Current Research Projects

Project Description

This randomized controlled trial will test whether adding child biomarker measurement (cotinine) and informed proactive outreach for tobacco smoke exposure (TSE) as part of routine practice increases identification and improves treatment, effectiveness, and sustainability of a parental tobacco control intervention that will be integrated into practices that see pediatric patients.

We will determine the quit rate for parents and other household members, changes in smoke-free/vape-free home and car rules, child exposure to tobacco smoke/aerosol, and cost-effectiveness of adding biomarker measurement to the intervention. If trial results favor the use of this innovative biomarker test (i.e., at times of existing routine blood draws), it may help promote a paradigm shift in how TSE of children is addressed in pediatrics by creating a new clinical imperative for treatment of household tobacco users. 

Key Early Findings (if available)

None

Principal Investigators

PI - Jonathan P. Winickoff, MD, MPH  (Mass General Harvard) 
MetroHealth Site PI – David Kaelber, MD, PhD, MPH (MetroHealth)

Co-Investigator Names

Anna Joseph, MD, MPH (University of Minnesota)
Eric Kim, MD, PhD  (MetroHealth) 
Douglas E. Levy, PhD (Mass General Harvard)
Robert McMillen, PhD (Mississippi State University)
Sharon E. Murphy, PhD (University of Minnesota)
Deborah J. Ossip, PhD (University of Rochester)
Nicholas Riley, MD, PhD (MetroHealth)
Janet Thomas, PhD, LP (University of Minnesota)
Mark Vangel, PhD (Massachusetts General Hospital)
Debra B. Waldron, MD, MPH (American Academy of Pediatrics)
Karen M. Wilson, MD, MPH (University of Rochester)

Project Contact

Janeen Leon, Project Site Manager
[email protected]

Project Description

Adolescents utilize mental health professionals and disclose to trusted adults less than adults, which arguably heighten risk for suicidal behaviors, but lacks research around tracking.  We propose that the heterogeneity of suicidal trajectories will not only help explain suicidal behavior disparities but will aid in tailoring prevention initiatives based upon the onset of symptomology. This proposed work will create profiles that reflect the variation of suicidal behaviors.

The proposed study will use secondary analysis of the Add Health dataset to 1) describe the longitudinal patterns and progression of suicidal behaviors; 2) examine how social relationships and behavioral health are related to the escalation and de-escalation of suicidal behaviors, and 3) observe the heterogeneity of sexual minority presentations in these suicidal behavior trajectories. The study will produce recommendations for how pediatricians and other health care providers, as well as educators and community leaders, particularly in the context of gatekeeping and understanding suicidal risk factors, can support parents and other trusted adults in communicating effectively with their children about suicidal behaviors.

Funding Agency

National Institute of Mental Health (NIMH)

Key Early Findings (if available):  

Not applicable

Principal Investigators

Susan De Luca, MSW, PhD (MPI) – MetroHealth/Case Western Reserve University
John Blosnich, MPH, PhD (MPI) – USC
Stephen Russell, PhD (site MPI) – UT Austin

Co-Investigator Names

Jessica Fish, MS, PhD – University of Maryland

Project Contact

[email protected]

Project Description

This is an independent research fellowship to understand how clinicians are responding to and resisting criminalization in healthcare with an emphasis on gender affirming care. Using multiple outreach strategies, the goal will be to understand the practical impact of criminalization in care and what clinicians are doing to respond to it. After analysis, we will produce community-facing resources to support clinicians and practices resisting criminalization.

Funding Agency

Interrupting Criminalization

Key Early Findings (if available)

Electronic surveillance exacerbated by the 21st Century Cures Act drives significant formal and informal criminalization of gender expansive people and communities.

Principal Investigators

Laura J. Mintz, MD, PhD

Project Contact

Laura Mintz, MD, PhD 
via Jacquie Dolata, [email protected]

Project Description

The Choose2Quit intervention builds on our prior successes with the Ask, Advice, Connect study, but now

1. allows personalized choice of counseling modality (phone, text, web, in-person);
2. conveys the value and low/no-cost availability of medications to support quit attempt success and sends providers the patient’s request in e-prescription to transmit to patient’s pharmacy;
3. assesses patient’s need to manage social barriers to quitting by linking them to United Way 2-1-1; and
4. uses an initial phone contact from a recognizable local number, will increase the engagement of patients in cessation treatment and in tobacco cessation.

This study aims to:

1. Test the effect of a traditional eReferral vs. a Choose2Quit personalized guidance and choice approach on the ability to contact patients, and the proportion of patients that initiate tobacco cessation treatment, use tobacco cessation medications and make quit attempts.
2. Assess the impact of each intervention arm on equitable engagement in tobacco cessation treatment, medication use and quit outcomes across gender, race and age groups. 
3. Evaluate intervention experience from the patient perspective.
4. Evaluate the cost to implement, and per engagement and quit outcome in each of the intervention arms.  

