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Seattle-Denver Center of Innovation (COIN)

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COIN Investigators & Staff

COIN Investigators


Roman A. Ayele, MPH, PhD
Title: Core Investigator; Career Development Awardee
Clinical Assistant Professor, University of Colorado School of Public Health
Location: Denver
University of Colorado webpage

Research Interests


See Dr. Ayele's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials

The following images visualize Dr. Ayele's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):

Dr. Ayele's publication titles indicate primary work is Veteran care
Word cloud from pub titles
Dr. Ayele's collaborations are primarily from the University of Colorado
Research collaboration map
The following research fields have been used to summarize Dr. Ayele's publications and grants.
Clinical Research
Health Services
Behavioral and Social Science
Brain Disorders
Patient Safety
Infectious Diseases

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Optimizing Transitions for Dual-Use Veterans Living with Dementia following Hospitalization in the Community

Role: PI
The VA mandated expanded community care services for Veterans with the MISSION Act of 2018. We have increasingly partnered with community-based facilities to provide acute care for Veterans Living with Dementia (VLWD).
Research shows that transitions across care systems are vulnerable times, resulting in fragmentation and worse health outcomes. Unfortunately, these Veterans are at an increased risk of adverse outcomes, resulting in physical and emotional deterioration.
Our work will evaluate transitions of care from community hospitals to VA care using a mixed-methods approach. We will identify important risk factors that lead to adverse outcomes during transitions for dual-use VLWD. We will then develop and pilot an intervention to improve transitions of care. This work is a high-priority area of the VA’s MISSION Act implementation. The VA Offices of Geriatrics and Extended Care, Community Care, and Emergency Medicine support it.
Funder: Veterans Administration
NIH Reporter: NIH website
Publications of note:
Barriers and facilitators to goals of care conversations with Veteran residents of community nursing homes

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Recent Publications


Daus M, Lee M, Ujano-De Motta LL, Holstein A, Morgan B, Albright K, Ayele R, McCarthy M, Sjoberg H, Jones CD. Perspectives on supporting Veterans' social needs during hospital to home health transitions: findings from the Transitions Nurse Program. BMC Health Serv Res. 2024 Apr 25;24(1):520. doi: 10.1186/s12913-024-10900-9. PMCID: PMC11043030.
PMID: 38658937.
Learn more about this publication on Dimensions

Bock MA, Macchi ZA, Harrison KL, Katz M, Dini M, Jones J, Ayele R, Kutner JS, Pantilat SZ, Martin C, Sillau S, Kluger B. Does a novel community-based outpatient palliative care intervention for Parkinson's disease and related disorders improve care? Qualitative results from patients and care partners. Palliat Med. 2024 Jan 24:2692163231219923. doi: 10.1177/02692163231219923. Epub ahead of print.
PMID: 38267836
Learn more about this publication at Dimensions

Ayele R, Macchi ZA, Jordan S, Jones J, Kluger B, Maley P, Hall K, Sumrall M, Lum HD. Holding back in communications with clinicians: Patient and care partner perspectives in Parkinson's disease. PEC Innov. 2024 Jan 22;4:100255. doi: 10.1016/j.pecinn.2024.100255. PMCID: PMC10832496.
PMID: 38304553
Learn more about this publication at Dimensions

Heffernan B, Forbes E, Seeberger L, Shattuck J, Cook M, Ayele R, Kluger BM. Perceptions of palliative care in Huntington's disease: A qualitative study. Parkinsonism Relat Disord. 2024 Jan 12;120:106007. doi: 10.1016/j.parkreldis.2024.106007. Epub ahead of print.
PMID: 38241953
Learn more about this publication at Dimensions


Radcliff T, Ayele R, McCreight M, Lui W, Battaglia C. Implementation of VA care coordination program to improve transitional care for veterans post-non-VA hospital discharge: an incremental cost analysis. Implement Sci Commun. 2023 Nov 13;4(1):135. doi: 10.1186/s43058-023-00513-4.
PMID: 37957780
Learn more about this publication at Dimensions

