# Developing and Testing an Evidence-Based Toolkit for Nursing Home Care of Residents with Obesity

> **NIH AHRQ R01** · MAGEE-WOMEN'S RES INST AND FOUNDATION · 2021 · $384,481

## Abstract

PROJECT ABSTRACT
In the research proposed here, we will evaluate the strategies nursing homes (NHs) use to prevent adverse
safety events affecting residents with obesity and develop an evidence-based toolkit to help NHs adapt to the
increasing care challenges for residents with obesity. Thirty percent of the 1.4 million NH residents in the U.S.
are obese, and every day, resident obesity makes it more difficult to provide safe, high-quality nursing and
custodial care in the more than 15,000 NHs in the U.S. Obese residents require much more nursing and
custodial assistance with daily activities such as mobility, toileting, and skin assessments. NH residents with
obesity are at high risk for adverse safety events such as preventable pressure ulcers, infections, falls, and
hospital readmissions. To cope with these challenges, NHs may adapt to the needs of obese residents and
prevent adverse safety events through organizational adaptation strategies that utilize some combination of
more staff members, more staff time, more equipment, specialized nursing units, or even avoiding admission of
obese individuals. It is not known which adaptation strategies predominate across NHs, which adaptation
strategies are associated with improved health and safety, or which adaptation strategies are associated with
increased adverse safety events. Due to these safety concerns and the lack of evidence-based adaptation
strategy recommendations, there is a critical need to perform a large-scale evaluation of the adaptation
strategies NHs use to maintain the health and safety of obese residents and associate these methods with
other key facility characteristics and individual outcomes. We propose the following aims to improve safety for
residents with obesity in NHs. In Aim 1, we will prioritize and determine the prevalence of the safety concerns
and available adaptations for residents with obesity through structured research observations of care delivery,
semi-structured interviews of stakeholders, and a large national survey of NHs. In Aim 2, we will examine the
relationship between different types of adaptation strategies and a resident adverse safety events composite
outcome, including pressure ulcers, wound infections, urinary tract infections, falls, and hospital readmissions,
using national NH assessment data. In Aim 3, we will develop and validate a toolkit for decision makers and
caretakers to facilitate implementation of the most effective adaptation strategies in NHs. This work will provide
qualitative and quantitative evidence-based research and develop evidence-based tools to help implement
improved safety and care of hundreds of thousands of vulnerable NH residents with obesity.

## Key facts

- **NIH application ID:** 10141236
- **Project number:** 5R01HS026943-03
- **Recipient organization:** MAGEE-WOMEN'S RES INST AND FOUNDATION
- **Principal Investigator:** John Alexander Harris
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $384,481
- **Award type:** 5
- **Project period:** 2019-07-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10141236

## Citation

> US National Institutes of Health, RePORTER application 10141236, Developing and Testing an Evidence-Based Toolkit for Nursing Home Care of Residents with Obesity (5R01HS026943-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10141236. Licensed CC0.

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