Category Archives: Prevention

Apr 8 2014
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Preventing Youth Violence May Cost Less Than You Think…

Adam L. Sharp, MD, MS is an emergency physician and recent University of Michigan Robert Wood Johnson Foundation Clinical Scholar (2011-2013). He works for Kaiser Permanente Southern California in the Research and Evaluation Department performing acute care health services and implementation research.

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Violence is a leading cause of death and injury in adolescents. Recent studies show effective interventions can prevent violent behavior in youth seen in the Emergency Department (ED). Adoption of this type of preventive care has not been broadly implemented in EDs, however, and cost concerns frequently create barriers to utilization of these types of best practices. Understanding the costs associated with preventive services will allow for wise stewardship over limited health care resources. In a recent publication in Pediatrics, "Cost Analysis of Youth Violence Prevention," colleagues and I predict that it costs just $17.06 to prevent an incident of youth violence.

The violence prevention intervention is a computer-assisted program using motivational interviewing techniques delivered by a trained social worker. The intervention takes about 30 minutes to perform and was evaluated within an urban ED for youth who screened positive for past year violence and alcohol abuse. The outcomes assessed were violence consequences (i.e., trouble at school because of fighting, family/friends suggested you stop fighting, arguments with family/friends because of fighting, felt cannot control fighting, trouble getting along with family/friends because of your fighting), peer victimization (i.e., hit or punched by someone, had a knife/gun used against them), and severe peer aggression (i.e., hit or punched someone, used a knife/gun against someone).

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Sep 19 2013
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Documentary on Food Allergies Features RWJF Physician Faculty Scholar

Discovery Channel will air an encore of its medical documentary, “An Emerging Epidemic: Food Allergies in America,” on Saturday, September 21 at 8 a.m. ET. The program, which aims to raise awareness of food allergies as a serious and growing public health issue, features stories of families living with the potentially life-threatening condition.

The documentary features Robert Wood Johnson Foundation (RWJF) Physician Faculty Scholars alumna Ruchi S. Gupta, MD, MPH, who is an allergy researcher and mother of a child with egg, peanut, and tree nut allergies. Gupta wrote a post for the RWJF Human Capital Blog about the intersection of her professional and personal missions to keep children safe and raise awareness about food allergies.

The documentary is also available for viewing at www.discoverychannelpatienteducation.com and available for download on iTunes.

Learn more about the documentary.
Read Gupta’s post on the RWJF Human Capital Blog.

Sep 9 2013
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Community Linkages Increase Access to Diabetes Prevention Education

Robin Whittemore, PhD, APRN, FAAN, is an associate professor at Yale School of Nursing. Whittemore has received national and international recognition for her work in behavioral interventions for type 1 and type 2 diabetes. One focus of her work has been to examine ways to improve access to health programs for vulnerable high-risk populations. She is the primary investigator on a study funded by the RWJF Interdisciplinary Nursing Quality Research Initiative to prevent diabetes among at-risk adults in public housing. This post originally appeared on the U.S. Department of Health and Human Services’ National Partnership for Action blog.

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Minority adults are at a disproportionate risk for developing type 2 diabetes, a challenging illness to manage that is a leading cause of morbidity and mortality in the U.S. Evidence indicates that lifestyle change programs, which incorporate healthy eating, physical activity and modest weight loss, can prevent or delay the development of type 2 diabetes. Yet, access to diabetes prevention programs is limited, particularly among minority and low-income adults.

To help address the issues with access to diabetes prevention programs, we designed a study to link existing community resources—public housing communities and a homecare agency— to minority and low-income adults at-risk for type 2 diabetes. Public housing communities provide housing at reduced rental costs for families of low socioeconomic status. We chose this setting because these communities often have the space and personnel to support a community-based program. The homecare agency consists of nurses who monitor and implement healthcare in a home environment, and are trusted health professionals in public housing communities.

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Apr 5 2013
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Spending Money to Save Money in Health Care

Ashok Reddy, MD, is a Robert Wood Johnson Foundation (RWJF) Clinical Scholar in residence at the University of Pennsylvania and a senior fellow at the Leonard Davis Institute of Health Economics.  This is part of a series of essays, reprinted from the Leonard Davis Institute of Health Economics’ eMagazine, in which scholars who attended the recent AcademyHealth National Health Policy Conference reflect on the experience.

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With the debate about the fiscal cliff and the sequester hanging so heavily over Washington, it was no surprise that congressional staffers at the AcademyHealth National Health Policy Conference seemed so exclusively focused on cutting health care spending. Some estimated that 30 percent of the $2.5 trillion spent on health care may provide little value; finding interventions that provide high-value care is a top priority that tends to obscure any other possibilities.

In this prevailing atmosphere of stark fiscal reality and gridlocked politics it can be hard to gain traction for the idea that investing in programs that prevent chronic diseases would ultimately decrease the costly long-term expenditures driven by those diseases. But that’s where traction is needed.

