Identifying Best Practices of Medical Home Implementation for Older Adults
PI: Timothy Hoff
Funder:  Agency for Healthcare Research and Quality (R03)
Period:  October 1, 2011 – September 30, 2013    

This study examines the implementation of patient-centered medical home (PCMH) care for older adult patients within primary care settings.  The patient-centered medical home care model is an important health care innovation that seeks to strengthen the U.S. primary care system through improvements in quality, access, and care delivery.  Recent U.S. health reform legislation places significant emphasis on PCMH care to improve both quality and efficiency within the current system, and to create a more patient-oriented care experience.  Many state governments are also looking to medical home care innovations to improve public health insurance programs like Medicaid and Child Health Plus.  This study, one of the first nationally to examine how to tailor medical home care to different populations, will draw upon extended interviews and focus groups with physicians and nurses now delivering medical home care within primary care practices. 

Step Up to Stop Falls Evaluation
PI: Mary Gallant
Funder: Community Health Foundation of Western and Central New York
Period: May 2011- April 2014  

This project involves a comprehensive evaluation of the Step Up to Stop Falls Collaborative, a multi-county falls prevention initiative taking place in 7 counties in western and central NY.  Over an 18-month project period, 7 county coalitions are conducting various falls prevention activities, directed at both older adults and at health care providers.  The overall goals of the evaluation are to: (1) Assess the reach and spread of falls prevention practices into grantee communities; (2) Assess the ability of the work to continue beyond the formal structure of the collaborative; and (3) Compare the results of selected best practice interventions with published benchmarks.  To achieve these goals, a mixed method evaluation design is being employed, utilizing both quantitative and qualitative data to evaluate reach, impact, and sustainability of the Step Up to Stop Falls initiative. 

Evaluation of Gold STAMP Pressure Ulcer Reduction Program
PI: Yuchi Young
Funder: NYS Health Foundation
Period: April 1, 2011 – March 31, 2012

The purpose of this project is to evaluate the effectiveness of the Gold STAMP intervention program which aims to reduce pressure ulcers in New York State. The Gold STAMP is a coalition of health care providers convened to provide resources and education across the continuum of care in New York State with the goal of improving the assessment, management, and prevention of pressure ulcers.  This evaluation program will 1) examine the intervention process and 2) evaluate the most effective modalities in reducing pressure ulcer incidence and prevalence rates and   associated cost.  The results will lead to a larger scale demonstration project and an R01 grant to AHRQ.

Assessing Health Literacy for Adolescents: A Pilot Study
PI: Jennifer Manganello
Funder: National Institutes of Health/National Institute of Child Health and Human Development (R03)
Period: July 22, 2010 – May 31, 2012

Health literacy plays a significant role in one's ability to fully understand health information. Much information exists concerning health literacy and adult health, but few studies have focused on health literacy for adolescents. However, adolescents are increasingly involved with their health care and are at a crucial stage in their development, experiencing many changes and learning skills for adulthood while still accessing settings that can facilitate interventions. In order to promote research focusing on adolescents and health literacy, the main aim of this study is to measure health literacy among a sample of adolescents and to test a new method of assessment. Using a convenience sample of 300 adolescents, this study will compare previously validated methods for assessing aspects of health literacy with a set of newly developed self-report questions to create a new measurement tool (Health Literacy Assessment Scale for Adolescents, HAS-A). The development of the HAS-A will allow for researchers to include a validated scale assessing health literacy in self-administered surveys as either an explanatory or outcome variable to support future research in the area of adolescent health literacy.

A Childhood Obesity Prevention Program Designed by Families for Families
PI: Janine Jurkowski (with Kirsten Davison)
Funder: National Institutes of Health/ (R24)

This project (commonly referred to as Communities for Healthy Living (CHL)) targets childhood obesity and its differential distribution among children in low-income and ethnic minority families - with a particular focus on families enrolled in Head Start.  CHL has two key innovative features.

  1. CHL uses Community-Based Participatory Research (CBPR) to empower low-income families to play a central role in the development and implementation of a family-centered obesity prevention program. 
  2. CHL responds to low-income caregivers’ multiple time demands, child care challenges, and transportation constraints by building the intervention into existing systems of care – in this case Head Start and WIC.  This strategy promises to facilitate family engagement and sustained involvement.  

CHL has an active Community Advisory Board (CAB) that includes parents, community representatives and our partner organization staff. The CAB is the decision making body of the project. The CHL partnership conducted a nine method community assessment.  In partnership with the CAB, CHL and researchers developed a multicomponent intervention that included a social marketing campaign to increase awareness of childhood obesity and its risk behaviors, a 6-7 session Parent –led parent obesity prevention and health promotion program, nutrition counseling and childhood obesity and child health awareness through existing systems of care to improve access to health resources. Head Start requires measuring and reporting children’s health status indicators.  Students, staff and faculty measured body mass index in the county’s Head Start Centers, revised the health status reporting letter to parents, and provided health education materials. CHL also provided support for the parent-led program, administered a child program, and provided outreach to the Head Start centers. CHL conducted a mixed method, repeat-measure evaluation.

Health Behaviors and Lifestyles in Old Age in the United States and Japan
PI: Benjamin A. Shaw
Funder: National Institutes of Health/National Institute of Aging (R01)
Period: September 1, 2008 – June 30, 2012

This study aims to examine how health behaviors and lifestyles evolve during old age in the United States (US) and Japan. Although individual health behaviors – including alcohol consumption, smoking, physical activity, and weight management – have been widely studied, we currently know little about how these behaviors change in later life. Moreover, few studies have moved beyond the analysis of individual health behaviors to examine configurations of multi-behavior profiles within individuals (i.e., health lifestyles). The proposed research has the following specific aims: 1) To describe how individual health behaviors change during old age; 2) To describe the prevalence of various health lifestyles during old age; 3) To assess the extent to which interindividual variations in late life health behavior trajectories and lifestyle profiles are patterned by key social status indicators (e.g., ethnicity, socioeconomic status, and gender) and changing psychosocial factors (e.g., personal control beliefs, social resources, and stress); 4) To analyze the interrelationships between health outcomes and various health behavior trajectories and lifestyle profiles during late life; and 5) To compare and contrast the prevalence, determinants, and health impact of various late life health behavior trajectories and lifestyle profiles in the US and Japan. Data for the proposed project come from four nationwide panel surveys conducted in the US, and one nationwide panel survey of Japanese elderly.

NYS Older Adult Fall Prevention Program. 
PI: M.P. Gallant, Principal Investigator of Subcontract for Evaluation. 
Funder: Centers for Disease Control and Prevention / NYS DOH Bureau of Injury Prevention
Period:  9/30/09 – 7/31/11 

The goal of this project was to implement two evidence-based falls prevention programs (Tai Chi Moving for Better Balance and Stepping On) in community settings, and evaluate their effectiveness in modifying falls risk factors and reducing falls.