Category Archives: Research
Human Capital News Roundup: Medication errors affecting children with cancer, particulate matter, the needs of urban communities, 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, alumni and grantees. Some recent examples:
CBS Evening News profiled RWJF Community Health Leader Roseanna Means, MD, who founded the nonprofit Women of Means in 1988 to provide free medical care to homeless women in the Boston area. Today, 16 volunteer doctors and staff nurses provide care at the city’s shelters to women with unique sensitivities and needs. Read a post Means wrote about her nonprofit for the RWJF Human Capital Blog.
A study led by RWJF Clinical Scholars alumnus Matthew M. Davis, MD, MAPP, finds more than 40 percent of American parents give over-the-counter cough and cold medicines to children under age 4, despite product label warnings to the contrary. Health Day and the Examiner report on the findings.
Helena Hansen, MD, PhD, an alumna of the RWJF Health & Society Scholars program, is the lead author of an analysis that concludes social determinants—rather than changes in the environment or flawed diagnostic criteria—help explain the dramatic rise in the number of Americans diagnosed with mental disorders in recent years. Health Canal and MedPage Today report on the findings.
Forty-seven percent of children with cancer who receive part of their treatment at home have been exposed to at least one medication error, according to a study led by RWJF Physician Faculty Scholars alumna Kathleen E. Walsh, MD, MSc. Those errors had the potential to harm 36 per 100 patients, and actually did cause injury to four per 100, MedPage Today reports.
Strategies for Enhancing Diversity
Catherine J. Malone, MBA, DBA(c), is a program associate working in the areas of diversity and nursing for the Robert Wood Johnson Foundation. This is the first in a series of posts looking at diversity in the health care workforce.
As a member of the Robert Wood Johnson Foundation’s (RWJF) Human Capital team leading the group’s diversity efforts and the Foundation’s Diversity Team, I would like to share some of our work in this area. I must start by noting that “diversity” means different things to different people. At RWJF we recognize and value all types of diversity and therefore have a broad definition of the term which is described in the Foundation “Diversity Statement” below:
“Diversity and inclusion are core values of the Robert Wood Johnson Foundation, reflected in our Guiding Principles. We value differences among individuals across multiple dimensions including, but not limited to, race, ethnicity, age, gender, sexual orientation, physical ability, religion and socioeconomic status. We believe that the more we include diverse perspectives and experiences in our work, the better able we are to help all Americans live healthier lives and get the care they need. In service to our mission, we pledge to promote these values in the work we do and to reflect on our progress regularly.”
Dementia’s Growing Cost to Caregivers
Kathleen J. Mullen, PhD, is an alumna of the Robert Wood Johnson Foundation Scholars in Health Policy Research program, and an economist and associate director of the RAND Center for Disability Research at the nonprofit, nonpartisan RAND Corporation.
Dementia, a chronic disease characterized by significant impairment of cognitive functioning, afflicts 15 of every 100 Americans over age 70 – and it is their caregivers who are perhaps most familiar with the disease’s effects.
Family members are often the ones who find themselves navigating the complex system of nursing homes, in-home health care, and health insurance (Medicare, Medicaid, and private insurance), all while dealing with heartbreaking changes in the physical and mental functioning of their spouses, siblings, parents or grandparents. Indeed, my own family is struggling to sort through an overwhelming number of options and decisions to help ensure that my 86-year old grandmother receives the best available care now that she is unable to live without daily assistance.
For many families, a significant barrier to that best available care is cost: Caring for someone with dementia is extremely expensive. A recent RAND study, the results of which were published in the New England Journal of Medicine, offers some of the most comprehensive and credible estimates to date of the monetary costs of dementia in the United States. These costs include both out-of-pocket spending and spending by Medicare, Medicaid, and other third parties on nursing home and hospital stays, medical visits, outpatient surgery, home health care, special services (such as outpatient rehabilitation), prescription drugs, dental services, and other needs.
Human Capital News Roundup: Teen moms and obesity, female lawmakers, HIV prevention, 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, alumni and grantees. Some recent examples:
A study led by RWJF Clinical Scholar Tammy Chang, MD, MPH, finds that women who had their first child before age 20 are more likely to be obese later in life than those who were not teen moms, Health Day reports. “When clinicians care for teen mothers, we have so many immediate considerations— child care, housing, school, social and financial support—that we may fail to consider the long-term health effects of teen pregnancy,” Chang said. Caroline Richardson, MD, a Clinical Scholars alumna, and Matthew Davis, MD, MAPP, an alumnus and program site co-director at the University of Michigan, co-authored the study with Chang.
