A Citation Review of 83 Dissemination and Implementation Theories, Models, or Frameworks Utilized in U.S.-Based Aging Research.

BACKGROUND AND OBJECTIVES: Dissemination-implementation.org outlines 110 theories, models, and frameworks (TMFs): we conducted a citation analysis on 83 TMFs, searching Web of Science and PubMed databases. RESEARCH DESIGN AND METHODS: Search terms were broad and included "aging," "older," "elderly," and "geriatric." We extracted each TMF in identified articles from inception through January 28, 2022. Included articles must have used a TMF in research or quality improvement work directly linked to older adults within the United States. RESULTS: We reviewed 2,681 articles of which 295 articles cited at least one of 56 TMFs. Five TMFs represented 50% of the citations: Reach, Effectiveness, Adoption, Implementation, and Maintenance 1.0, Consolidated Framework for Implementation Research, Greenhalgh Diffusion of Innovation in Service Organizations, Quality Enhancement Research Initiative, Community-Based Participatory Research, and Promoting Action on Research Implementation in Health Services. TMF application varied and there was a steady increase in TMF citations over time, with a 2- to 3-fold increase in citations in 2020-2021. We identified that only 41% of TMF use was meaningful. DISCUSSION AND IMPLICATIONS: Our results suggest TMF utilization is increasing in aging research, but there is a need to more meaningful utilize TMFs. As the population of older adults continues to grow, there will be increasing demand for effective evidence-based practices and models of care to be quickly and effectively translated into routine care. Use of TMFs is critical to building such evidence and to identifying and evaluating methods to support this translation.

Alzheimer's disease and nursing homes.

Close to two-thirds of all US nursing home residents have some type of cognitive impairment such as Alzheimer's disease, and the quality of care and quality of life of these people has long been called into question. In this overview we first clarify the ongoing importance of nursing home care for people with Alzheimer's, even as policy makers "rebalance" long-term supports and services with home and community-based programs. We next identify the components of optimal care for people with Alzheimer's in nursing homes, and we highlight care innovations already in use. Finally, we summarize policy-relevant challenges to implementing best practices and innovations and explore potential policy solutions. Federal and state policy makers have a critical role to play in ensuring that nursing home residents with Alzheimer's disease have access to the appropriate, high-quality care that they and their families expect.