Key Early Findings (if available)

None

Principal Investigators

Susan Flocke, Principal Investigator (Oregon Health and Science University
Eileen Seeholzer, MetroHealth Site Principal Investigator and grant Co-Investigator (MetroHealth)

Co-Investigator Names (alphabetical listing by last name)

David Kaelber, Co-Investigator (MetroHealth)
Elizabeth Albert, Co-Investigator, Project Manager (Case Western Reserve University)
Steven Lewis, Quantitative Analyst (MetroHealth)
Thomas Love, Co-Investigator (MetroHealth)

Project Contact

Susan Flocke, PhD - [email protected]  or Eileen Seeholzer, MD, MS - [email protected]

Project Description

This is a $2 million STTR grant that involves both a clinical trial and a commercialization project with Eamon Johnson PhD, CEO of Triton X, the industry partner. MetroHealth is the lead academic partner for the project. The project will test a Device that Recognizes the Need to Intake Water (currently codenamed the DRINK band) in older adults aged 55 plus who are admitted to the ED dehydration.

The project has two phases: in Phase 1, investigators will conduct a comparative study of the device among acutely ill dehydrated older adults being cared for in the emergency department. In Phase 2, the investigators will conduct a clinical trial of continuous home monitoring of fluid levels among patients returning home after an acute care episode for dehydration. 

Funding Agency

National Institute on Aging (NIA)

Key Early Findings (if available):  

None

Principal Investigators 

Mary Joan Roach, PhD 
Joseph S. Piktel, MD, FACEP 

Co-Investigators

Nathan Makowski, PhD
Adam Perzynski, PhD 
Lance Wilson, MD

Project Contact

Mary Joan Roach, PhD  
[email protected]

Project Description

This project uses community-based concept mapping to tailor and refine the River Clinic, a status neutral post-incarceration clinic operating in Pittsburgh to meet the highest priority needs for individuals in sexual and gender minority communities leaving jail and carceral locations in Cuyahoga County. Concept mapping is a participatory, mixed method research approach that yields a conceptual framework for how a group views a particular topic or aspect of a topic. Two groups will build concept maps, one composed of persons that self-identify as a part of SGM (Sexual and Gender Minority) communities and have been impacted by carceral systems in the past three years and persons that provide community support (both formal and informal) to community members coming home from jail or prison. After both maps are built, there will be a collective assessment and consolidation into one priority map. Those priorities will then be integrated into the practice of a mobile clinic at MetroHealth, which will provide healthcare and priority community needs. We will test the impact of this clinic on HIV care cascade outcomes and for feasibility, acceptability, and appropriateness.

Funding Agency

National Institutes of Health

Key Early Findings (if available)

None

Principal Investigators

Laura J. Mintz, MD, PhD
Emily Dauria, PhD

Co-Investigators

Ann Avery, MD
AKeem Rollins
Stephanie Creasy (Pittsburgh): Project Director
Carey Gibbons (NEOCH): Community Research Partner 

Project Contact

AKeem Rollins, MPH
[email protected]

Project Description

The overall goal of this collaborative effort is to recruit, train, and employee Community Health Workers (CHWs) in urban and rural underserved communities, increasing diversity in the public health workforce.  

Funding Agency

HRSA

Key Early Findings (if available):  

None

Principal Investigators

Aleece Caron, PhD
Katie Davis MSN, RN, PHNA-BC

Co-Investigators

Ifeolorundbode A. Adebambo, MD   
Christina Antenucci, MD
James W. Campbell, MD, MS, AGSF 
Joseph K. Daprano, MD
Rita Horwitz, RN
Kate Nagel, DrPH, MPH
Alan K. Nevel, MBA
Adam T. Perzynski, PhD
Mark Rodney, PA-C
Eileen L. Seeholzer, MD, MS
Marie Velez, MPA

Project Contact(s)

Aleece Caron, PhD - [email protected] or Katie Davis MSN, RN, PHNA-BC - [email protected]

Project Description

This is a randomized controlled trial involving 24 Community Members charged with the task of reviewing 568 manuscripts submitted to two medical journals in order to add community perspectives to the manuscript review process.  Journal editorial will use all reviews to help them make decisions about acceptance, revision, or rejection of manuscripts.  Quantitative and qualitative analyses will compare the content of community and scientific reviews, determine the usefulness of community reviews to journal editors, and explore how community reviewer comments are integrated into published articles.     

