# Safety Outcomes of Obese Residents in US Nursing Homes- Resubmission

> **NIH AHRQ R01** · UNIV OF ARKANSAS FOR MED SCIS · 2020 · $324,367

## Abstract

PROJECT SUMMARY / ABSTRACT
 The U.S. obesity epidemic now affects 1 in 3 adults. As our population ages, obese persons are growing
older and increasingly need long-term care services at a significantly younger age than their non-obese peers.
Our analysis shows that over the last 10 years, there has been a significant increase in the proportion of
nursing home (NH) residents who are obese, with 1 in 4 residents now severely obese (BMI ≥ 35). Ensuring
high quality care for all NH residents is a national priority, and resident safety is a priority issue. Nevertheless,
a specific focus on the safety of obese residents is lacking.
 Emerging, albeit sparse, research shows that obesity complicates NH care. Obese residents have
significantly more functional limitations, require significantly more assistance from staff to perform basic ADLs,
have higher rates of urinary catheterization, and have different nutritional needs than non-obese residents.
Specific protocols are required for their care to prevent adverse events (e.g., skin breakdown and falls). Two-
thirds of NH directors who responded to our survey on their experience with obese residents reported
significant concerns about being prepared to care for them. In addition, research indicates that obese residents
are concentrated in NHs with poor quality of care. These results indicate that obese persons needing long-term
care likely reside in unsafe environments. Poor and unsafe NH care leads to adverse safety events.
 Differences in care needs, disparities in care received, and reports of negative outcomes provide ample
evidence to justify further study of the safety of obese residents in U.S. NHs. The specific goals of our
proposed mixed-methods study are to describe disparities in adverse safety events among obese NH
residents, factors which lead to higher rates of adverse safety events among obese residents, and develop
data collection tools to inform best practices that can be used to reduce adverse safety events among obese
residents. We have assembled a team of experts in the study of obesity in NHs, NH clinical care, NH structures
and performance, organizational theory, and, statistical methods to undertake this innovative study. We will
use existing data to document and assess differences in outcomes by obesity status and to examine
associations between key factors and NHs with high rates of adverse resident safety events among obese
residents. Through key informant interviews, we will explore NH directors' experience in the care of obese NH
residents and obtain input on how to improve NH environments and minimize the risk of adverse safety events
among obese residents. Our proposed study is innovative, focusing on an understudied, but important and
rapidly emerging, vulnerable NH resident group—the obese, and it will have significant impact, by enhancing
knowledge, informing further research, and identifying actionable strategies to improve patient safety among
AHRQ priority populations (e...

## Key facts

- **NIH application ID:** 9928000
- **Project number:** 5R01HS025703-03
- **Recipient organization:** UNIV OF ARKANSAS FOR MED SCIS
- **Principal Investigator:** Holly Caroline Felix
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $324,367
- **Award type:** 5
- **Project period:** 2018-08-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9928000

## Citation

> US National Institutes of Health, RePORTER application 9928000, Safety Outcomes of Obese Residents in US Nursing Homes- Resubmission (5R01HS025703-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9928000. Licensed CC0.

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