In this Fast-Track SBIR project, ASTER Labs will address an urgent, immediate, need for accessible and accurate contact tracing to aid management of infectious disease outbreaks in long-term care facilities of patients with Alzheimer's disease and related dementias. An estimated 5.8 million Americans in 2020 live with Alzheimer's dementia and nearly half of nursing home and other long-term care residents have been diagnosed with a form of dementia. Challenges in infectious disease management in these care settings are increased by frequent interactions between patients, caregivers, staff, and visitors, as well as higher risk from contagion due to age and underlying health conditions. The COVID-19 pandemic has only exacerbated the issue due to the susceptibility of the elderly to the virus. Contact tracing to identify, test, and isolate those who may have been exposed to an infected person has traditionally been a manual, labor-intensive process. Many care facilities lack the financial, human, and logistical resources to track sufficient detail to retrace movements. For dementia patients in particular, limited recall of recent events and interactions, inability to respond to tracing questions, and potential distrust of tracers risk inaccurate data. Investment in human resources to perform contact tracing is costly, and ad hoc tracing can limit effective outcomes. Existing methods to automate contact tracing have largely been smartphone software applications, widely criticized for lack of privacy protection, and in long-term care settings, guarantees on mobile phone use are limited. The few available solutions for care facilities rely on non-discreet wearable devices that, due to unfamiliarity, may be unacceptable to dementia patients, and often require large infrastructure additions with limitations on range. Therefore, there exists a significant unmet need to support care facilities by providing an unobtrusive, on- demand, accurate, and automated contact tracing solution that works both indoors and outdoors with little to no infrastructure requirements, and that addresses the special needs of dementia patients. ASTER Labs' proposed Activtrace system leverages intelligent processing of WiFi, GPS, cellular, and inertial sensor data from a small hardware suite concealed in a shoe insole, unnoticeable to the wearer, that achieves high- precision location and duration of close-contact encounters in complex indoor and outdoor environments. In Phase I, the prototype system will be assembled, and feasibility will be demonstrated by determining the positional and temporal accuracy of the device in timed motion experiments, and through a focus group study with contact tracers and caregivers in senior care settings. Phase I testing will provide the success criteria for the start of the Phase II program. In Phase II, the pre-production insoles and comprehensive software application will be assembled, and the integrated system evaluated in a study with research actors wearing the insoles, along with confederate targets. Comparisons of results done manually by trained contact tracers and the automated Activtrace solution in multiple planned scenarios will establish the system's efficacy.
Public Health Relevance Statement: Project Narrative Large increases in the elderly population suffering from dementia in the United States have presented significant challenges to management of infectious disease outbreaks in long-term care facility settings. Particularly in light of the COVID-19 pandemic, a strong, immediate need exists for capabilities to quickly and effectively perform contact tracing in these communities of vulnerable individuals in order to help inform and protect others who may have been exposed due to frequent interactions between residents, staff, and visitors. The proposed research seeks to develop a solution to this need by developing a comprehensive on-demand, fully-automated contact tracing system to precisely and accurately identify potential close-contact encounters, while addressing the critical needs for privacy protection as well as patient comfort and safety.
Project Terms: Affect; Age; ages; Elderly; advanced age; elders; geriatric; late life; later life; older adult; older person; senior citizen; Algorithms; Alzheimer's Disease; AD dementia; Alzheimer; Alzheimer Type Dementia; Alzheimer disease; Alzheimer sclerosis; Alzheimer syndrome; Alzheimer's; Alzheimer's disease dementia; Alzheimers Dementia; Alzheimers disease; Primary Senile Degenerative Dementia; dementia of the Alzheimer type; primary degenerative dementia; senile dementia of the Alzheimer type; Back; Dorsum; Behavior; Communicable Diseases; Infectious Disease Pathway; Infectious Diseases; Infectious Disorder; Communication; Communities; Diagnosis; Disease; Disorder; Disease Outbreaks; Outbreaks; Electronics; electronic device; Engineering; Environment; Epidemiology; epidemiologic; epidemiological; Exhibits; Florida; Focus Groups; Health; Health care facility; Health Facilities; Healthcare Facility; care facilities; Recording of previous events; History; Human; Modern Man; Intelligence; Interview; Investments; Laboratories; Lead; Pb element; heavy metal Pb; heavy metal lead; Light; Photoradiation; Long-Term Care; extended care; longterm care; Manuals; Methods; Motion; Movement; body movement; Persons; Nursing Homes; nursing home; Patients; Production; Research; Research Personnel; Investigators; Researchers; Resources; Research Resources; Risk; Safety; Shoes; Computer software; Software; Technology; Testing; Time; United States; Universities; Virus; Work; Contact Tracing; Communicable Disease Contact Tracing; Infectious Disease Contact Tracing; Measures; Caregivers; Care Givers; Infection Control; Administrator; Risk Assessment; Caring; base; sensor; patient home care; Home Care; patient homecare; Specific qualifier value; Specified; Phase; Series; Evaluation; Predisposition; Susceptibility; Training; Individual; Logistics; Data Storage and Retrieval; data retrieval; data storage; Exposure to; tool; Life; Disorder Management; Disease Management; programs; Complex; Event; 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health care-associated infections; phase 1 testing; phase 1 evaluation; phase I evaluation; phase I testing; aging in place; age in place; functional independence; Infrastructure; Alzheimer's disease related dementia; AD related dementia; ADRD; Alzheimer related dementia; COVID-19; COVID19; CV-19; CV19; corona virus disease 2019; coronavirus disease 2019; 2019-nCoV; 2019 novel corona virus; 2019 novel coronavirus; COVID-19 virus; COVID19 virus; CoV-2; CoV2; SARS corona virus 2; SARS-CoV-2; SARS-CoV2; SARS-associated corona virus 2; SARS-associated coronavirus 2; SARS-coronavirus-2; SARS-related corona virus 2; SARS-related coronavirus 2; SARSCoV2; Severe Acute Respiratory Distress Syndrome CoV 2; Severe Acute Respiratory Distress Syndrome Corona Virus 2; Severe Acute Respiratory Distress Syndrome Coronavirus 2; Severe Acute Respiratory Syndrome CoV 2; Severe Acute Respiratory Syndrome-associated coronavirus 2; Severe Acute Respiratory Syndrome-related coronavirus 2; Severe acute respiratory syndrome associated corona virus 2; Severe acute respiratory syndrome corona virus 2; Severe acute respiratory syndrome coronavirus 2; Severe acute respiratory syndrome related corona virus 2; Wuhan coronavirus; coronavirus disease 2019 virus; hCoV19; nCoV2; web platform; internet platform; memory care; COVID-19 pandemic; COVID crisis; COVID epidemic; COVID pandemic; COVID-19 crisis; COVID-19 epidemic; COVID-19 global health crisis; COVID-19 global pandemic; COVID-19 health crisis; COVID-19 public health crisis; COVID19 crisis; COVID19 epidemic; COVID19 global health crisis; COVID19 global pandemic; COVID19 health crisis; COVID19 pandemic; COVID19 public health crisis; SARS-CoV-2 epidemic; SARS-CoV-2 global health crisis; SARS-CoV-2 global pandemic; SARS-CoV-2 pandemic; SARS-CoV2 epidemic; SARS-CoV2 pandemic; SARS-coronavirus-2 epidemic; SARS-coronavirus-2 pandemic; Severe Acute Respiratory Syndrome CoV 2 epidemic; Severe Acute Respiratory Syndrome CoV 2 pandemic; Severe acute respiratory syndrome coronavirus 2 epidemic; 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