Department of Medicine

University of Pittsburgh

GIM News
Donna L. Bishop, Editor

Next issue:
April 2010

Submission deadline:
March 26, 2010

E-mail: bishopdl@upmc.edu

Grants and Funding

Subject: Equity and Quality of Contraceptive Care within the VA.
Principal Investigator: Sonya Borrero, MD, MS.
Sponsor: Center for Health Equity Research and Promotion (CHERP) Pilot Research Program.
Purpose: The aims of this pilot study are to describe national contraceptive use patterns in the VA in terms of race/ethnicity and to understand how the availability of specialized women's health clinics affects the quality and equity of contraceptive care.

Subject: Equity and Quality in Diabetes Care: The Role of Neighborhoods.
Principal Investigator: Sanae Inagami, MD, MPH.
Sponsor: CHERP Pilot Research Program.
Purpose: This pilot study is designed to better understand the impact of neighborhoods on observed disparities in the veteran population. The study will describe the geographic patterns of demographic and socioeconomic characteristics among veterans obtaining outpatient care at the VA Pittsburgh Healthcare System (VAPHS), will describe geographic variations in the prevalence of diabetes and in intermediate outcomes and processes of care in the same veterans, and will assess whether geographic variations in diabetes prevalence and health care outcomes are associated with the residential neighborhood socioeconomic environment.

Subject: Understanding Quality and Equity in Wheelchairs for Veterans.
Principal Investigator: Larissa Myaskovsky, PhD.
Sponsor: VA Rehabilitation Research and Development Service.
Purpose: This cross-sectional multisite study of veterans who use wheelchairs as their primary source of mobility aims to determine whether patient characteristics and health care provider factors are associated with wheelchair quality; whether wheelchair quality is associated with key patient outcomes, including satisfaction with medical care, quality of life, amount of wheelchair activity, and participation in social and work-related activities; whether patient and provider factors are independently associated with key patient outcomes, including satisfaction with medical care, quality of life, amount of wheelchair activity, and participation; and whether the association of patient and provider factors with patient outcomes is explained by differences in wheelchair quality.

Subject: Understanding Race and Culture in Living Donor Kidney Transplantation.
Principal Investigator: Larissa Myaskovsky, PhD.
Co-Investigator: Galen Switzer, PhD.
Sponsor: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Purpose: The goals of this prospective cohort study are to understand the culturally related and psychosocial factors associated with race disparities in living donor kidney transplantation and to understand the relationship of these factors with early posttransplant health outcomes in a sample of African American and white transplant candidates.

Subject: Intensive Care Unit (ICU) Triage Decisions for Elders with End-Stage Cancer: The Role of Patient Race.
Principal Investigator: Amber Barnato, MD, MPH, MS.
Sponsor: National Institutes of Health.
Purpose: The overall goal of this project is to better understand the reasons for hospital-level variations in end-of-life ICU use among patients with end-stage cancer. The findings will be used to develop hospital-level interventions to improve the patient-centeredness of communication and decision making for dying patients. The study will also provide further support for a simulation method that the investigators developed and that could be used in the future both as a technique for identifying mechanisms underlying physician behavior and as a training tool for changing physician behavior.

Subject: Developing a Robust Measure of Hospital End-of-Life Intensity.
Principal Investigator: Amber Barnato, MD, MPH, MS.
Sponsor: National Institutes of Health.
Purpose: The relevance of the proposed project to public health involves the potential to use the investigators' measure of hospital end-of-life intensity as a policy tool. For example, hospitals with a very high intensity of treatment among patients with a high probability of dying can be given feedback about their performance. This feedback may provide motivation to the hospital's administrative and clinical staff to implement policies, procedures, or services that improve communication and decision making for very sick patients and their families. Changes such as this have the potential to better align patient and family preferences with the care they receive and to reduce hospital spending.

Subject: Data Coordinating Center for the HALT Polycystic Kidney Disease (PKD) Trials—Administrative Supplement.
Principal Investigator: James E. Bost, PhD.
Sponsor: National Institutes of Health.
Purpose: Autosomal dominant PKD is a leading cause of end-stage renal disease. The HALT-PKD trials were designed to assess the efficacy of renin-angiotensin-aldosterone system blockade in altering disease progression for patients with early and moderate to advanced disease. The supplement initiatives will accelerate the ability to achieve the study goals by providing quality data, needed data reports, and supplemental analyses to support the study aims.