RWJF Scholars in Health Policy Research alumnus Craig Volden, PhD, was a guest on MSNBC’s The Cycle to discuss his study published in the American Journal of Political Science. Volden and his colleagues examined the sponsorship histories of 140,000 bills introduced in the U.S. House of Representatives over the last 40 years, and concluded that female lawmakers may be more effective at passing legislation than their male counterparts, particularly during times of party polarization, because they tend to work across party lines.
A study led by RWJF Executive Nurse Fellows alumna Margaret Grey, DrPH, RN, FAAN, finds that Internet-based psycho-educational intervention programs improve outcomes for young patients entering adolescence with type 1 diabetes, Monthly Prescribing Reference reports.
Medical News Today and the MinnPost report on an article written by Gary Taubes, MSE, MS, recipient of an RWJF Investigator Award in Health Policy Research, in The British Medical Journal about the non-profit he co-founded, the Nutrition Science Initiative. The Initiative will fund nutrition and obesity research, which Taubes says has been flawed and inconclusive in the past. Learn more about the Nutrition Science Initiative.
Human Capital News Roundup: Conflict resolution strategies, the federal cigarette tax, patient outcomes at Magnet hospitals, 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, alumni and grantees. Some recent examples:
RWJF/U.S. Department of Veterans Affairs Physician Faculty Scholars alumnus Amal Trivedi, MD, MPH, is co-author of a study that finds older patients are routinely prescribed potentially harmful drugs, particularly in the South. Although the specific reasons for the regional differences are unknown, the researchers hypothesize factors like education, socioeconomic status, and access to quality medical care might be to blame, the New York Times Well Blog reports. NPR and Nurse.com are among the other outlets to report on the findings.
Fierce Healthcare reports on a study led by RWJF/U.S. Department of Veterans Affairs Clinical Scholar Kelly Doran, MD, that finds frequent use of the emergency department at Veterans Health Administration facilities is often due to “severely compromised life circumstances,” rather than poor access to outpatient health care. The study raises questions about the degree to which increasing access to outpatient care, as the Affordable Care Act aims to do, will reduce emergency department use.
Manish K. Sethi, MD, a health policy associate at the RWJF Center for Health Policy at Meharry Medical College, spoke to the Leaf Chronicle about a program he started at Cameron College Prep Middle School in Nashville to teach teens conflict resolution strategies in an effort to reduce violence in the Nashville area. Read a Q&A with Sethi about the program.
RWJF Milestones, April 2013
The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni.
The Chicago Parenting Program, an innovative program that supports healthy parenting and reduces behavioral problems among children, was recently added to the National Registry of Evidence-Based Programs and Practices, run by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. RWJF Executive Nurse Fellow alumna Deborah Gross, DNSc, RN, FAAN, was a driving force behind the program, which is used by Head Start centers in Chicago and New York City, among others. RWJF Nurse Faculty Scholar Susan Breitenstein, PhD, RN, PMHCNS-BC, and Executive Nurse Fellow alumna Sharon Tucker, PhD, RN, joined with Gross and others to conduct a study on the program, published in Research in Nursing & Health. It was recently named the journal’s Best Research Article award for 2012.
David Kindig, MD, PhD, RWJF Health & Society Scholars program director at the University of Wisconsin, and Health & Society Scholars program National Advisory Committee (NAC) member George Isham, MD, MS, co-chaired the Institute of Medicine’s Roundtable on Population Health Improvement, which is exploring factors beyond medical care that affect people's health. Among other participants in the Roundtable: RWJF Senior Program Officer Pamela Russo, MD, MPH, and Health & Society Scholars NAC Member James Knickman, PhD.
RWJF Health Policy Fellows alumna Carmen R. Green, MD, was appointed the University of Michigan Health System’s inaugural Associate Vice President and Associate Dean for Health Equity and Inclusion. In the position, Green will find and address inequalities in care, education and research, and promote health care careers to those from groups that are underrepresented in the field.
Sylvia Garcia, JD, a member of the RWJF Community Health Leaders program NAC, was elected to the Texas State Senate (District 6) in a run-off election to fill the seat previously held by the late state Sen. Mario Gallegos.
Human Capital News Roundup: Lead exposure from soil, breast cancer mortality, climate change, 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:
Asthmapolis, founded and directed by RWJF Health & Society Scholars alumnus David Van Sickle, PhD, MA, has secured a $5 million investment that will be used to expand operations and further enhance its product, the Milwaukee Business Journal and Journal-Sentinel report. The company has engineered a GPS-enabled asthma inhaler called the Spiroscout, which sends a signal with the time and location to a remote server every time a patient uses it, allowing patients and providers to track and analyze the onset of asthma symptoms. Read more about Asthmapolis here and here.