Key Early Findings (if available)

None

Principal Investigators

Ash Sehgal, MD

Project Contact 

Joshua Beltran
[email protected]

Project Description

The proposed project will test the effectiveness of technology-facilitated Customized Adherence Enhancement (CAE) vs. enhanced treatment as usual (eTAU) using a prospective randomized controlled trial design in public mental health care settings and preferentially enrolling poorly adherent/high-risk individuals with Bipolar Disorder (BD). CAE is a modular behavioral intervention that maps onto specific barriers that people with BD may experience that impede optimal medication adherence. Project deliverables include a curriculum-driven adherence enhancement approach that can be implemented in public healthcare settings and which can improve outcomes for the most vulnerable groups of people with BD.   

Key Early Findings (if available)

None

Principal Investigators

Martha Sajatovic, MD
Jennifer Levin, PhD

Co-Investigators

Carol Blixen PhD
Farren Briggs, PhD
Doug Einstadter, MD

Project Contact 

[email protected] 

Project Description

Using Latent Variables and Directly Observed Treatment to Improve the Diagnosis and Management of Depression among Hemodialysis Patients

Many hemodialysis patients have depression that is difficult to diagnose and treat. The goal of this project is to develop a screening instrument to improve diagnosis and to test the value of weekly directly observed antidepressant medication in treating depression.

Key Early Findings (if available)

Principal Investigators

Ashwini Sehgal, MD
Douglas Gunzler, PhD

Project Coordinator

Co-Investigators

Jeffrey Albert, PhD
Martha Sajatovic, MD

Project Contact

Ashwini Sehgal, MD
[email protected]

Funding Agency: National Institute of Nursing Research (NIH-NINR)

Project Description: The proposed project will characterize longitudinal phenotypic patterns among robust biobehavioral impairment measures in multiple sclerosis (MS) and identify distinct phenotypic clusters of individuals with similar impairment patterns, with the goal of facilitating decision making for clinicians and patients.

Key Early Findings (if available): None

Principal Investigators (please include credentials such as MD, MS, PhD, etc):

Douglas D. Gunzler, PhD

Farren B.S. Briggs, PhD

Alessandro S. De Nadai, PhD

Co-Investigator Names (alphabetical listing by last name):

Daniel Ontaneda, MD, PhD

Deborah M. Miller PhD

Project Contact:

Farren B.S. Briggs, PhD
[email protected]

Project Description

To describe the characteristics of traumatic spinal cord injury (SCI) population who received their injury due to falls, and the re-occurrence of falls over time after the initial SCI. Our key findings were that Blood Alcohol Level had a positive association with neurologic recovery in patients with spinal cord injury as measured by the International Standards for Neurological Classification of Spinal Cord Injury exam’s Motor Score Gain during acute rehabilitation.

Funding Agency

National Institute on Disability, Independent Living and Rehabilitation Research

Key Early Findings (if available)

Blood Alcohol Level had a positive association with neurologic recovery in patients with spinal cord injury as measured by the International Standards for Neurological Classification of Spinal Cord Injury exam’s Motor Score Gain during acute rehabilitation. 

Online Manuscript: https://meridian.allenpress.com/tscir/issue/26/4

Principal Investigator

Mary Joan Roach, PhD

Co-Investigators

Michael Kelly, MD
Greg Nemunaitis, MD
Argyrios Stampas, MD
Josephine Volovetz, MD

Project Contact

Mary Joan Roach, PhD
[email protected]

Project Description

This project was funded to improve cardiovascular health equity within identified census tracts in Cuyahoga County with the highest burden of hypertension. We will apply a learning collaborative approach with data sharing and linkages among health systems, community organizations, payers, and other partners to align efforts for greater cardiovascular health impact.

We will improve both the processes and outcomes of care for adults with hypertension while advancing health equity. Partners will make a concerted effort to track and address clinical and health-related social needs at the census tract level, paired with continuous quality improvement (QI) efforts to advance cardiovascular health equity.

Funding Agency

Center for Disease Control and Prevention

Key Early Findings (if available)

None

Principal Investigators

Aleece Caron, PhD
Shari Bolen, MD, MPH

Co-Investigators

Douglas Einstadter, MD, MPH
Anne Gaglioti, MD, MS, FAAFP
Rita Horwitz, BSN
David Kaelber, MD, PhD
Ndidi Larburg, MPH, RRT
Tom Love, PhD
Christopher Mundorf, MPH, PhD
Sonal Patil, MD, MSPH
J. Daryl Thornton, MD, MPH

