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Tue, March 27, 2018

U-M/AARP National Poll on Healthy Aging looks at perceived overuse of tests and medicines from the patient’s perspective. Doctors and older patients may disagree more often than either of them suspects about whether a particular medical test or medicine is truly necessary, according to findings from a new poll of Americans over age 50. Improving communication about that mismatch of opinions, the poll suggests, might reduce the use of unneeded scans, screenings, medications and procedures – and health care costs as well.

Jeffrey Kullgren designed the poll and analyzed its results. More details, a brief video, and a link to the full report of the findings and methodology can be found below.

Funded by Blue Cross Blue Shield of Michigan Foundation

Investigators from University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI), in partnership with the Detroit Health Department, the Southfield-Joy Community Development Corporation and five health plans insuring Detroit-based Medicaid and Healthy Michigan enrollees have collaboratively developed an innovative new model for a Community Health Worker-led (CHW) demonstration project in Detroit’s Cody Rouge neighborhood. The demonstration project will evaluate a potentially financially sustainable model targeting neighborhoods with high numbers of high- and under-health care utilizing Medicaid enrollees. The health plans will each deploy one of their CHWs to the project for a 12-month period. After undergoing joint training through the Michigan Community Health Worker Alliance (MICHWA) program and using assessment tools that cover shared domains, the CHWs will proactively reach out to identified beneficiaries to conduct an initial health and social needs assessment, develop an individualized ‘action plan’ with each beneficiary, work with neighborhood-based organizations to address each enrollee’s unique needs, and provide follow-up support as needed. CHWs will work closely with local organizations both to meet program participants’ needs and to strengthen community capacity to bridge gaps between healthcare services and community-level social determinants of health. The Detroit Health Department will provide office space for the CHWs to meet weekly in a neighborhood facility and provide ongoing booster support and mentorship. UM investigators will evaluate the program in a parallel, two-armed, randomized controlled pragmatic trial. We will evaluate effect on health care utilization among high-utilizing participants and zero-utilizing participants (ED visits, hospitalizations, primary care use) and health care costs at 6- and 12-months and compared to eligible individuals not yet enrolled in the project, on key patient-centered outcomes, and project costs, return on investment, and barriers and facilitators to adoption, implementation, maintenance, and potential spread.

PI: Michele Heisler
CBSSM Co-I: H. Myra Kim

Funded by Health and Human Services, Department of-National Institutes of Health

Funding Years: 2013 - 2015.

With the aging of society and restructuring of families, it is increasingly important to understand how individuals become disabled. New disability is associated with increased mortality, substantial increases in medical costs (often borne by public payers), and a heavy burden on families and caregivers. While the disablement process?as theorized by Verburgge & Jette and their successors?has traditionally been seen as chronic and gradual, there is increasing recognition that acute events play a critical role in disability. Medical illnesses are not the only potentially disabling events. NIA & NINR recently posted PA-11-265, calling for ?Social and Behavioral Research on the Elderly in Disasters? in recognition that natural disasters are common, but we know little about their impact on health and disability. The National Research Council?s Committee on Population published a report in 2009 documenting not only our ignorance in this area, but, importantly, the potential value of studying disasters to understand fundamental processes in disability and health.
Our long-term research agenda is (a) to test the hypothesis that natural disasters cause enduring morbidity for survivors that is not fully addressed by existing health and welfare programs, and (b) to discover remediable mechanisms that generate that enduring morbidity. Here we propose a nationwide test of the association of living in a disaster area with individuals? long-term disability and health care use. To perform this test, we will combine the unique longitudinal resources of over 16,000 respondents in the linked Health and Retirement Study (HRS) / Medicare files with a newly constructed mapping of all FEMA disaster declarations between 1998 and 2012. We will address key gaps in the existing literature of detailed single-disaster studies with a generalizable perspective across time and space via these Specific Aims:
AIM 1: Quantify the association between the extent of a disaster ? measured as the repair cost to public infrastructure and increases in level of disability among survivors. We will follow respondents for an average of 5 years after the disaster. AIM 2: Quantify the association between the extent of a disaster and increases in the likelihood of hospitalization among survivors. AIM 3: Test the hypothesis that increases in level of disability and likelihood of hospitalization after disasters are worse for those living in counties with higher levels of poverty.
This proposal is specifically responsive to PA-11-265. This proposal is innovative because long-term effects of disasters, particularly for vulnerable older Americans, have been systematically neglected in previous research. It is significant because it will address the public health consequences of a relatively common but understudied exposure. Further, a key contribution of this R21 will be to evaluate the feasibility of the National Research Council conjecture that natural disasters can be studied as exogenous shocks to the environment, and that we can thereby test and elaborate usually endogenous mechanisms in the development of disability.