Subject: Cardiovascular Disease Mechanisms in HIV Infected and Uninfected Veterans—Minority Supplement.
Principal Investigator: Matthew Freiberg, MD, MSc.
Sponsor: National Institutes of Health.
Purpose: In the parent study entitled "Cardiovascular Disease Mechanisms in HIV Infected and Uninfected Veterans," the investigators are focusing on the assocation between HIV infection and cardiovascular events and measures of subclinical atherosclerosis and the extent to which this association is influenced by comorbidities such as alcohol consumption and hepatitis C. The supplemental study will provide new insights into the association between HIV and cardiovascular disease risk as it pertains to African American patients.

Subject: University of Pittsburgh Clinical and Translational Science Institute: Workforce Development—Competencies.
Principal Investigator: Steven Reis, MD.
Directors: Wishwa Kapoor, MD, MPH, and Terri Collin, MSc, PhD.
Sponsor: National Institutes of Health.
Purpose: The project will study the implementation and evaluation of a competency-based educational structure that strives to align course content, skills, and experiental learning with competencies. The project is part of an effort to help advance the field of clinical and translational science by defining the characteristics, skills, and knowledge that are unique to the discipline.

Subject: Online Counseling to Enable Lifestyle-Focused Obesity Treatment in Primary Care.
Principal Investigator: Kathleen McTigue, MD, MPH.
Sponsor: Agency for Healthcare Research and Quality.
Purpose: With over half of the U.S. population currently overweight and 31% of adults now obese, the primary care setting may represent an important source of weight-loss support in the interest of cardiovascular disease prevention. The investigators will examine whether Internet-based interventions for developing healthier lifestyles can improve preventive health care in a cost-effective manner.

Subject: Media Literacy to Prevent Adolescent Smoking Initiation—Administrative Supplement.
Principal Investigator: Brian Primack, MD, EdM, MS.
Sponsor: National Institutes of Health.
Purpose: The supplement will be used by the investigators to hire personnel to implement a revised version of their media literacy curriculum in two target schools, to rigorously evaluate the curriculum by using quantitative and qualitative methods, and to gather pilot data (e.g., effect sizes and intraclass correlations) that will be instrumental for undertaking a randomized controlled trial.

Subject: Investigating Associations between Media Use, Depression, and Anxiety, Using Ecological Momentary Assessment.
Principal Investigator: Brian Primack, MD, EdM, MS.
Sponsor: RAND Corporation.
Purpose: In this project, the investigators will use data collected via ecological momentary assessment (EMA) to develop and validate a coding scheme to classify content- and context-based variables that are related to media exposure. They will use the data to investigate a variety of questions regarding the relationship between media exposure and development of psychiatric symptoms and conditions in adolescents.

Subject: The Optimal Timing of Transplantation in Pediatric Acute Liver Failure.
Principal Investigator: Mark Roberts, MD, MPP.
Sponsor: National Institutes of Health.
Purpose: The investigators will use statistics and mathematical models to better predict how quickly liver disease will progress in children. The goal is to improve decisions regarding the use of liver transplantation for young patients with acute liver disease.

Subject: Self-Management and Reminders with Technology (SMART): Appraisal of an Integrated Personal Health Record (PHR).
Principal Investigator: Mark Roberts, MD, MPP.
Sponsor: Agency for Healthcare Research and Quality.
Purpose: Electronic PHRs that provide patients with a view of their electronic medical record have the potential to improve the care of patients with complex diseases. This project will compare the use of an interactive PHR with the use of a standard "passive" PHR to assess whether patients' health outcomes can be improved. It will also explore barriers to the use of PHRs.

Subject: Virtual Continuity and Its Impact on Complex Hospitalized Patients' Care.
Principal Investigator: Kenneth Smith, MD, MS.
Sponsor: Agency for Healthcare Research and Quality.
Purpose: Poor communication between a patient's hospital care providers and the patient's primary care provider can diminish health care quality and safety. This project will lead to better communication between physicians and could decrease medication errors that tend to occur as the patient goes from hospital to home.