Collaborating Organizations

Better Health Partnership
Case Western Reserve University
Cleveland Clinic
The Centers
University Hospitals
American Heart Association
Burten, Bell, Carr Development, Inc.
CHN Housing Partners
Cleveland Department of Public Health
Cleveland Foodbank
Cleveland State University
Cuyahoga Community College (Tri-C)
Cuyahoga County Board of Health
Health Impact Ohio
Humana Ohio Medicaid
Major League Barbershop
Medical Mutual of Ohio
Ohio Department of Health
Ohio Department of Medicaid 
Ohio Association of Health Plans
Urban Kutz Barber Shop; The Urban Barber Association (TUBA)
YMCA

Project Contacts

Cathy Sullivan MS, RD 
[email protected]

PJ Kimmel, MPH 
[email protected]

Project Description

This national 3-year, multi-site Patient Centered Outcomes Research Institute (PCORI) multi-phase clinical trial involves studying the integration of behavior health services into primary care clinics. Participating primary care clinics are randomized to early versus delayed integration of behavior health services within the clinics. Standard, low-resource, and scalable techniques are used to integrate behavior health services into the clinics. The degree of co-location and integration of behavior health services in participating primary care clinics is measured at baseline and throughout the study. Participating sites are also evaluated based on improvement in self-identified chronic medical conditions such as diabetes and hypertension. The MetroHealth System has 4 primary care sites enrolled in this study.

Key Early Findings (if available)

Principal Investigators

Benjamin Littenberg, MD (University of Vermont)

Project Coordinator

Co-Investigators

David Kaelber, MD, PhD, MPH 
Terry Stancin, PhD
Kathryn Teng, MD

Project Contact

David Kaelber, MD, PhD, MPH
[email protected]

Project Description

Our center grant provides a combination of research, career development, and community partnership activities. The Administrative Core oversees, manages, and coordinates all proposed activities. The Investigator Development Core operates pilot awards for community-based approaches to understanding and reducing health disparities. Our two research projects (Journal Reviewers and Sleep Apnea Study) involve novel approaches for engaging community members. The Community Engagement and Dissemination Core engages with and disseminates research findings to community members, partner organizations, service organizations, policymakers, and scientists. 

Key Early Findings (if available)

Principal Investigators 

Ash Sehgal, MD

Co-Investigator Names (alphabetical listing by last name)

Jeffrey Albert
Cheryl Killion
Cyleste Collins
Adam Perzynski
Kurt Stange
Daryl Thornton

Project Contact

Jacqueline Dolata, MBA
[email protected]

Development and Validation of Probabilistic Matching Algorithm 

Project Description

Using trauma registry data from 5 Spinal Cord Injury Model Systems (SCIMS) and the corresponding SCI National Database to develop a probabilistic matching algorithm.

Funding Agency

Findings

Online Manuscript: https://meridian.allenpress.com/tscir/issue/26/4 

Principal Investigator

YuYing Chen, MD, MPH

Co-Investigators

Wendy Huacong, PhD
Russel Griffin, PhD
Michael Kelly, MD
Mary Joan Roach, PhD 

Project Contact

Mary Joan Roach, PhD
[email protected]

Project Description

About 25-50% of women who undergo breast cancer surgery develop persistent chest wall pain and shoulder mobility limitations following surgery. This NIH funded study seeks to determine whether massage therapy will reduce pain and increase mobility for women experiencing pain or mobility issues in the chest or shoulder after breast cancer surgery.  Women are randomized to licensed massage therapy twice a week for two months versus light touch therapy.

Key Early Findings (if available)

None

Principal Investigators

Ash Sehgal, MD  

Project Contact

Project Description

Electronic health record (EHR) databases have existed for two decades, introducing many improvements in health care delivery and information management. Yet, their potential as a research tool to enable deeper understanding of unique aspects of health in populations, novel treatment pathways and best practices for data-informed, shared clinical decisions remains to be fully realized. Supported by the National Institute on Aging, the Northeast Ohio Cohort for Atherosclerotic Risk Estimation (NEOCARE) Learning Health Registry is a regional collaboration between MetroHealth and Cleveland Clinic to combine electronic health records and link the merged health records with community data resources. The registry includes health information from more than 3.1 million unique individuals over 20 years.

Key Early Findings (if available)

NEOCARE team members have published findings examining:

1. how neighborhood socioeconomic status influences cardiovascular health outcomes;
2. the failure of clinical indicators to predict cardiovascular morbidity among older patients;
3. patterns of disease and health conditions among homeless persons;
4. relationships between neighborhood conditions and cognitive decline among older persons;
5. the association of immune-hematologic markers with cardiovascular and all-cause mortality; and
6. the structure of neighborhood-level measures of socioeconomic disadvantage.

These findings will help inform future interventions to improve the cardiovascular health of people who often have the highest cardiovascular risk.