PI(s): Theodore Iwashyna

Co-I(s): Kenneth Langa, Yun Li, Anne Sales

Funded by National Institutes of Health

Funding Years: 2011-2016

This proposal seeks to advance our understanding of the role of psychosocial and environmental health risk factors as well as medical care in understanding the large socioeconomic and racial/ethnic disparities in health and the way health changes with age in our society. It does so by proposing to extend to four waves and 15 years of follow-up an ongoing prospective study (known as Americans' Changing Lives) of a nationally representative sample of 3,617 adults aged 25 and over in the coterminous United States, who were first interviewed in 1986, with reinterviews of about 83 percent of the surviving members of the original sample already completed in 1989 and 1994, along with ongoing mortality ascertainment on the full original 1986 sample. A proposed fourth wave would be collected on about 83 percent of the surviving sample (estimated respondents - 2,300 of about 2,800 survivors) in 2001, primarily by telephone and in person as necessary, with mortality ascertainment continuing indefinitely and the hope and intent of reinterviewing surviving respondents again about 20-22.5 years after the baseline interview. The ongoing ACL study has generated a large body of publications both by staff of the ACL project and users of the public use data sets for the first two waves (with the third wave to be archived for public use by the end of 1999). ACL analyses and publications have illuminated to the role of a broad range of psychosocial factors, ranging from health behaviors through stress and adaptive resources to productive activities, in predicting health, changes in health and mortality, and in mediating or explaining socioeconomic differences in health. It has also played a major role in understanding the nature, causes, and consequences of paid and unpaid productive activities over the lifecourse. The proposed continuation and extension of the ACL project will address a number of aims: (1) continuing and enhancing ongoing analysis by extending prospective follow-up to 15 years, allowing for better analysis of- (a) time- varying covariates, (b) the impact of changes in risk factors on changes in health, and (c) potential reciprocal relationships between and among SES, psychosocial risk factors and health; (2) enhancing and improving the measurement of a number of variables already being considered in ongoing analysis, including SES (e.g., improving assessment of wealth), productive activities, religious beliefs and behaviors, and personality or dispositional factors (e.g., hostility, optimism, hopelessness, and John Henryism); (3) adding new measures to ACL 4 or (via archival data) to all waves of data for both medical care and exposures in physical and social environments; and (4) to undertake more focused analysis of racial/ethnic differences in health and explanations of them.

PI(s): Sarah Burgard

Co-I(s): Wen Ye, Michael Elliott, Philippa Clarke, Kenneth Langa

Susan Goold presented a talk entitled, "Transforming public health: Deliberation, simulation, prioritization" at TEDxUofM, a university-wide initiative to galvanize the community for an event like no other: filled with inspiration, discovery and excitement. TEDxUofM takes place on Thursday, March 29, at the Power Center, 10 am - 5 pm.  Click here for more information.

Borrowing the template of the world-renowned TED conference, TEDxUofM aims to bring a TED-like experience to the University of Michigan. The vision is to showcase the most fascinating thinkers and doers, the "leaders and best" in Michigan terms, for a stimulating day of presentations, discussions, entertainment and art that will spark new ideas and opportunities across all disciplines.

TED is a nonprofit organization devoted to Ideas Worth Spreading. Started as a four-day conference in California 26 years ago, TED has grown to support those world-changing ideas with multiple initiatives. At TED, the world’s leading thinkers and doers are asked to give the talk of their lives in 18 minutes. Talks are then made available, free, at TED.com. TED speakers have included Bill Gates, Jane Goodall, Elizabeth Gilbert, Sir Richard Branson, Benoit Mandelbrot, Philippe Starck, Ngozi Okonjo-Iweala, Isabel Allende and former UK Prime Minister Gordon Brown.

