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Grants

Katzan wins CDC Grant Award to Study Stroke Outcomes
The Ohio Coverdell Stroke Registry Coordinating Center, directed by Center faculty member Irene Katzan MD received support through the Ohio Department of Health from the Centers for Disease Control and Prevention (CDC) to evaluate outcomes in patients hospitalized for stroke. The overall goal of this project is to determine factors that are associated with improved 30-day outcomes after stroke in 26 hospitals throughout Ohio. The Center is partnering in this project with the Knowledge Program in Cleveland Clinic’s Neurological Institute. Dr. Katzan is being assisted by program manager Alice Liskay RN, BSN, MPA, CCRC and Siobhan Martin ND, BA. The Ohio Stroke Registry is one of 6 state-wide stroke registries in United States funded by the CDC, in partnership with the Joint Commission and the American Heart Association, to track stroke management and perform data-driven quality improvement activities.

Hispanic/Latino HIV Patient Program to Improve Medical CareCommunity Education
Dr. Ash Sehgal, Director of the Center for Reducing Healthcare Disparities, received a $60,000 grant from the AIDS Taskforce of Greater Cleveland (ATGC) in September to provide better medical access and education to Hispanic/Latino persons with HIV. The goal of this three year commitment is to improve the medical outcomes for Hispanic/Latino persons living with HIV/AIDS in northeast Ohio. Hispanic/Latino people living with HIV, especially those with difficulty speaking and reading English, access HIV care and treatment services at lower rates than their European-American counterparts. Hispanic/Latino people with HIV have comparatively higher levels of HIV morbidity and mortality. These disparities hold true both nationally and locally. The program, entitled Mas Vida (“More Life”) initiative, is a partnership between the AIDS Taskforce of Greater Cleveland (ATGC), and the HIV Unit at MetroHealth Medical Center. The program will provide HIV Hispanic/Latino persons with bilingual services such as social workers in clinics and community programming. It will also facilitate the development of community partnerships including ATGC, MetroHealth Medical Center, and a range of community organizations and groups serving the northeast Ohio Hispanic/Latino communities. (posted 12/2005)

Jennifer Bailit, MD, MPH Awarded a Grant from the Agency for Healthcare Research and Quality (AHRQ)
Jennifer Bailit MD, MPH along with Dr. David Aron from the VA hospital and Dr. Thomas Love from the Center for Health Care Research and Policy have been awarded a two year grant from the Agency for Healthcare Research and Quality to investigate the characteristics of hospitals that provide higher quality obstetrical care. Results of this study will help hospitals understand how to improve the quality of inpatient obstetrical care. The study is co-funded by the National Institute for Child Health and Human Development. (posted 12/2005)

Irene L. Katzan, M.D., M.S. Awarded AHA Grant to Study Racial Disparities in Stroke Care and Outcomes
Dr. Katzan MD and others of the Cleveland Stroke Outcomes Research Program received the $120,000 grant from the American Heart Association`s Ohio Valley Affiliate. The two-year study will collect data at 17 hospitals in Cuyahoga and Geauga Counties to provide information that will address ways to reduce the excess mortality observed in black stroke victims. Currently, stroke mortality is approximately twice as high in blacks as in whites, making it the single most important contributor to excess mortality among blacks.

Joseph J. Sudano, Jr., PhD, Awarded $1.4 Million to Study Racial/Ethnic Measurement Bias in Health Surveys
Center faculty member Joseph J. Sudano, Jr., PhD, Assistant Professor of Medicine and Epidemiology and Biostatistics, has been awarded a 3-year grant from the National Institutes on Aging to investigate racial/ethnic measurement bias in the most commonly used health survey tools. Along with co-Investigators Patrick Murray MD, Thomas Love PhD, and Neal Dawson, MD, 1320 whites, blacks, English-speaking and Spanish-speaking Hispanics will take a standard health survey and then asked to perform a series of tests to measure physical functions related to the concepts in the survey. Comparisons between the subjective assessments of health and the objective tests of physical performance will be made to determine if there are differences in these measures across the 4 groups. Results will help in designing future health surveys and more accurately understand differences in health status across racial/ethnic groups. Joining Dr. Sudano in this study are consortium researchers from Northwestern University`s Feinberg School of Medicine, including David W. Baker, MD and Gail Huber, PT.