Principal Investigators

Adam T. Perzynski, PhD
Jarrod E. Dalton, PhD

Co-Investigators

Kristen Berg, PHD, CRC
Claudia J. Coulton, PhD
Neal V. Dawson, MD
Douglas Einstadter, MD, MPH
Darcy Freedman, PhD, MPH
Douglas D. Gunzler, PhD
David Kaelber, MD, PhD, MPH, FAAP, FACP, FACMI
Michael B. Rothberg, MD, MPH

Project Contact

Adam Perzynski, PhD  [email protected]

Project Description

The purpose of this collaborative proposal led by NEOMED’s Dept. of Family and Community Medicine is to improve the primary care workforce by enhancing inter-professional training for primary care clinicians, teachers and researchers, with specific attention to underserved populations, across the care continuum. Through this proposal, we will achieve the quadruple aim of improved healthcare quality (specifically for underserved populations), lowered costs, improved patient and family experience, and improved health care provider experience.

We will achieve this goal by implementing a formal curriculum for medical students, faculty, and residents to meet four objectives:

1. transform healthcare systems by providing the knowledge and skills necessary for improving systems of care, building multidisciplinary teams, increasing quality of skills, and improving the work-life of healthcare providers;
2. incorporate population health to gain knowledge of strategies and interventions across the continuum of care to improve health at the lowest cost;
3. reduce disparities by increasing understanding of the causes of disparities and solutions to them, including social, economic, political, cultural, legal and ethical theories related to health disparities; and
4. develop research expertise to develop collaborative projects to improve access, quality of care, and cost-effectiveness.

This collaborative program engages family medicine, general internal medicine, pediatric and behavioral health departments from one medical school, nine residency programs, and two federally qualified health centers. MetroHealth Services of Cleveland (MHS) will provide training and mentoring in adapting their HRSA-funded PCTE program. We will provide interdisciplinary training to faculty physicians from each residency program and FQHC, with other care team members from each site including NPs, PAs and behavioral health specialists. The goal of this train the trainer model is for each of the training sites to have a minimum of three care team faculty complete the program, with one master trainer in each of the following three areas: transforming health systems, population health management, and reducing health disparities. The faculty experts at their site will champion the work, and train residents and other faculty. 

Key Early Findings (if available)

None

Principal Investigator

John Boltri, MD 

Site PI

Aleece Caron, PhD

Co-Investigators

Nathan Beachy, MD
James Campbell, MD
Adam Perzynski, PhD

Project Contact

Aleece Caron, PhD
[email protected]

Project Description

The Ohio Department of Medicaid (ODM), in collaboration with academic leaders, healthcare providers, and payers, has established Regional Quality Improvement (QI) Hubs across Ohio to advance population health improvement for Medicaid enrollees. The Northeast Ohio (NEO) QI Hub is led by Case Western Reserve University (CWRU) School of Medicine in partnership with Northeast Ohio Medical University (NEOMED), regional healthcare systems, and Federally Qualified Health Centers (FQHC).

The initial QI project of the NEO QI Hub, Achieving HEAlth Equity in Diabetes (AHEAD), seeks to improve the health of adults living with diabetes in Northeast Ohio by using quality improvement science in participating primary care practices to improve glycemic control and eliminate disparities in glycemic control. AHEAD builds upon a prior successful statewide Diabetes QI Project which improved A1C > 9% from 25% to 20% at high-volume Medicaid primary care sites led by Ohio’s seven schools of medicine, the Ohio Colleges of Medicine Government Resource Center, and ODM. Resources developed by the AHEAD Initiative include the Diabetes QI Clinical and Patient Education Toolkits and a podcast series and are available at https://neoqihub.org/.

Funding Agency

Ohio Department of Medicaid

Key Early Findings (if available)

None

Principal Investigators

Michael Konstan MD – Case Western Reserve University
Shari Bolen MD, MPH – MetroHealth Medical Center and Case Western Reserve University
Rebecca Fischbein, PhD – Northeast Ohio Medical University

Collaborating Organizations

Case Western Reserve University
Northeast Ohio Medical University (NEOMED)
AxessPointe Community Health Centers 
Better Health Partnership
Cleveland Clinic
Health Impact Ohio
MetroHealth System
Neighborhood Family Practice Community Health Centers
Northeast Ohio Veterans Affairs Healthcare System
Summa Health
University Hospitals

Project Contact

Cathy Sullivan MS, RD - [email protected]
PJ Kimmel, MPH - [email protected]

Project Description

Founded in 2017, the mission of Cardi-OH is to improve cardiovascular and diabetes health outcomes and eliminate disparities in Ohio's Medicaid population.

