​​​​​​​​Welcome to the IMPACT Knowledge Repository, a searchable collection of resources related to pragmatic clinical trials for people living with dementia and their caregivers. For additional content and information visit the IMPACT Collaboratory.

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Early Career Researchers Respond to Cross-Cutting Principles for Dementia Care Pragmatic Trials: Lessons Learned6/24/2026Publications/Articles
(Article) This forum article describes pragmatic data sources across diverse healthcare settings in dementia care research. Through case examples, we show how early career researchers (ECRs) can innovate to identify and collect pragmatic data despite challenges. These case examples highlight unique data sources across disciplines, including nursing, social work, neuropsychology, occupational therapy, and speech-language pathology. They also illustrate creative approaches to using pragmatic data in each setting, encouraging ongoing innovation in dementia care research.
IMPACT Grand Rounds 67: Shaping Dementia Research Together: Engaging People Living With Dementia and Care Partners (Video)6/18/2026Grand Rounds/Webinars
(Video) In this grand rounds, members of the Engaging Partners Team present the science of engaging community partners in research on dementia care and hear directly from members of IMPACT's community review panel.
IMPACT Grand Rounds 67: Shaping Dementia Research Together: Engaging People Living With Dementia and Care Partners (Slides)6/18/2026Grand Rounds/Webinars
(Slides) In this grand rounds, members of the Engaging Partners Team present the science of engaging community partners in research on dementia care and hear directly from members of IMPACT's community review panel.
IMPACT Grand Rounds 66: ePCTs and Health System Ethical Obligations (Video)5/21/2026Grand Rounds/Webinars
(Video) Stephanie Morain, PhD, MPH introduce a framework of ten obligations for institutions when leading or participating in PCTs, and the corresponding practical implications for the ethical conduct of embedded PCTs.
IMPACT Grand Rounds 66: ePCTs and Health System Ethical Obligations (Slides)5/21/2026Grand Rounds/Webinars
(Slides) Stephanie Morain, PhD, MPH introduce a framework of ten obligations for institutions when leading or participating in PCTs, and the corresponding practical implications for the ethical conduct of embedded PCTs.
Reply to: Comment on “Comparative Effectiveness of Two Methods for Assigning Care Coordinators to People Living with Dementia”5/12/2026Publications/Articles
Response to letter about the authors' recent publication, Journal of the American Geriatrics Society requesting clarification on the rationale for methods used to identify people with highly fragmented ambulatory care.
Designing Consent Processes for Research that Enrolls Older Adults Who May Lack Decisional Capacity: A Practical Guide for Investigators5/7/2026Publications/Articles
(Article) Investigators outline an eight step framework for designing a study-specific consent process to help researchers anticipate and address common challenges and ensure they fulfill their ethical and regulatory obligations when  writing the human subjects portion of grant applications, preparing protocols for IRB submission, and seeking consent in the course of research.
D-CARE: Results of a Pragmatic Intervention Trial and Implications for the GUIDE model (Slides)4/16/2026Grand Rounds/Webinars
(Slides) April 2026 – Grand Rounds 65, David Reuben, MD, presents processes and outcomes of the D-Care study, followed by brief overview of NIA's Guide Model and discussion between Dr. Reuben and Jeff Willimason, MD, MHS, about the  research study and Guide Model.
IMPACT Grand Rounds 65: D-CARE: Results of a Pragmatic Intervention Trial and Implications for the GUIDE model (Video)4/16/2026Grand Rounds/Webinars
(Video) April 2026 – Grand Rounds 65, David Reuben, MD, presents processes and outcomes of the D-Care study, followed by brief overview of NIA's Guide Model and discussion between Dr. Reuben and Jeff Willimason, MD, MHS, about the research study and Guide Model.
Using the Readiness Assessment for Pragmatic Trials (RAPT) Model to Structure Partner Engagement and Strengthen Pragmatic Research Readiness3/25/2026Publications/Articles
(Article) Translational Science Case Study.  Brown University researchers and Bluestone Physician Services leaders used the Readiness Assessment for Pragmatic Trials (RAPT) model to structure joint planning for a study to improve end-of-life care. Collaborative completion of RAPT created a shared Cambridge University Press Journal of Clinical and Translational Science For Peer Review process for assessing feasibility, contextual fit, and alignment with Bluestone priorities. The exercise identified domains needing refinement and guided planning to strengthen data, workflows, and measurement, demonstrating that RAPT can serve as a practical framework for early stage co-design in pragmatic research.
Identifying and Engaging Care Partners though Electronic Health Records for Pragmatic Research (Slides)3/19/2026Grand Rounds/Webinars
(Slides) March 2026 – Grand Rounds 64 presentation by Jennifer Portz, followed by panel discussion with Julia Burgdorf, and Jody Long.
IMPACT Grand Rounds 64: Identifying and Engaging Care Partners though Electronic Health Records for Pragmatic Research (Video)3/19/2026Grand Rounds/Webinars
(Video)  IMPACT PCRO Core member Dr. Hillary Lum and guest speakers Drs. Julia Burgdorf and Jenny Portz, and Jody Long present on “Identifying and Engaging Care Partners through Electronic Health Records for Pragmatic Research.”
