Michael Lepore, PhD
Co-Director, Center for Health Equity and Outcomes Research
Areas of Expertise:
Long-term care financing, staffing, and measurement systems; Equity in long-term care access and quality; Home- and community-based services for people living with dementia; Mixed methods, pragmatic trials, and engaging people living with dementia as co-researchers
Lepore’s research focus grew out of his experience as a nursing assistant in a dementia care unit, where, he explains, “I saw firsthand many of the issues that continue to limit equity in long-term care access and quality today, including low pay, limited training, and lack of respect for direct care work conducted by nursing assistants.” Driven by the goal of improving the quality of the intertwined lives of people living with dementia and care workers, Lepore explains, “my work grapples with policies that shape long-term care systems, clinical practice and leadership in long-term care contexts, and the measurement of long-term care quality.”
The BIG Idea:
Motivated by my experience as a nursing assistant in a dementia care unit, my work is focused on improving long-term care jobs, equity in long-term care access, and long-term care quality, through research that meaningfully informs policy and practice, and meaningfully engages primary stakeholders in conducting the research.
Lepore’s ongoing research, as the principal investigator (PI) on multiple grants, and as a co-investigator and consultant on other projects, is currently supported by the National Institute on Aging (NIA), part of the National Institutes of Health, and by the Alzheimer’s Association. These projects, which include community-based participatory research methods, focus on broadening access to evidence-based treatments for people with dementia, improving dementia care quality and the use of data in dementia care, and growing understanding of end-of-life care among people with dementia in residential long-term care settings.
Why does the research matter?
Dementia care and long-term care are global public health priorities as well as deeply personal and challenging undertakings by millions of Americans daily. Currently, dementia care and long-term care access and quality are limited and inequitable in the United States, leaving many people living with dementia to have unmet or poorly met care needs. Resolving the shortcomings in dementia care and long-term care access and quality is essential to reducing inequities and promoting population health.
Who does the research matter to?
My research on long-term care financing, jobs, access, and quality matters to many stakeholder groups, including nurses, social workers, geriatricians, therapists, and other clinicians in long-term care; long-term care residents and other older adults and their families; younger adults with disabilities and their families; long-term care providers and policymakers; taxpayers and Medicaid programs that pay for most long-term care provision in the United States, including Managed Long-Term Services and Supports plans that administer an increasing number of state Medicaid programs; as well as agencies responsible for overseeing and measuring long-term care quality and safety.
What are the clinical applications of the research?
My research has direct clinical applications. For example, my work on cognitive stimulation therapy is advancing access to this evidence-based treatment for people with mild to moderate dementia in the United States by building evidence for online delivery of cognitive stimulation therapy and by advancing the design of a pragmatic trial that links physicians in memory clinics who currently lack post-diagnosis treatment options for people living with dementia to community-based service providers who provide cognitive stimulation therapy for this population.