• WHO WE ARE: An initiative of health care professionals across Ohio’s seven medical schools, funded by Ohio Department of Medicaid (ODM).
• WHAT WE DO: Identify, produce, and disseminate evidence-based cardiovascular and diabetes best practices to primary care teams.
• HOW WE DO IT: Monthly publications including newsletters, online cardiovascular and diabetes resources available on Cardi-OH.org, webinars, short brief cardiovascular e-mail and online topics called Currents and Capsules, Cardi-OH Radio podcasts, and Project ECHO® TeleECHO Clinics. These TeleECHO clinics are a 12-week virtual training series led by experts that feature didactics and case studies presented by participating primary care teams to enhance their capacity to manage cardiovascular conditions.

Key Early Findings (if available)

Principal Investigators

Michael W. Konstan MD
Shari Bolen, MD, MPH 

Site PIs at Ohio’s 6 other medical schools (www.cardi-OH.org)

Co-Investigators

Over 50 experts from across Ohio (www.cardi-OH.org)
Other collaborators on this project exist within the other 6 medical schools across Ohio, Ohio Colleges of Medicine Government Resource Center and Ohio Department of Medicaid.

Project Contact

Ann Nevar, MPH
[email protected]

Project Description

The Ohio Coverdell Stroke Program is a Centers for Disease Control and Prevention (CDC) federally funded program managed by the Ohio Department of Health (ODH). Ohio is one of nine states funded to focus on measurement, tracking, and improvement of quality of care and access to care for patients with stroke from onset of stroke symptoms through rehabilitation and recovery. 

MetroHealth, has received funding from ODH since 2007 to serve as the Clinical Consulting Team. We provide clinical direction to the Coverdell Leadership team, lead statewide quality improvement initiatives and develop and support educational programs for pre-hospital, hospital and post-hospital providers. The Clinical Consulting Team at MetroHealth is responsible for statewide data integrity for data sent to the CDC. This encompasses statewide abstraction training for hospital staff, individual hospital quarterly inter-rater reliability processes and quality improvement strategies for statewide data.  

Key Early Findings (if available)

Principal Investigators

Julie Fisher, MHA, BSN, RN, CPHQ
Program Manager, Ohio Coverdell Stroke Program

Co-Investigators

Agnieszka Ardelt, MD, PhD, MBA, FAHA
Tracy Cushler, BSN, RN
Alice Liskay, MPA, BSN, RN
Steven Lewis, MS, MPH, MBA

Project Contact

Julie Fisher, MHA, BSN, RN, CPHQ
[email protected]

Project Description

Key Early Findings (if available)

Principal Investigators

J. Daryl Thornton, MD, MPH

Project Contact

Marquisha Marbury
[email protected]

Project Description

The REACH grant is funded by the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. This project will help to advance work that was initiated in 2007, with significant progress made during the first REACH grant cycle (2014-2018) in the areas of healthy eating, active living, and clinical and community linkages. The Cuyahoga County Board of Health leads this regional initiative as part of their regional health collaborative called Health Improvement Partnership (HIP)-Cuyahoga. HIP-Cuyahoga hopes to improve healthy food access, physical activity and active transportation opportunities, increase breastfeeding supports, and increase the use of community and health support programs among African Americans in Cuyahoga County. Better Health Partnership in conjunction with PHRI’s Center for Health Care Research and Policy and United Way 2-1-1 HelpLink (UW 2-1-1) lead a project at several clinics linking children with overweight/obesity and/or asthma as well as adults with uncontrolled blood pressure to community resources for self-management and social needs with the ultimate goal of improving health outcomes.

Key Early Findings (if available)

Since the program began, 161 adults with hypertension and 215 children with asthma and/or overweight/obesity have been given a referral to UW 2-1-1. The top three areas of need include: physical activity and recreation, food/meals, and self-management resources. Among the 178 patients reached by UW 2-1-1, 162 clients were given referrals to over 200 community agencies. Of the 162 clients given referrals, 134 (82.7%) clients have at least one need in progress or resolved.   

Here are some stories of patients helped by the program:

• One mom (Ms. R) was concerned because there was mold and pest issues after plumbing leaks in their rental. The plumbing was eventually fixed but the landlord didn’t correct the damage which was causing the mold and pest issues. UW 2-1-1 referred Ms. R to some resources on tenant rights/legal assistance, as well as resources on mold/pest information and inspection.  She also wanted information on fresh food distributions. Ms. R. was very thankful for the resources.  
• When circumstances get tough, Mr. W has a go-to phone number that he got in a visit to MetroHealth’s J Glen Smith clinic. When he calls Katie at UW 2-1-1 she helps him find resources he needs in the community, including food pantries and fresh produce markets. Katie also calls him every couple of weeks to check in on him. “Katie has been such a jewel,” said Mr. W. “She’s always trying to find programs that can help me. And when you call her, she calls you back.”

