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CBSSM Researchers: 

Funded by National Institutes of Health; National Institute on Aging

This is competing continuation proposal for Years 23-28 of the Health and Retirement Study (HRS) cooperative agreement, in response to NIA RFA #AG-12-001. We propose to continue core data collection on the steady-state design laid out in the two previous renewal cycles, and collect biomarkers and measures of physical performance in in-person interviews on the rotating half-sample design established in the previous cycle.

PI(s): Sharon Kardia/David Weir

Research Topics: 

Founded in 2006, MICHR develops research talent through its predoctoral and postdoctoral education programs; helps investigators launch their ideas through pilot grant funding and consultation; connects researchers with community groups, clinics, practice-based networks, and potential study volunteers; and supports research teams with clinical research management services, including biostatistical design and analysis, study management and monitoring, data management, a clinical trials office for industry partnerships, and a fully-equipped and professionally-staffed clinical research unit.

CBSSM Researchers: 

Funded by NIH - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

The central hypothesis of this study is that early patient CKD education combined with health coach support will improve patient behaviors aligned with blood pressure control by increasing patient knowledge, self-efficacy, and motivation. These in turn will lead to optimal health behaviors and improved blood pressure control. The long-term goal of this research is to develop, test, and disseminate sustainable patient-centric education and coaching support interventions to improve quality and outcomes in CKD. The objective of this proposal is to test the impact of a pilot-tested, provider-delivered patient education tool, followed with health coaching focused on blood pressure control. A cluster-randomized controlled trial will compare outcomes in patients with CKD stages 3-5 between intervention and control groups in primary care settings. Continuous quality improvement and systems methodologies will be used to optimize resource neutrality and identify how to leverage existing technology and resources to support implementation and future dissemination. Involving local partners from a state-wide primary care practice-based research network will support future transferability and uptake into community settings.

CBSSM Researchers: 

Funded by National Institute of Health (NIH), National Heart, Lung, and Blood Institute (NHLBI)

SPECIFIC AIMS : 1) Develop a re-organized model of peri-procedural anticoagulation care within six diverse healthcare centers using health systems engineering methods; 2) Develop an implementation strategy for a re- organized model of peri-procedural anticoagulation management of atrial fibrillation patients within a diverse group of healthcare centers; and 3) Perform a single-center pilot study of implementing a re-organized peri- procedural anticoagulation delivery model emphasizing improved intra-organizational provider coordination and communication. RESEARCH PLAN: To accomplish these aims, Dr. Barnes will perform direct observations and semi-structured interviews with key stakeholders to develop and then optimize a work flow model for evidence-based peri- procedural anticoagulation management. He will then use stakeholder semi-structured interviews to develop an implementation strategy for re-organizing per-procedural anticoagulation management. Finally, he will perform a single center pilot study where the re-organized anticoagulation strategy is implemented to assess feasibility, acceptability and efficacy. This study will inform a future multi-center implementation study.

Research Topics: 

Post stroke disability represents a significant public health problem as there are over 7 million stroke survivors in the US, most of whom have persistent disability. Despite the fact that acute stroke treatments dramatically reduce post-stroke disability and are cost saving, they are markedly underutilized. There is no region in the US where acute stroke treatments are more underutilized than in Flint, Michigan. Flint is an urban, underserved city of about 100,000 residents of whom about 60% are African American.

CBSSM Researchers: 

Funded by NIH - National Institute Of Nursing Research

The project aims are 1) To develop a tailored web-based decision support intervention to prepare stroke surrogates to make decisions on use of life sustaining treatments; and 2) To pilot test the tailored decision support intervention in surrogate decision makers of hospitalized stroke patients. Key features of the tool will include an advanced statistical prognostic calculator that presents customized outcome data in a tailored and accessible fashion; an exercise to assist the surrogate in clarifying values most important to the patient, and questions to ask the health care team to empower surrogates to communicate more effectively. Information obtained in this R21 is critically important to the development of a novel tool that can be tested in a future definitive R01 study in order to better match treatment plans to patient wishes, reduce adverse outcomes among surrogates, and limit unwanted variability in end-of life treatment.

Funded by Accreditation Council for Graduate Medical Education (ACGME)

PI: Andrew Shuman, MD

CBSSM Co-I: Janice Firn, PhD, MSW

Funded by Michigan Department of Health and Human Services (Subcontract)

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.

CBSSM Researchers: 

The major goals of this project are to identify the degree to which social disparities exist in physicians' communication about important clinical issues with patients with serious and life-limiting illnesses. This project also studies patient communication behaviors that exacerbate or attenuate those disparities. Results from this research will inform interventions for physicians and patients to promote better communication and thereby reduce or eliminate social disparities in care.

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