School of Medicine Researcher Awarded $44 Million NIH Grant

A School of Medicine faculty member has been awarded a $44 million grant over the next five years from the National Institutes of Health (NIH) to test a fundamentally new model of advance care planning (ACP). 

Michael Paasche-Orlow, professor of medicine at Tufts University School of Medicine and director of the Center for Health Literacy Research and Practice at Tufts Medicine, will co-lead the project, which aims to begin conversations about end-of-life care earlier to give patients and caregivers more time to communicate their preferences for future medical care. These conversations will be led by social workers and nurses using video tools available in 25 languages.

Building on his two decades of research with collaborators on video-assisted ACP, this new clinical trial is distinguished by its main outcome measure: whether patients actually receive care at the end of their life that is concordant with their goals. The trial is also designed to extend the benefits of ACP to communities that have historically experienced lower rates of such planning, including patients in rural areas and those who speak languages other than English. 

“Advance care planning has traditionally been treated as an end-of-life crisis conversation, happening too late and too rushed for patients to truly reflect on what matters most to them,” said Paasche-Orlow. “This model starts that conversation much earlier and puts social workers—who are trained to have meaningful, sustained conversations about goals and values—at the center of the process. The video tools are designed to overcome health-literacy and language barriers so that every patient, regardless of background, can make an informed, meaningful choice alongside their family.”

The multi-site trial will be conducted with two partner health systems: Dartmouth Health, the nation’s most rural health system, and Northwell Health. The study will be led by principal investigators Angelo Volandes, chief research officer at Dartmouth Health and senior associate dean of clinical and translational research at the Geisel School of Medicine at Dartmouth, and Edith Burns, professor of medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health and director of research for the Division of Geriatrics and Palliative Medicine.

For more information on how Paasche-Orlow’s model works and specifics about the project, read the full story from Tufts Medicine.