Principal Investigators

Cuyahoga County Board of Health
Martha Halko, MS, RD, LD

Clinic to Community Linkages Project Leads
Shari Bolen MD, MPH
Jonathan Lever, MPH, NRP

Funded partners on this grant include:

• The Cuyahoga County Board of Health,
• A Vision of Change
• Better Health Partnership
• Bike Cleveland
• Case Western Reserve University (the Center for Community Health Integration and the Prevention Research Center for Healthy Neighborhoods)
• Cleveland State University School of Nursing
• Fairhill Partners,
• Neighborhood Family Practice
• United Way of Greater Cleveland

Contact for the Clinic to Community Linkage project

Jonathan Lever, MPH, NRP
[email protected]

Project Description

African-Americans have substantially higher stroke rates, compared to any other racial-ethnic group and racial disparities in stroke outcomes are particularly high among AA men. This project will test a nurse and patient co-led, curriculum-guided, self-management support approach, “TargEted MAnageMent” (TEAM) focused specifically on African-American men at high risk for stroke.

Key Early Findings (if available)

Principal Investigators

Martha Sajatovic, MD
Carolyn Harmon Still, PhD

Co-Investigators

Project Contact

[email protected] 

Project Description

A crucial scientific gap in suicide prevention stems from the majority of suicide research relying on individual psychopathology, largely overlooking meaningful constellations of risk in a broader context of social environmental life disruptions that commonly precede suicide. This proposal uses a two-pronged approach that ventures beyond traditional funding mechanisms by challenging what we typically consider to be “health” vs. “non-health”-related suicide prevention research and intervention.

First, by taking the tested methodology of psychological autopsy and reinventing it as a social autopsy, we will dive deeply both into the nature of life disruptions that often precede suicide and the contacts with non-medical services that a suicide decedent may have made prior to their death. Second, by surveying and interviewing employees of industries that commonly deal with life disruptions (i.e., divorce, mortgage foreclosure, and job loss), we will explore their experiences with suicidal clients, such as occupational wisdom and intuition around warning signs among clients, training around suicide prevention, knowledge about suicide, and approaches they may have used when working with clients in distress. True integration of social determinants into suicide prevention research requires rethinking the problem of suicide as solely a clinical mental health problem requiring clinical solutions, to suicide as a problem at a social and clinical nexus, thus necessitating both social and clinical solutions.

Funding Agency

National Institute of Mental Health (NIMH)

Key Early Findings (if available):  

N/A

Principal Investigators

John Blosnich, MPH, PhD (PI: USC)

Co-Investigators

Susan De Luca, MSW, PhD

Project Contact

Susan De Luca, MSW, PhD
[email protected]

Project Description

The goal of the Systems Marketing Analysis for Research Translation (SMART) Innovation Program is to accelerate the translation of known, effective interventions into practice and at a speed and reach that can significantly close regional gaps in health. The project does this by engaging clinical research teams in a structured process for understanding and identifying the drivers of health outcomes.

Funding Agency

NIH-NCATS

Key Early Findings (if available)

None

Principal Investigators

Peter Hovmand, PhD
Brian Biroscak, PhD

Site Principal Investigator at MetroHealth

Douglas Gunzler, PhD

Project Contact

Peter Hovmand, PhD
[email protected]

Project Description

The EXPAND study will develop and pilot a pharmacist led model of medication delivery. Following a co-design phase, patients may receive injections at satellite pharmacies by a licensed pharmacist. The acceptability, appropriateness, and feasibility of this approach will be assessed and compared with standard in clinic administration by a nurse.

Funding Agency

VIIV Healthcare

Key Early Findings (if available)

None

Principal Investigators

Corrilyn Hileman, MD

Co-Investigators

Aleece Caron, PhD
Ann Avery, MD

Project Contact

Corrilyn Hileman, MD
[email protected]

Project Description

Ohio has one of the highest rates of morbidity and mortality for people with high blood pressure, high cholesterol and for people who smoke. The Agency for Health Care Research and Policy has funded a Heart Healthy Ohio Initiative to expand a statewide Ohio cardiovascular health collaborative (Cardi-OH) to improve cardiovascular health and reduce cardiovascular disparities for all Ohioans. To do this, we will work with primary care teams, patients and families and other partners to develop a heart healthy intervention that primary care clinics in Ohio can use to improve care and reduce disparities for patients with high blood pressure, high cholesterol and who smoke.