Getting to the bottom of TMLE: targeting in action3/18/2026Other
(Blog post) Fourth post in the blog series exploring targeted maximum likelihood estimation or targeted minimum-loss estimate (TMLE).  In this post Dr. Goldfeld uses simulation to look directly at what targeting changes. He compare two estimators of the average treatment effect (ATE)—the plug-in estimator and TMLE—with the goal of understanding what the targeting step is doing mechanically and how it affects the final estimate.
Getting to the bottom of TMLE: forcing the target to behave3/9/2026Other
(Blog post) Dr. Goldeld builds on previous posts exploring targeted minimum-loss estimate (TMLE) theory by walking through simulations to see the theory in action.
Getting to the bottom of TMLE: the (almost) vanishing nuisance interaction3/3/2026Other
(Blog post) Dr. Goldfeld uses simulations to examine how the interaction term from estimated nuisance models in TMLE affects estimation error and how that term tends to shrink as sample size increases, though not always quickly enough to ignore.
Characteristics of the Long-Term Care Data Cooperative: A New Resource for Research on Outcomes in Long-Term Care2/19/2026Publications/Articles
Investigators compared characteristics of SNF residents and facilities represented in the LTC Data Cooperative in 2023 to national characteristics and summarized variation and completeness of key data elements in the LTC Data Cooperative EHR data including length of stay, discharge disposition, vital signs, and blood glucose, medication administration, and vaccination records.
Getting to the bottom of TMLE: influence functions and perturbations2/5/2026Other
(Blog post) by Keith Goldfeld exploring the theory behind Targeted maximum likelihood estimation or targeted minimum-loss estimate (TMLE), which , at it's core addresses a tension that appears throughout modern causal inference and semiparametric statistics.  In this blog, Dr. Goldfeld argues taht understanding TMLE starts with understanding how estimation error behaves.
Champion-led Deprescribing for Persons with Dementia in Primary Care: A Qualitative Study in Accountable Care Organizations2/2/2026Publications/Articles
(Article) Researchers share results of IMPACT-funded qualitative study exploring clinical champions' perspectives about their deprescribing projects and the factors that influenced their deprescribing PIMs for people with dementia within accountable care organizations primary care.
The Learn as you Go (LAGO) design (Slides)2/2/2026Grand Rounds/Webinars
(Slides) February 2026 – Grand Rounds 63, Donna Spiegelman presents, The Learn as you Go (LAGO) design.
IMPACT Grand Rounds 63: The Learn as you Go (LAGO) design (Video)2/2/2026Grand Rounds/Webinars
(Video) February 2026 – Grand Rounds 63, Donna Spiegelman, ScD presents her “Learn as You Go”  approach to conducting ePCT for people living with dementia, which emphasizes using ongoing data collection and analysis to iteratively refine research questions, interventions, and study procedures during a project.
Uncovering treatment effect heterogeneity in pragmatic gerontology trials1/31/2026Publications/Articles
(Article) This study demonstrates how embedding machine learning methods, such as BART, within a principled causal inference framework can offer deeper insights into trial data with complex features including truncation by death and clustering-key considerations in analyzing pragmatic gerontology trials.
Which activity tracker features matter to you? Older Black participants living with memory challenges and care partner preferences1/31/2026Publications/Articles
Investigators conducted focus groups to explore preferences for features in activity trackers among Black people living with memory challenges or dementia and their care partners.
Home Time as a Patient-Centered Outcome in Pragmatic Trials: Promise, Pitfalls, and the Path Forward1/15/2026Grand Rounds/Webinars
(Video) January 2026 – Grand Rounds 62, Drs. Hanson, Kim, Ankuda, and Van Houtven discuss home time as a patient-centered outcome in pragmatic trials.
Home Time as a Patient-Centered Outcome in Pragmatic Trials: Promise, Pitfalls, and the Path Forward (Slides)1/15/2026Grand Rounds/Webinars
(Slides) January 2026 – Grand Rounds 62, Drs. Hanson, Kim, Ankuda, and Van Houtven discuss home time as a patient-centered outcome in pragmatic trials.
LEAP! Rx: A randomized trial of a pragmatic approach to lifestyle medicine (Video)12/18/2025Grand Rounds/Webinars
(Video) IMPACT Grand Rounds 61. Panel presentation: Amanda N. Szabo-Reed, PhD & Amber Watts. Amanda and Amber will present the LEAP study.
LEAP! Rx: A randomized trial of a pragmatic approach to lifestyle medicine (Slides)12/18/2025Grand Rounds/Webinars
(Slides) In Grand Rounds 61, Amanda N. Szabo-Reed, PhD & Amber Watts present the LEAP study.
IMPACT Grand Rounds 59: Using pragmatic trials to address prescription safety in older patients with diabetes (Video)11/20/2025Grand Rounds/Webinars
(Video) Richard W. Grant, MD, MPH, is a research scientist at the Kaiser Permanente Division of Research, Kaiser Permanente Northern California and The Permanente Medical Group regional director of Research and Evaluation for Complex Needs presents an overview of 2 pragmatic trials he has conducted intended to address prescription safety in older patients with diabetes.
IMPACT Grand Rounds 59: Using pragmatic trials to address prescription safety in older patients with diabetes (Slides)11/20/2025Grand Rounds/Webinars
(Slides) Richard W. Grant, MD, MPH, is a research scientist at the Kaiser Permanente Division of Research, Kaiser Permanente Northern California and The Permanente Medical Group regional director of Research and Evaluation for Complex Needs presents an overview of 2 pragmatic trials he has conducted intended to address prescription safety in older patients with diabetes.
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