Take diabetes for instance. One estimate has the medical treatments for people with diabetes costing 2.4 times more than expenditures that would be incurred by the same group in the absence of diabetes. By preventing the development of diabetes in an individual you decrease the risk of heart attack, kidney failure and amputated extremities.

It is true that, so far, research in cost-effectiveness analyses has not shown that prevention reduces medical costs. Besides childhood vaccination and flu shots for the elderly, few health care services ‘save money.’ A 2010 Health Affairs article calculated that if 90 percent of the U.S. population used proven preventive services, it would save only 0.2 percent of health care spending.

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Mar 8 2013
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Upcoming Webinar: Reducing Falls in Hospitals

The Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI) will present the next webinar in its “Translating Research into Practice” series on March 12.

INQRI grantees Marita Titler, PhD, RN, FAAN, and Paul Conlon, PharmD, JD, will present their research on reducing falls in hospitals by implementing a risk specific fall prevention bundle. Titler and Conlon’s 18-month study implemented fall prevention interventions targeted to patient risk factors, and evaluated the use and impact of these practices.

The webinar will take place from 4-5 p.m. EST.

Register for the webinar.
Learn more about the research.

Dec 27 2012
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Taking Urban Health Equity Seriously in 2013

Jason Corburn, PhD, MCP, is associate professor at the School Public Health & Department of City & Regional Planning, University of California, Berkeley.  He is a recipient of a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research and an RWJF Health & Society Scholar. This post is part of the "Health Care in 2013" series.

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The U.S. health care system must stop treating people only to send them back into the living, working and playing conditions that are making them sick in the first place. Glaring health inequities continue to persist in our metropolitan areas – differences in life expectancy, disease and disability by racial and ethnic groups and neighborhood location.  Our zip codes are often a greater predictor of our likelihood of disease, disability and early death than our genetic code.  We need to shift our health care system from a focus largely on cures to preventing illness and death by improving our living, working and playing environments.

2013 must be the year we all view community development and city planning as ‘preventative medicine.’

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Aug 22 2012
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Oral Health: Putting Teeth Into the Health Care System

Last week, the Robert Wood Johnson Foundation (RWJF) and The Alliance for Health Reform sponsored a briefing to discuss oral health care in the United States, particularly for children and other vulnerable populations.

The discussion was co-moderated by David Krol, MD, MPH, FAAP, RWJF Human Capital Portfolio team director and senior program officer. “Oral health is an integral part of overall health,” he said. It faces the same challenges as overall health care, including “racial, ethnic, geographic disparities in disease and access to care, financing challenges, issues of determining and maintaining quality of care, and workforce controversies.” Krol said he would like to see “all conversations on health and health care… naturally include oral health.”

In 2009, preventable dental conditions accounted for more than 830,000 emergency department visits nationwide, Julie Stitzel, MA, of the Pew Center on the States’ Children’s Dental Campaign told the audience. Children were the patients for 50,000 of those visits. “There’s a real opportunity for states to save money because these visits, again, are totally preventable,” she said. “We know that getting treated in an emergency room is much more costly than the care delivered in a dental office, and states are bearing a significant share of these expenses through Medicaid and other public programs.”

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May 31 2012
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Human Capital News Roundup: Prevention, kidney stones, healthy snacks for children, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

“Preventing diseases before they start is one of the most common sense ways to keep people healthy,” writes Risa Lavizzo-Mourey, MD, MBA, RWJF president and CEO, in a blog post for The Atlantic, “but this nation continues to focus too narrowly on treating medical conditions after they occur.” Lavizzo-Mourey’s essay is part of the “America the Fixable” series, hosted by Atlantic.com in partnership with Common Good. See the full series here.

A study led by RWJF/U.S. Department of Veteran’s Affairs (VA) Clinical Scholar Charles Scales, MD, finds that the number of Americans suffering from kidney stones has nearly doubled since 1994, due in large part to the increase in obesity and diabetes, WTVD (Raleigh-Durham, N.C.) reports. “While we expected the prevalence of kidney stones to increase, the size of the increase was surprising,” Scales said. HealthDay also reported on the findings.

Kavita Patel, MD, MSHS, an alumna of the Clinical Scholars program, was a guest on NPR for a story that asked “Does Race Affect Your Hospital Stay?” The story keyed off findings from Sick in America, a poll commissioned by RWJF, NPR and the Harvard School of Public Health to better understand Americans’ experiences and attitudes related to the cost and quality of their medical care. Nearly half of respondents said that a lack of cultural understanding plays a big role in the problems with U.S. health care quality, the story reports.

Dominick L. Frosch, PhD, an alumnus of the RWJF Health & Society Scholars program, continues to receive media coverage for a study he led that finds some patients are afraid or feel they are unable to speak up and participate in shared decision making with their physicians. American Medical News and Forbes are among the outlets to report on the findings.

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