General Health Services Research
Projects
UNC-CH Training Program in Health Services Research
Training program to provide academic training and direct experience in the application of the research skills from a number of disciplines to the study of the organization, financing, utilization, and delivery of personal health care services.
Program Director: Timothy S. Carey, M.D., M.P.H.
Source: Agency for Healthcare Research and Quality
Total Project Period: 09/89 - 06/13
UNC Post-Doctoral Training Program in Comparative Effectiveness Research – This program will build on over 20 years of collaboration between the Sheps Center and AHRQ in pre and post-doctoral training in health services research. CER is a growing interdisciplinary activity, drawing from the disciplines of clinical medicine, epidemiology, health policy and pharmacy. Our society has an urgent need to evaluate the best strategies of diagnostic testing and treatment so as to improve care for our citizens. The components of CER include: evaluation of current evidence through systematic reviews; observational studies and analyses such as pharmacoepidemiology and modeling research; conduct of large effectiveness trials; and dissemination and implementation activities. Fellows will be expected to participate in ongoing content and methods research. Didactic work will include degree granting programs through UNC-CH’s MPH or MS program for clinicians. PhD’s will enroll in selected courses. Specialized courses in CER methods are included in these curricula, as well as elsewhere on campus. Fellows will participate in a weekly integrative seminar, as well as a weekly seminar on CER methods.
Principal Investigator: Timothy Carey, MD, MPH
Funding: AHRQ
Total Project Period: 07/01/2010 – 06/30/2013
Primary Care Research Fellowship – The goal of this fellowship is to train primary care physicians for research-focused academic careers. This two to three year fellowship provides participants with the knowledge, skills, and experience to plan, fund, complete and disseminate quality research. The curriculum includes course work in the UNC School of Public Health, seminars in the campus’ K-30 sponsored research curriculum, weekly works-in-progress seminars, in-depth hands-on involvement and leadership in research projects, and mentoring by clinical and research faculty. Housed within the Sheps Center, the program also receives support from the primary care clinical departments of the UNC School of Medicine.
Principal Investigator: Donald E. Pathman, M.D., M.P.H.
Funding Source: National Research Service Award, through the Bureau of Health Professions, HRSA
Total Project Period: 07/98 – 06/12
National Information System on Health Services Research (HSRProj) – This project develops and maintains a health services research information system that collects available information on ongoing research projects funded by both public and private sector agencies for the National Library of Medicine. Through HSRProj, individuals can access information about on-going health services research projects before results are available in published form.
Principal Investigator: Christiane Voisin
Funding Source #2: National Library of Medicine, NIH (through Academy Health and The Foundation for Health Services Research)
An Observational Descriptive Study of Institutional Review Board (IRB) Practices – Given the widespread reliance on IRBs as oversight bodies for assuring ethical conduct of research, it is surprising that there has been little if any investigation of their decision-making process. This project will focus exclusively on decision making about new protocols that are presented to IRBs. By applying both quantitative and qualitative research techniques to tape-recorded IRB deliberations, and to semi-structured interviews with IRB reviewers, the process of decision making will be described and what types of projects are likely to get the most thorough reviews will be determined. The project aims are to: 1) describe the content of IRB decisions about individual research protocols; 2) characterize the interaction processes by which IRBs make decisions; and 3) describe the IRB decision-making processes in terms or organizational design making theory. What domains of decision making, as described by organizational decision making theory, receive the most attention in IRB processes will be determined, as well as determining what variables and protocol variables predict the domains that receive the most attention.
Principal Investigator: Laura C. Hanson, M.D., M.P.H.
Funding Source: National Institutes of Health (via University of Massachusetts)
Total Project Period: 09/06 – 04/12
Creation and demonstration of a collaborative, multi-site, palliative care research network to reinvigorate biomedical research in Palliative Medicine - We propose to cultivate new collaborations among established investigators, and to assemble a new multidisciplinary team, to facilitate the conduct of innovative, high-impact, clinically relevant research in one of the most challenging biomedical and behavioral areas – palliative care. While developing policies and procedures for inter-institutional, collaborative research, this project will also test the collaborative network and refine its methods through the design and conduct of a specific study addressing clinical uncertainty regarding withdrawal of lipid-lowering agents in the palliative care setting. This study, conducted in the context of a new national cooperative research network, will broaden our research base and enhance cross-fertilization. At the conclusion of the funding period, we expect to have both (1) completed the planned investigation, and (2) created a unique and innovative palliative care cooperative group that is sustainable, poised to conduct multiple future studies, and prepared to serve as a venue for recruiting new investigators and new expertise into the palliative care research community. An embedded clinical trial will serve as a focal point for development of the cooperative group. We propose a randomized comparative effectiveness study that is intended to provide important evidence regarding a standard, but unstudied, palliative care practice – withdrawal of medications for medical comorbidities as death nears. We focus on HMG Co-A reductase inhibitors (a.k.a., statins), prescribed for the primary or secondary prevention of hyperlipidemia, since they are common medications and their withdrawal is a source of major debate. Recommendations for their withdrawal have been proposed, but never tested. Specific aims include: 1. To determine if there is a difference in time-to-event in patients who are discontinued on statins vs. maintained on statins, as assessed via a composite endpoint encompassing death and major cardiovascular events (e.g., myocardial infarction, stroke). 2. To determine whether there are differences in patient- and family-perceived burden, and quality of life of patients and family/caregivers, when patients have statins withdrawn versus when patients continue on statins. 3. To assess the difference in cost between patients who have statins withdrawn versus those who continue on statins. UNC-CH will be a subcontractor for this work.