Keddem S**, Ayele R**, Ersek M, Murray A, Griffith M, Morawej S, Kutney-Lee A. Barriers and facilitators to goals of care conversations with Veteran residents of community nursing homes. J Am Geriatr Soc. 2023 Apr 10. doi: 10.1111/jgs.18365. Epub ahead of print.
** - Co-primary authors
PMID: 37036028
Learn more about this publication at Dimensions



Macchi ZA, Seshadri S, Ayele R, Bock M, Long J, Coats H, Miyasaki J, Pantilat SZ, Katz M, Santos EJ, Sillau SH, Lum HD, Kluger BM. Aggression Towards Caregivers in Parkinson's Disease and Related Disorders: A Mixed Methods Study. Mov Disord Clin Pract. 2022 Sep 7;9(7):920-931. doi: 10.1002/mdc3.13555. PMCID: PMC9547131.
PMID: 36247911
Learn more about this publication at Dimensions

McCreight M, Rohs C, Lee M, Sjoberg H, Ayele R, Battaglia C, Glasgow RE, Rabin BA. (2022). Using a longitudinal multi-method approach to document, assess, and understand adaptations in the Veterans Health Administration Advanced Care Coordination program. Frontiers in Health Services, VOL 2. DOI=10.3389/frhs.2022.970409
PMID: 35859140
Learn more about this publication at Dimensions

Ersek M, Sales A, Keddem S, Ayele R, Haverhals LM, Magid KH, Kononowech J, Murray A, Carpenter JG, Foglia MB, Potter L, McKenzie J, Davis D, Levy C. Preferences Elicited and Respected for Seriously Ill Veterans through Enhanced Decision-Making (PERSIVED): a protocol for an implementation study in the Veterans Health Administration. Implement Sci Commun. 2022 Jul 20;3(1):78. doi: 10.1186/s43058-022-00321-2. PMCID: PMC9296899.
PMID: 35859140
Learn more about this publication at Dimensions

Bock MA, Katz M, Sillau S, Adjepong K, Yaffe K, Ayele R, Macchi ZA, Pantilat SZ, Miyasaki JM, Kluger B. What's in the sauce? The Specific Benefits of Palliative Care for Parkinson's Disease. J Pain Symptom Manage. 2022 Jan 31:S0885-3924(22)00040-9. doi: 10.1016/j.jpainsymman.2022.01.017. Epub ahead of print.
PMID: 35114353
Learn more about this publication at Dimensions

Sjoberg H, Liu W, Rohs C, Ayele RA, McCreight M, Mayberry A, Battaglia C. Optimizing care coordination to address social determinants of health needs for dual-use veterans. BMC Health Serv Res. 2022 Jan 12;22(1):59. doi: 10.1186/s12913-021-07408-x. PMCID: PMC8754195.
PMID: 35022053
Learn more about this publication at Dimensions



Ayele R, Macchi ZA, Dini M, Bock M, Katz M, Pantilat SZ, Jones J, Kluger BM. Experience of Community Neurologists Providing Care for Patients With Neurodegenerative Illness During the COVID-19 Pandemic. Neurology. 2021 Sep 7;97(10):e988-e995. doi: 10.1212/WNL.0000000000012363. Epub 2021 Jun 14.
PMID: 34489348

Macchi ZA, Ayele R, Dini M, Lamira J, Katz M, Pantilat SZ, Jones J, Kluger BM. Lessons from the COVID-19 pandemic for improving outpatient neuropalliative care: A qualitative study of patient and caregiver perspectives. Palliat Med. 2021 May 18:2692163211017383. doi: 10.1177/02692163211017383. Epub ahead of print.
PMID: 34006157

