Summary:

This proposal’s four specific aims will evaluate the usefulness of PROMIS item banks in diverse cancer patient populations and in clinical settings to:

(1) Assess differences in the measurement properties of selected PROMIS item banks using IRT-based methods across age and racial-ethnic groups;

(2) Compare PROMIS measures versus legacy instruments to detect differences in patient-reported outcomes for selected domains across age, race-ethnicity, and cancer clinical sub-groups;

(3) Assess the association of selected PROMIS item banks with clinical events and disease/treatment states in cancer patients treated in diverse health care settings;

(4) Assess the responsiveness of selected PROMIS domains to changes in clinical status among groups versus individual cancer patients.

Primary Aim:

This is a comparative effectiveness study. This project adds a third arm to previously funded studies that examine a hypertension counseling intervention and a colon cancer navigation intervention in African American men aged >50.

Recruitment occurs at churches and barber shops. The additional third arm will receive both the hypertension and colon cancer screening interventions.

Specific Aim 1:

To examine in NOMEM cross-sectional analyses the respective contributions of Health Disparity Environmental Factors (HDEF) at the national, state, city, neighborhood, and individual levels to proximal behavioral and biological risk and protective factors for diabetes and depression in a midlife Hispanic population.

Specific Aim 2:

To examine how HDEF at the national, state, city, neighborhood, and individual levels modify the response to the community-based interventions in NOCHOP, NOMA-CERED, and COACH (NYU).

Objective:

Aim 1: Improve the recognition of early dementia in primary care by providing PCPs with training and the results of screening tests

Aim 2: Improve the discrimination of AD from vascular and other dementias

Aim 3: Increase the proportion of patients with dementia who receive appropriate treatment by implementing a system of care for early dementia

Objective:

Working with the top experts in elder mistreatment, including a leading geriatrician at Weill Cornell Medical College and an elder abuse research pioneer at NYU, this project addresses the problem of violence and aggression committed by nursing home residents that is directed toward other residents. A three module training program for staff will be developed that enhances identification and intervention with respect to episodes of resident-to-resident elder mistreatment (R-REM) in long term care facilities. The modules are titled

(a) Recognition and Risk Factors;

(b) Management of Resident-to-Resident Elder Mistreatment; and

(c) Implementation of Best Practices Related to Resident-to-Resident Elder Mistreatment. The training modules will be evaluated with respect to impact on resident falls, accidents and injuries and on quality of life.

Summary:

This research project aims to:

(1) refine methodology for identifying cases of resident-to-resident elder mistreatment (RREM) in long-term care facilities using triangulation methodology that derives information from resident, staff, and incident reports;

(2) conduct the first systematic prevalence study of RREM in a representative sample of 10 long-term care facilities; and

(3) describe the victims and perpetrators of RREM with respect to clinical, functional, and other characteristics and the environmental and situational contexts in which RREM episodes occur.

Summary:

While mistreatment of long term care residents by staff is unconscionable, this proposal asserts that the greatest threat of elder abuse to American nursing home residents comes not from staff, but from other cohabitants in the form of resident-to-resident elder mistreatment (R-REM). Despite pilot data suggesting R-REM is prevalent, it is both under-studied and under-reported. Accordingly, the specific aims of this project are to:

(1) enhance institutional recognition of R-REM by deriving R-REM information from five different sources, including two added for this project: forensic medical record review, and accident/incident reports. Additionally, a gold standard consensus conference classification is proposed for a random sample of residents;

(2) examine the convergence of R-REM reports across the five different methodologies;

(3) identify the most accurate mechanism for detecting and reporting R-REM;

(4) develop profiles to describe the types of people reported by each different source;

(5) investigate the existing policies and procedures for reporting R-REM in each facility;

(6) develop institutional guidelines for the reporting of R-REM episodes.

Summary:

The center is aimed at reducing and ultimately eliminating racial and ethnic disparities in health care among Latinos and African Americans. The foci of the three research projects are:

(a) Northern Manhattan Diabetes Community Health Worker Project (NOCHOP)
Walter Palmas, MD, MS, Columbia School of Medicine
This project examines the effectiveness of a multilevel community health worker intervention in improving diabetes care among 360 Latino adults with Type 2 diabetes.

(b) Informatics in Diabetes Education and Telemedicine – Cognition (IDEATel-COG)
Jose Luchsinger, MD, MPH Columbia University School of Medicine
This project aims to establish the predictors and mechanisms of memory impairment among minorities with diabetes.

(c) Counseling Older Adults to Control Hypertension (COACH)
Olugbenga Ogedegbe, MD, MY School of Medicine
This project aims to test the effect of a group-based behavioral counseling intervention (MINT-TLC) on reducing BP, improving diet, physical activity, and adherence to prescribed antihypertensive medications among 250 older hypertensive African American and Latino patients.

Objective:

This is a randomized, prospective, double blind study of 120 subjects (60 per treatment arm) with 1:1 randomization of patients to subcutaneous erythropoietin or placebo (saline injection) over a 6 month follow-up period. The project aims to evaluate the effect of erythropoietin on left ventricular structure, specifically end diastolic volume (EDV) in order to determine if treating anemia significantly decreases EDV.

Summary:

This project simultaneously evaluates in a randomized controlled trial, the effectiveness of two evidence-based interventions targeted at blood pressure reduction and colorectal cancer screening among Black men in NYC. The long-term goal is to develop a program that could serve as a new nontraditional model of disseminating proven interventions for cardiovascular risk reduction and colorectal cancer prevention in black men nationwide. In translating these proven interventions to community-based settings, community health promotion is linked to the healthcare system. Thus, this program could serve as a new nontraditional model of disseminating proven interventions for cardiovascular risk reduction and colon cancer prevention in black men nationwide - a group that is often underrepresented in traditional clinical practices. The potential for dissemination is high, as there is at least one church in virtually every neighborhood across the United States.

Summary:

The National Institute on Aging (NIA) funded a set of collaborative research projects nationally located at ten sites. These projects were designed to examine the nature and effectiveness of special care unit (SCU) care in institutional settings using state-of-the-art research methods. A common core data set was used across all sites to examine issues such as resident and environmental characteristics, prevalence of dementia, costs of care, and resident outcomes. According to the NIA, results from these studies have made a significant contribution to current knowledge about the organization and impact of these settings.