Principal Investigator: Laura Hanson, MD, MPH
Funding: Duke University Medical Center via NIH
Total Project Period: 09/01/2010 – 08/31/2013
Total Funding: Total: $572,768; Direct: $387,006; Indirect: $185,762
Recent Completed Projects
National AHEC Organization Committee on Research and Evaluation - The Cecil G. Sheps Center for Health Services Research of The University of North Carolina at Chapel Hill (Sheps Center) proposes to support the work of the National AHEC Organization (NAO) and the AHEC Training and Consultation Center (TrACC) as it develops standards for evaluation and assessment of AHEC programs. 1. Provide consultation and advice in the creation of needs assessment materials: attend meetings between the TrACC team and another subcontractor (e.g.. NTACC) to understand how the needs assessment plans and tool have been drafted. These meeb'ngs may be conducted by phone with documents shared electronically. 2. Provide guidance to the TrACC leadership in the creation of a detailed needs assessment tool. 3. Share data and summaries that relate to the assessment and evaluation of AHECs with the TrACC staff. 4. Develop and help implement technical assistance activities for AHECs. 5. Assist the TrACC in the compilation of a database of indicators of AHEC performance to support technical assistance and evaluation activities. 6. Provide guidance to the TrACC team in the design of primary, secondary, and tertiary outcomes that are updated, practical, and useful to AHEC funder staff and interested policymakers. 7. Align the above tasks with the Outcome Protocol designed by the National AHEC Organization Committee on Research and Evaluation (NAO CORE).
Principal Investigator: Thomas Ricketts, Ph.D.
Funding Source: National AHEC Organizations, Inc
Total Project Period: 4/1/10-4/30/11
America’s Health Rankings – This project supports the continuing work of the Scientific Advisory Committee to the America’s Health Rankings®, an assessment of the relative health of the 50 states in the U.S. The United Health Foundation publishes these rankings annually. The funds support the review of issues and trends by the Committee, the analysis of options in calculating the rankings, and the implementation of improvements to the rankings methodology.
Principal Investigator: Thomas C. Ricketts, III, M.P.H., Ph.D.
Funding Source: United Health Foundation
Project Period: 05/07 – 6/10
UNC TraCS Feasibility Study for Web-Assisted Evaluation of Evidence Based Practice Implementation - The focus of this study is (1) to test the utility and fit for North Carolina substance abuse treatment providers of reliable and valid measures for (a) provider readiness-to-change, (b) knowledge acquisition regarding evidence-based practice, (c) change in symptom severity for consumer participants enrolled in evidence-based practice treatment groups, and (d) provider adherence or fidelity to an evidence based model for integrated treatment of substance abuse and trauma associated disorders, and (2) to evaluate the feasibility of a web-interface tool for data collection associated with translation research in public substance abuse treatment settings. Through a collaborative approach, providers and consumers who have recently adopted Dr. Lisa Najavits’s evidence-based practice model for present-focused integrated treatment of substance abuse and trauma-related disorders titled Seeking Safety will be invited to have direct input regarding the utility of instruments chosen and on the potential for a web-interface data collection system to be beneficial for larger translation research studies in North Carolina. A research collaborative made up of experts from continuing education, research-to-practice knowledge dissemination, women’s substance abuse and trauma treatment, public health policy, and health systems technology will guide and inform this study. Findings will be communicated to the North Carolina Practice Improvement Collaborative and to research and policy staff integral to mental health, developmental disabilities, and substance abuse research-to-practice translation efforts in North Carolina. This pilot study will inform a future translation research agenda in women’s evidence-based substance abuse treatment services for the principal investigator.
Principal Investigator: Sherri L. Green, Ph.D., LCSW
Funding Source: North Carolina TraCS Institute
Total Project Period: 5/1/09-2/28/10
Robeson County Bridges for Families - Dr. Green will have the responsibility of collecting and interpreting data as the evaluator of the perinatal programs and other evidence based programs that have been approved by the NCPIC for statewide rollout, as well as prepare collaborative grant applications with the approval of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services. In addition, she will serve as the Principle Investigator of the Robeson County Bridges for Families which is funded by a contract between the Institute and the North Carolina Division of Social Services.
Principal Investigator: Sherri Green
Funding Source: Governor's Institute on Alcohol and Substance Abuse Inc.
Total Project Period: 08/01/08 – 9/30/10