Submit Your Paper for Consideration in the ASBH Student Paper Competition

If you are a student who would like to be considered for the Student Paper Award, please send your paper to the ASBH office in an electronic format (Word or PDF) to candersen@asbh.org, with “ASBH Student Paper Competition” in the subject line.  All papers need to be received at the ASBH office by July 15, 2013 to be considered.    The Awards Committee will review and rank all submissions.  The top three papers will be placed in a special session at the Annual Meeting, and one winner will be chosen at the meeting by the Awards Committee. The award will be presented during the Members’ meeting.

All papers will be assessed anonymously.  Do not include identifying information in your paper submissions, such as title pages with your name. Previous winners are not eligible for consideration. Eligible papers should be no more than 3500 words in length. A student is defined as one who is actively pursuing an advanced degree and has not received a doctoral-level degree (e.g., MD, PhD, JD or equivalent degree). Authors who are not students according to the definition above are not eligible for the Student Paper Award. Coauthored papers are eligible only if all authors are students.

If you have any questions, please do not hesitate to contact the ASBH office at: info@asbh.org

Thank you,
 
American Society for Bioethics + Humanities (ASBH)
Phone: 847-375-4745

www.asbh.org

 

It is with both sadness and joy that we announce that CBSSM Co-Director Dr. Angela Fagerlin will be assuming a new position as the inaugural Chair of

Population Health Sciences at the University of Utah. While we are very sad to see Angie leave, we congratulate her on this well-deserved opportunity and are thrilled to see her enter this new stage in her career.

Dr. Fagerlin has been with the University of Michigan for 15 years and Co-Director of CBSSM for the last 5 years. She has been an integral member of CBSSM and all its precursors—the Program for Improving Health Care Decisions and The Center for Behavioral and Decision Sciences in Medicine. Dr. Fagerlin will be greatly missed for her friendship, collegiality, mentorship, and the great science she has produced over the years.

As of January 2016, current Co-Director of CBSSM Dr. Raymond De Vries will be joined by Dr. Brian Zikmund-Fisher, who will serve as an Interim Co-Director. Dr. Zikmund-Fisher is an Associate Professor of Health Behavior and Health Education at the School of Public Health, as well as a Research Associate Professor of Internal Medicine. He has been actively involved with CBSSM and its precursors for over 13 years and has many research collaborations and mentoring relationships with CBSSM faculty, fellows, and affiliates. Dr. Zikmund-Fisher looks forward to helping to grow CBSSM's many research and educational initiatives in the future.

Thu, February 11, 2016

Raymond De Vries, PhD and Scott Kim, MD, PhD 's study of euthanasia and assisted suicide (EAS) for persons with psychiatric illnesses was recently written up in the New York Times. They found that persons receiving EAS for psychiatric disorders in the Netherlands were mostly women, of diverse ages, with complex and chronic psychiatric, medical, and psychosocial histories. They also reported that in more than half of approved cases, people had declined treatment that could have helped, and that many cited loneliness as an important reason for wanting to die. Dr. De Vries and Dr. Kim are current and former co-directors of the Center for Bioethics and Social Sciences in Medicine (CBSSM) .


Citation: Kim SYH, DeVries RG, Peteet JR. Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014. JAMA Psychiatry. 2016.

 

Fri, October 30, 2015

Brian Zikmund-Fisher was quoted by a number of news outlets on the relaunch of 23andme.

In an interview for the LA Time article regarding the relaunch, “Genetic testing evolves, along with health and ethics debates,” Brian Zikmund-Fisher disagrees that more information is always good.  Dr. Zikmund-Fisher points out, "Providing people with more information is not helpful if they can't do anything about it, or it leads them to focus on the wrong thing" — on their genes rather than their lifestyles, for example.”

Holly Witteman, formerly a post doctoral fellow at CBSSM and currently an assistant professor in the Faculty of Medicine at Université Laval, and colleagues’ 2016 article “One-Sided Social Media Comments Influenced Opinions And Intentions About Home Birth: An Experimental Study” was featured on Eurekalert!  an online, global news service operated by AAAS, the American Association for the Advancement of Science. The article was published in the April edition of Health Affairs and the co-authors are Angela Fagerlin, Nicole Exe, Marie-Eve Trottier and Brian Zikmund-Fisher.

An online experiment revealed that one-sided comments after health articles could influence people’s opinion about the health topic. It raises questions about how to ensure health related comment sections remain balanced.

EurekAlert!

Research Topics: 

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