Health & Society Scholar Sammy Zahran, PhD, is co-author of a study that finds that children in Detroit are being exposed to lead from an overlooked source: contaminated soil. Zahran and his team examined seasonal fluctuations in children’s blood lead levels and found that levels were highest in the summertime, when contaminated soil turns into airborne dust. The researchers were able to rule out exposure to lead-based paint as the main source of the contamination, NPR’s Shots Blog reports, because blood lead levels were lower in the winter, when children are more likely to be indoors.
A study from the Center for Climate Change Communication at George Mason University, which is directed by RWJF Investigator Awards in Health Policy Research recipient Edward W. Maibach, PhD, MPH, finds a majority of Republicans and Republican-leaning Independents think action should be taken to address climate change, United Press International reports. The New York Times Dot Earth Blog also reported on the findings.
Recent Research About Nursing, April 2013
This is part of the April 2013 issue of Sharing Nursing's Knowledge.
Survey of Nurses: Hospitals’ Patient Safety Programs Lacking
A new survey of hospital nurses in the United States, the United Kingdom, and China finds that nurses lack confidence in their hospitals’ safety programs.
The online survey, conducted by a research firm for the American Nurses Association (ANA) and GE Healthcare, included 500 respondents from the United States and 200 each from the United Kingdom and China. Each country's responses were given equal weight in the final results. Among the findings:
- Ninety-four percent of nurses report that their hospitals have programs in place that promote patient safety, but only 57 percent believe those programs are effective.
- Just 41 percent describe their hospital as “safe.”
- Ninety percent of nurses believe it is important that nurses not be penalized for reporting errors or near misses, but 59 percent agree that nurses often hold back in reporting patient errors in fear of punishment (67 percent in the United States, 62 percent in the United Kingdom, and 49 percent in China). Sixty-two percent agree that nurses often hold back in reporting near misses for the same reason (69 percent in the United States, 65 percent in the United Kingdom, and 54 percent in China).
- Thirty-three percent of nurses said that "poor communication among nurses at handoff" has increased the risk of patient safety incidents in their hospitals in the past 12 months. Thirty-one percent said "poor communication with doctors" has also increased the risk of patient safety incidents.
Human Capital News Roundup: Weight loss programs, cybersecurity policy, employees who smoke, 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:
A study led by RWJF/U.S. Department of Veterans Affairs Clinical Scholars alumnus Jeffrey Kullgren, MD, MPH, finds that weight loss programs motivate patients to lose more weight when they offer financial prizes in group competitions, rather than individual rewards. MedPage Today and Medscape [registration required] report on the findings.
Healthcare Finance News reports on a study co-authored by RWJF Investigator Award in Health Policy Research recipient Mark A. Hall, JD, that finds insurers subject to the medical loss ratio requirements in 2011 spent less than one percent of premium revenue on quality improvements (0.74%) or rebates (0.35%). The researchers write that “current market forces do not strongly reward insurers’ investments in this area.”
In a post on the New York Times’ Room for Debate blog about prenuptial agreements, Investigator Award recipient Celeste Watkins-Hayes, PhD, writes: “There is no doubt that women need to be savvy about protecting their assets and ensuring that their contributions and hard work are valued, even in marriage. But prenups can only protect a certain demographic. What is needed is a comprehensive strengthening of all women’s safety nets through access to jobs that build wealth, increased financial literacy and a better infrastructure for raising children with or without a significant other.”
Facing What May Be the Affordable Care Act’s Ultimate Challenge: The Gap Separating Evidence from the Policy-Makers Who Need It
David Grande, MD, MPA, is an assistant professor of medicine at the University of Pennsylvania's Perelman School of Medicine, a senior fellow at the Leonard Davis Institute of Health Economics, associate director of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program and an alumnus of the RWJF Health & Society Scholars program. 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.
It’s a time of unprecedented upheaval in U.S. health care. Big changes are bursting through on virtually every front. Legislators and administrators in Washington and 50 state capitals struggle daily to reinvent their health care systems even as they lack an exact blueprint for the new things they’re supposed to be building.
This was nowhere more evident than at the recent AcademyHealth National Health Policy Conference, where state and federal officials and interest groups lined up to present long lists of policy questions that confront them as they grapple with implementation of the Affordable Care Act and mounting public budgetary pressures.
Managing 'Churn'
For instance, in the “Opportunities & Challenges for State Officials” session, New Mexico’s Medicaid Director Julie Weinberg described the unknowns surrounding how “churn” between private and public coverage will change and how new Medicaid eligibility standards will impact enrollment processes.