Valverde PA, Ayele R, Leonard C, Cumbler E, Allyn R, Burke RE. Gaps in Hospital and Skilled Nursing Facility Responsibilities During Transitions of Care: a Comparison of Hospital and SNF Clinicians' Perspectives. J Gen Intern Med. 2021 Feb 2. doi: 10.1007/s11606-020-06511-9. Epub ahead of print.
PMID: 33532965



Lawrence E, Casler JJ, Jones J, Leonard C, Ladebue A, Ayele R, Cumbler E, Allyn R, Burke RE. Variability in skilled nursing facility screening and admission processes: Implications for value-based purchasing. Health Care Manage Rev. 2020 Oct/Dec;45(4):353-363. doi: 10.1097/HMR.0000000000000225. PMCID: PMC6506403.
PMID: 30418292

Leonard C, Ayele R, Ladebue A, McCreight M, Nolan C, Sandbrink F, Frank JW. Barriers to and Facilitators of Multimodal Chronic Pain Care for Veterans: A National Qualitative Study. Pain Med. 2020 Sep 24:pnaa312. doi: 10.1093/pm/pnaa312. Online ahead of print.
PMID: 32974662

Manges KA, Ayele R, Leonard C, Lee M, Galenbeck E, Burke RE. Differences in transitional care processes among high-performing and low-performing hospital-SNF pairs: a rapid ethnographic approach. BMJ Qual Saf. 2020 Sep 21:bmjqs-2020-011204. doi: 10.1136/bmjqs-2020-011204. Online ahead of print.PMID:
PMID: 32958550

Ayele R, Manges KA, Leonard C, Lee M, Galenbeck E, Molla M, Levy C, Burke RE. How Context Influences Hospital Readmissions from Skilled Nursing Facilities: A Rapid Ethnographic Study. J Am Med Dir Assoc. 2020 Sep 14:S1525-8610(20)30665-4. doi: 10.1016/j.jamda.2020.08.001. Online ahead of print.
PMID: 32943342

Ayele RA, Liu W, Rohs C, McCreight M, Mayberry A, Sjoberg H, Kelley L, Glasgow RE, Rabin BA, Battaglia C. VA Care Coordination Program Increased Primary Care Visits and Improved Transitional Care for Veterans Post Non-VA Hospital Discharge. Am J Med Qual. 2020 Aug 10:1062860620946362. doi: 10.1177/1062860620946362. Online ahead of print.
PMID: 32772849

Glasgow RE, Battaglia C, McCreight M, Ayele RA, Rabin BA. Making Implementation Science More Rapid: Use of the RE-AIM Framework for Mid-Course Adaptations Across Five VA Health Systems Research Projects in the Veterans Health Administration. Front Public Health. 2020 May 27;8:194. doi: 10.3389/fpubh.2020.00194. eCollection 2020.
PMID: 32528921

Jordan SR, Kluger B, Ayele R, Brungardt A, Hall A, Jones J, Katz M, Miyasaki JM, Lum HD. Optimizing future planning in Parkinson disease: suggestions for a comprehensive roadmap from patients and care partners. Ann Palliat Med. 2020 Feb;9(Suppl 1):S63-S74. doi: 10.21037/apm.2019.09.10. Epub 2020 Feb 6.
PMID: 32036671



Ayele RA, Lawrence E, McCreight M, Fehling K, Glasgow RE, Rabin BA, Burke RE, Battaglia C. Perspectives of Clinicians, Staff, and Veterans in Transitioning Veterans from non-VA Hospitals to Primary Care in a Single VA Healthcare System. J Hosp Med. 2019 Oct 23;14(3):E1-E7. doi: 10.12788/jhm.3320. Epub ahead of print. PMCID: PMC7064299.
PMID: 31634102

