concepts, to smaller subnational research teams testing new measures of person-centered care across diverse local LTC settings, contributors spark new insights and point in new directions for a LTC measurement infrastructure supportive of person-centered care and lifelong thriving.

1.Zúñiga F, Chu CH, Boscart V, et al. Recommended Common Data Elements for International Research in Long-Term Care Homes: Exploring the Workforce and Staffing Concepts of Staff Retention and Turnover. Gerontology and Geriatric Medicine. 2019;5. doi:10.1177/2333721419844344

2. Chu CH, McGilton KS, Spilsbury K, et al. Strengthening International Research in Long-Term Care: Recommended Common Data Elements to Support Clinical Staff Training. Gerontology and Geriatric Medicine. 2021;7. doi:10.1177/2333721421999312

3.McGilton KS, Backman A, Boscart V, et al. Exploring a Common Data Element for International Research in Long-Term Care Homes: A Measure for Evaluating Nursing Supervisor Effectiveness. Gerontology and Geriatric Medicine. 2020;6. doi:10.1177/2333721420979812

4.Edvardsson D, Baxter R, Corneliusson L, et al. Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life. Gerontology and Geriatric Medicine. 2019;5. doi:10.1177/2333721419842672

5. Siegel EO, Backman A, Cai Y, et al. Understanding Contextual Differences in Residential LTC Provision for Cross-National Research: Identifying Internationally Relevant CDEs. Gerontology and Geriatric Medicine. 2019;5. doi:10.1177/2333721419840591

6. Wang J, Wu B, Bowers BJ, et al. Person-Centered Dementia Care in China: A Bilingual Literature Review. Gerontology and Geriatric Medicine. 2019;5. doi:10.1177/2333721419844349

7. Vellani S, Zuniga F, Spilsbury K, et al. Who’s in the House? Staffing in Long-Term Care Homes Before and During COVID-19 Pandemic. Gerontology and Geriatric Medicine. 2022;8. doi:10.1177/23337214221090803

8. Igarashi A, Eltaybani S, Takaoka M, Noguchi-Watanabe M, Yamamoto-Mitani N. Quality Assurance in Long-Term Care and Development of Quality Indicators in Japan. Gerontology and Geriatric Medicine. 2020;6. doi:10.1177/2333721420975320

9. White DL, Tunalilar O, Hasworth S, Winfree J. The Resident VIEW in Nursing Homes. Gerontology and Geriatric Medicine. 2019;5. doi:10.1177/2333721419877975

10. Lepore M, Corazzini K. Advancing International Research on Long-Term Care: Using Adaptive Leadership to Build Consensus on International Measurement Priorities and Common Data Elements. Gerontology and Geriatric Medicine. 2019;5. doi:10.1177/2333721419864727


Output 1Special Collection of Gerontology and Geriatric Medicine

Output 2Toward Common Data Elements for International Research in Long-term Care Homes: Advancing Person-Centered Care

Abstract To support person-centered, residential long-term care internationally, a consortium of researchers in medicine, nursing, behavioral, and social sciences from 21 geographically and economically diverse countries have launched the WE-THRIVE consortium to develop a common data infrastructure. WE-THRIVE aims to identify measurement domains that are internationally relevant, including in low-, middle-, and high-income countries, prioritize concepts to operationalize domains, and specify a set of data elements to measure concepts that can be used across studies for data sharing and comparisons. This article reports findings from consortium meetings at the 2016 meeting of the Gerontological Society of America and the 2017 meeting of the International Association of Gerontology and Geriatrics, to identify domains and prioritize concepts, following best practices to identify common data elements (CDEs) that were developed through the US National Institutes of Health/National Institute of Nursing Research's CDEs initiative. Four domains were identified, including organizational context, workforce and staffing, person-centered care, and care outcomes. Using a nominal group process, WE-THRIVE prioritized 21 concepts across the 4 domains. Several concepts showed similarity to existing measurement structures, whereas others differed. Conceptual similarity (convergence; eg, concepts in the care outcomes domain of functional level and harm-free care) provides further support of the critical foundational work in LTC measurement endorsed and implemented by regulatory bodies. Different concepts (divergence; eg, concepts in the person-centered care domain of knowing the person and what matters most to the person) highlights current gaps in measurement efforts and is consistent with WE-THRIVE's focus on supporting resilience and thriving for residents, family, and staff. In alignment with the World Health Organization's call for comparative measurement work for health systems change, WE-THRIVE's work to date highlights the benefits of engaging with diverse LTC researchers, including those in low-, middle-, and high-income countries, to develop a measurement infrastructure that integrates the aspirations of person-centered LTC.

Output 3Uncovering the Devaluation of Nursing Home Staff During COVID-19: Are We Fuelling the Next Health Care Crisis?