Andrew O`Connor, DO, MPH, awarded Pfizer Scholars Grant in Clinical Epidemiology to Study the Role of Chronic Lead Exposure in Diabetic Kidney Disease
Center faculty member Andrew O`Connor will undertake a 3-year project to investigate the role of chronic environmental lead toxicity as a factor in the progression of diabetic nephropathy. The research will take advantage of a longitudinal cohort of over 300 diabetic subjects who are being recruited to study genetic factors in diabetic kidney disease. Rather than using blood lead levels, lead exposure will be measured using a novel radiologic technique that allows quantification of long term lead exposure. Decline in kidney function will be assessed annually in the cohort. This will be the first study to examine the role of ambient low level environmental lead toxicity as a factor in chronic diabetic kidney disease. O`Connor`s application ranked first in a nationwide competition for the 3-year career development award, given to two junior medical school faculty each year.

Julia Rose, PhD, MA, Awarded $2 Million for a National Center to Support Evaluation in Geriatrics Education
Julia Hannum Rose, PhD, MA, Associate Professor of Medicine and Bioethics and Co-Director of the Program for Research on Aging, and her Co-Investigators Diana Gurley, PhD, and Patrick Murray, MD, have been awarded a $2 million, 5-year contract by HRSA to establish a National Technical Assistance Center (NTAC) for geriatric education programs. The central office will be housed at Case in the Center for Health Care Research and Policy, with regional offices at UCLA and the New Jersey College of Osteopathic Medicine. The NTAC will provide support for education evaluation and research to 47 Geriatric Education Centers throughout the country. These centers offer training in geriatric medicine to students, faculty and practitioners across the full range of health professions, including physicians and nurses, social workers, allied health professionals, psychologists, health administrators, and first responders. It will provide online resources and access to individuals throughout the country with expertise in research, policy, health disparities, and education, and will offer two training seminars each year to coincide with national conferences.

AHRQ Grant Awarded to Study Decision Support in Diabetes
Center Director Randall D. Cebul, MD, along with other Center faculty and investigators at the Cleveland Clinic Foundation (co-PI C. Martin Harris, MD, MBA) and the Weatherhead School`s Department of Information Technology (Betty Vandenbosch, PhD) , were recently awarded a $1.5 million grant to study new approaches for improving the care and outcomes of patients with diabetes in Northeast Ohio. Altogether, the 3-year trial will enroll over 13,000 adult patients with diabetes who are cared for by 200 primary care physicians in 22 CCF and MetroHealth community-based practices. Two innovative decision support systems will be studied - one that helps physicians and facilitates a disease management approach, and a second that empowers patients by providing web-portal access to their physicians and their diabetes-related information. Funded by the Agency for Healthcare Research and Quality, this project is part of a major new federal initiative to inter-connect electronic health data to improve the quality and cost of health care [link]. Both MetroHealth and the Cleveland Clinic use the same commercially available electronic medical record system. To find out more about the federal initiative, visit this page on the AHRQ web site.

Mark E. Votruba, PhD (Economics), receives National Science Foundation grant to study disability insurance use and the role of social interaction effects
The two-year project aims to measure the magnitude of social interaction effects in DI use among neighbors, i.e. the extent that DI use among one`s neighbors affects one`s own decision to enter disability. Dr. Votruba is joined on this project by Co-PI Mari Rege (PhD, Economics), a colleague in the Economics Department at Weatherhead School of Management. The researchers will take advantage of a comprehensive longitudinal dataset (employment, socioeconomic, geographic, and program participation information for every person in Norway since 1992) to implement a novel instrumental variables strategy. Under this strategy, the magnitude of social interaction effects will be estimated using the relationship between past employment shocks and the current DI participation rate in a neighborhood. For more information about this study, please contact Dr. Votruba at mark.votruba@case.edu.

Dr. Julia Hannum Rose Receives $2.2 Million from the National Cancer Institute to study "Aging and Supportive Care in Advanced Cancer," and an additional award of $560,000 from the Department of Veterans Affairs
This 5-year randomized control trial examines the effect of a coping and communication support (CCS) intervention for advanced cancer patients and their family members over a period of time when goals of care are expected to shift. Trained CCS practitioners will be continuously available to patients and their family caregivers to assist with coping and communication challenges as they arise. Clinical sites for the study include MetroHealth Medical Center and the Cleveland Veterans Administration Medical Center, CASE-affiliated medical centers with missions to serve low-income and other underserved populations. Dr. Rose is Associate Professor of Medicine and Oncology at CASE, Co-Director of CHRP`s Program of Research and Education on Aging (PREA), and Director of the Western Reserve Geriatric Education Center (WRGEC). Results of these combined studies will be disseminated in WRGEC-sponsored interdisciplinary training programs for health care professionals who provide care for cancer patients and their caregivers. For more information about this study, please contact Dr. Rose at jrose@metrohealth.org.