McCreight MS, Rabin BA, Glasgow RE, Ayele RA, Leonard CA, Gilmartin HM, Frank JW, Hess PL, Burke RE, Battaglia CT. Using the Practical, Robust Implementation and Sustainability Model (PRISM) to qualitatively assess multilevel contextual factors to help plan, implement, evaluate, and disseminate health services programs. Transl Behav Med. 2019 Nov 25;9(6):1002-1011. doi: 10.1093/tbm/ibz085. PMID: .
PMID: 31170296

Burke RE, Leonard C, Lee M, Ayele R, Cumbler E, Allyn R, Greysen SR. Cognitive Biases Influence Decision-Making Regarding Postacute Care in a Skilled Nursing Facility. J Hosp Med. 2020 Jan 1;15(1):22-27. doi: 10.12788/jhm.3273. Epub 2019 Aug 16. PMID: ; PMCID: PMC6932595.
PMID: 31433771

Tung GJ, Williams VN, Ayele R, Shimasaki S, Olds D. Characteristics of effective collaboration: A study of Nurse-Family Partnership and child welfare. Child Abuse Negl. 2019 Sep;95:104028. doi: 10.1016/j.chiabu.2019.104028. Epub 2019 Jun 21. PMID: .
PMID: 31229764

Williams VN, Ayele R, Shimasaki S, Tung GJ, Olds D. Risk assessment practices among home visiting nurses and child protection caseworkers in Colorado, United States: A qualitative investigation. Health Soc Care Community. 2019 Sep;27(5):1344-1352. doi: 10.1111/hsc.12773. Epub 2019 Jun 3. PMID: .
PMID: 31157940

Lum HD, Jordan SR, Brungardt A, Ayele R, Katz M, Miyasaki JM, Hall A, Jones J, Kluger B. Framing advance care planning in Parkinson disease: Patient and care partner perspectives. Neurology. 2019 May 28;92(22):e2571-e2579. doi: 10.1212/WNL.0000000000007552. Epub 2019 Apr 26. PMID: ; PMCID: PMC6556088.
PMID: 31028124

Ayele R, Jones J, Ladebue A, Lawrence E, Valverde P, Leonard C, Cumbler E, Allyn R, Burke RE. Perceived Costs of Care Influence Post-Acute Care Choices by Clinicians, Patients, and Caregivers. J Am Geriatr Soc. 2019 Apr;67(4):703-710. doi: 10.1111/jgs.15768. Epub 2019 Feb 1. PMID: .
PMID: 30707766

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NIA IMPACT Collaboratory 2023 Faculty Scholar

Roman was named a NIA IMPACT Collaboratory 2023 Faculty Scholar. This program aims to enhance the career development of investigators in the design and conduct of embedded pragmatic clinical trials for people living with dementia and their care partners by integrating them into the activities of our Cores and Teams. Faculty Scholars attend monthly Core meetings, are mentored by an IMPACT executive committee member, engage in scholarly projects to enrich career development, and attend Collaboratory-wide events including Training Workshops and the Annual Business Meeting and Scientific Conference. Throughout the year, Faculty Scholars participate in monthly Grand Rounds and quarterly Research-in-Progress seminars in addition to other opportunities for career development, training, and networking. Faculty Scholars are nominated by IMPACT members.

The mission of the National Institute on Aging (NIA) IMbedded Pragmatic Alzheimer's disease (AD) and AD-Related Dementias (AD/ADRD) Clinical Trials (IMPACT) Collaboratory is to build the nation’s capacity to conduct pragmatic clinical trials of interventions embedded within health care systems for people living with dementia and their care partners.

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Media (Cyberseminars, podcast etc.)


VA HSR YouTube: Understanding the Impact of Social Isolation on Older Veterans and Their Caregivers

Mar 13, 2023
Roman Ayele, PhD, of the Center of Innovation for Veteran-Centered and Value Driven Care, talks about her work understanding how the COVID-19 pandemic impacted older Veterans and their caregivers by creating additional burdens of social isolation.

Watch: Understanding the Impact of Social Isolation on Older Veterans and Their Caregivers