Key Early Findings (if available)

Principal Investigators

Shari Bolen MD, MPH [MetroHealth/Case Western Reserve University (CWRU)]
Aleece Caron, PhD (MetroHealth/CWRU)
Saundra Regan, PhD (UC)
Randell Wexler MD, MPH (OSU)

Collaborating Organizations

Ohio State University (OSU)
University of Cincinnati (UC)
The Health Collaborative
The Healthcare Collaborative of Greater Columbus
Better Health Partnership
Ohio Academy of Family Physicians
Ohio Association of Community Health Centers

Stakeholders

American Heart Association
CVS Health, Minute Clinic
Health Action Council
IPRO
National Association of Community Health Workers - Ohio Ambassador - 
Ohio Academy Of Nutrition and Dietetics
Ohio Association of Physician Assistants
Ohio Association of Health Plans
Ohio Chapter of the American College of Physicians
Ohio Department of Medicaid
Ohio Department of Health
Ohio Nurses Association
Ohio Pharmacists Association
Quality and Safety Education for Nurses Institute

Project Contact

Stephanie Kanuch, MEd  [email protected]
Catherine Sullivan, RD  [email protected]

Project Description

The goal of our work is to optimize primary care faculty and trainee academic productivity, job satisfaction, and retention rates in a large, urban safety-net hospital with 14 community-based practice sites. Within that frame, we describe specific goals in our work toward patient centeredness, integrating systems of care, quality improvement, clinical teaching and mentoring, and the elimination of health disparities. This proposal has 5 specific aims to develop scholarship in primary care with emphasis on areas critical to the faculty and residents that provide care for an underserved population. These aims are:

1. Care of the underserved: a formal curriculum reviewing social, political, economic, cultural, legal and ethical theories related to disparities in general, with a central focus on health disparities;
2. Teaching: a formal curriculum to facilitate faculty who are already active in teaching to improve teaching skills and gain skills in program development and teaching evaluation;
3. Quality Improvement: a formal curriculum for faculty and residents to gain skills necessary to improve systems of care and function in multidisciplinary teams;
4. Core content expertise development and enhancement in three areas important to caring for vulnerable populations; and
5. Improve academic productivity for faculty through protected time and mentorship to allow faculty who are clinically active and community-based to pursue scholarship.

This collaborative program will be offered to faculty and trainees in family medicine, geriatrics, general internal medicine, general pediatrics, internal medicine/pediatrics, and obstetrics/gynecology. Faculty will have 10% protected time to participate for two years and residents will participate during years 2 and 3 of their training. Each participant will:

1. Complete all 5 cores listed above;
2. Complete individualized development plans in teaching skills;
3. Complete a Quality Improvement project;
4. Complete a Health Disparities Case Narrative; and
5. Complete a personalized philosophy of teaching plan.

Faculty will receive individualized mentoring, develop long- and short-term career goals with measurable outcomes, and work with the project team and their residency programs to establish a robust, formal mentoring program for their specialty.

Key Early Findings (if available)

None

Principal Investigators

Aleece Caron, PhD

Co-Investigators 

Nathan Beachy, MD
James Campbell, MD
Adam Perzynski, MD

Project Contact

Aleece Caron, PhD
[email protected]

Project Description

This project will evaluate the efficacy of a personalized and automatized m-Health intervention targeting both intentional and non-intentional nonadherence, iTAB-CV + Self-Monitoring, compared to Self-Monitoring alone to improve medication adherence and lower systolic blood pressure in individuals with bipolar disorder (BD) and hypertension. Given the serious negative consequences of uncontrolled hypertension, including early mortality, an intervention that successfully improves adherence to antihypertensive medications while simultaneously addressing psychiatric medication adherence and which can be administered via text messaging would be of substantial public health benefit.

Key Early Findings (if available)

Principal Investigators

Jennifer Levin, PhD
Martha Sajatovic, MD

Co-Investigators

Project Contact

[email protected] 

Project Description

This project is using an implementation science approach to assess and test the acceptability and feasibility of a video-based narrative medicine strategy to decrease stigma and improve PrEP prescribing and management among trans and gender expansive Black women and Black men that have sex with men and other genders of people. The initial work will be focus groups centered in the aforementioned communities and with prescribing clinicians who either occasionally prescribe PrEP or who don’t prescribe PrEP to discuss the barriers and dynamics that drive the syndemics of HIV in these communities and the impact of the proposed intervention. The intervention will consist of both the patient and the provider recording a short pre-visit introductory video and the provider watching and responding to the patient’s video (providers are given protected time to do this) before the visit to decrease stigma and improve patient comfort and safety in receiving care. It will be conducted at two sites with different characteristics around Cleveland.

Funding Agency

National Institutes of Health, Center for AIDS Research

Key Early Findings (if available)

None

Principal Investigators

James Egan, PhD 
Mackey Friedman, PhD  

Co-Investigators

Laura J. Mintz, MD, PhD 
AKeem Rollins

Project Contact

Emmett Henderson, PhD 
[email protected]