Votruba Awarded Nord Foundation Grant for Curriculum Development in Health Economics
Mark E. Votruba, Ph.D., Assistant Professor of Economics and Medicine at CWRU and Director of the Center`s Health Economics Unit, received a one-year grant from the Nord Foundation to develop an innovative curriculum in health economics. The grant, titled "Economics Paradoxes in United States Health Policy", will be developed over the 2003-04 academic year with a series of cross-disciplinary seminars to be offered as part of the Methods Series in the Center`s Health Services Research Seminar. Mark will be aided in course development by an Oversight Committee consisting of Center faculty Randall D. Cebul, M.D. and Neal V. Dawson, M.D. as well as other faculty in Weatherhead`s Department of Economics, including Frank Tracy Carlton Professor and Chair James B. Rebitzer, Ph.D. and John Mannix Associate Professor Avi Dor, Ph.D. A brief description of the project follows, from the abstract to the proposal to Nord:

"We will develop an innovative curriculum in modern economic analysis for health care researchers by emphasizing economic paradoxes in U.S. health care policy. This curriculum will be unlike standard health economics courses that concentrate on narrowly-focused models and economic efficiency. Instead, our policy-oriented course will engage students on the role economic forces play in creating disparities and inefficiencies that are at odds with common social values, and on the frequently adverse economic consequences of health policies that are at odds with these values. The course will provide a unique opportunity for students to apply economics to health policy analysis and bridge chasms in methodology and jargon that exist between health service researchers, health economists, and health policy-makers."

Neal V. Dawson, MD receives NIH award of $1.9 million over 5 years to study alcohol use among hepatitis C-infected patients.
The National Institutes of Health (National Institute on Alcohol Abuse and Alcoholism) awarded CWRU and MetroHealth Medical Center $1.9M in support of Dr. Dawson`s project entitled "Alcohol Reduction in Medical Illnesses: HCV as Prototype" through 2007. This grant will explore the use of alcohol among nondependent patients who have medical illnesses or are on medications that generally preclude the use of alcohol. A questionnaire-based instrument will be developed and tested that will seek to predict the risk of continued alcohol use in medical situations where clinicians generally advise against continued alcohol use. The project will study alcohol use among nondependent patients with Hepatitis C as a prototypical example. To find out more about the study, click here.

Irene Katzan MD, MS, Director of the Center`s Stroke Outcomes Research Program (SORP) recently received a Career Development Award
Irene Katzan received a career development award from the National Institutes of Neurological Disorders and Stroke (NINDS) to study pneumonia after stroke, a frequent and serious medical complication. The award, in the amount of $745,000 will provide funding for 5 years through 2008 to evaluate the predictors, preventability of pneumonia after stroke and its impact on outcomes. Seventeen hospitals in Northeastern Ohio will be participating.

"I am thrilled about this wonderful opportunity," said Katzan, Assistant Professor of Neurology and Director of SORP at MetroHealth. "This study will provide the framework for future community-based projects and initiatives designed to optimize stroke care." The award will also provide an opportunity for comprehensive training in resarch techniques used in health services research.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the NIH awards CWRU $4.4 million over 7 years.
As Co-Investigator of this "Renal Framingham" cohort study Ash Sehgal, MD will follow 3000 patients with chronic renal insufficiency over 7 years to determine factors associated with progression of renal failure and development of cardiovascular disease among patients with chronic renal insufficiency.

"Understanding why patients with renal insufficiency progress or develop cardiovascular disease, may help develop interventions to improve outcomes", said Sehgal. Cleveland is one of six sites that will contribute patients to the study. MetroHealth Medical Center is one of the 5 hospitals within the city that makes up the Cleveland site.

The Robert Wood Johnson Foundation supports CWRU with a study examining Substance Abuse Disorders (SUD).
Neal Dawson, MD recently was named as Principal Investigator on a grant entitled "Increasing Substance Abuse Screening and Referral Rates in an Independent Practice Association."

"We are excited about having the opportunity to address this important issue in the primary care portion of a large health care system said Dawson, professor of medicine at CWRU at Metrohealth. "Doctors often fail to suspect substance abuse in their patients." By examining three methods of selecting groups for screening and comparing three methods of reducing substance use or obtaining appropriated treatment, Dawson said "we may help improve health outcomes amongst patients who receive care in health systems."

The study, conducted at Kaiser Permanente was awarded $350,000 and will go through December 2003.

~ More CHRP Active Grants & Contracts, March, 2003 ~

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