UCSF Center for Vulnerable Populations
 at San Francisco General Hospital and
            Trauma Center




         2009 ...
UCSF Center for Vulnerable Populations
     at San Francisco General Hospital and
                Trauma Center



       ...
I. CVP ANNUAL REPORT EXECUTIVE SUMMARY

The UCSF Center for Vulnerable Populations (CVP), directed by Dean Schillinger, MD...
California Program on Access to Care, the California Endowment and others that
contribute to a research portfolio of over ...
Annual Report Section    Summary

Faculty                  20 Faculty and Staff Members
                           -1 Cons...
II. BACKGROUND AND INTRODUCTION
Established in October 2006, the UCSF Center for Vulnerable Populations (CVP
http://cvp.uc...
During 2009, with support from an individual donor we met with architects (Tsao
Designs) and engineers to develop space de...
IV. CVP PROJECTS
In 2009, CVP researchers were involved in 10 innovative research projects ranging from
developing communi...
This project examines the role of early declines in kidney function and the development
of cardiovascular risk using a lon...
This project will examine the development of cardiovascular risk in black and white young
adults.

2. Clinical and Transla...
Goal: The aim of this study is to investigate the extent of medication regimen
concordance between ethnically diverse pati...
Women, Infants, and Children (WIC) beneficiaries. Outcomes will include fruit/vegetable
intake, blood pressure, and antiox...
existing Post-MI self-management educational materials and consulting cardiologists. We
will conduct focus groups with pat...
VI. DISSEMINATION
A central part of the CVP mission is to disseminate research and innovations to clinicians
and patients ...
educational intervention to a teach-to-goal educational intervention for self-management
of heart failure: Design of a ran...
cohort: The Health, Aging, and Body Composition study. Arch Intern Med. 2009;169
(7):708-15.

Kim Y, Situ M, Handley M, Mc...
Sarkar U, Ali S, Whooley MA. Self-efficacy as a marker of cardiac function and predictor
of heart failure hospitalization ...
Sudore R, Schillinger D. Interventions to Improve Care for Patients with Limited Health
Literacy. J Clin Outcomes Manag. 2...
fotonovela highlighting lead poisoning prevention for vulnerable populations in
   Monterey and Santa Cruz counties
   htt...
Regional
   1. From Immigrant Stories to Collaborative Action: A Case Study in Community
      Wellness, Culture and Trans...
Urmimala Sarkar

National

   1. Monitoring Patient Safety for Vulnerable Diabetes Patients using Automated
      Telephon...
Regional

   1. UCSF Center for Social Disparities in Health Seminar Literacy, Health
      Communication, and Chronic Ill...
10. Guest interview appearance, Hunger in America on KTVU Channel 2.

C. COMMUNITY FORUMS/Town Hall Meetings

a. KTVU: Hun...
communication strategies between primary care centers and vulnerable populations in
   the community who don’t receive the...
VII. AWARDS AND RECOGNITION
Below is a list of awards and recognition presented to CVP faculty and staff in 2009.

1. CVP ...
enable a more accurate description of disease trends over diverse populations and
   evaluation of interventions that targ...
b. The IDEALL project was sited as a national model in Mitch Katz, MD director’s
      report for the San Francisco Depart...
limited health literacy. Almost a million copies of the diabetes guide have been distributed
throughout the country to HMO...
APPENDIX A
CVP SPACE PLANS—2789 25th Street




               28
29
APPENDIX B

2009 FACULTY AND STAFF ADDITIONS




               30
Laura Plantinga, ScM, is Assistant Adjunct Professor in the Department of Medicine,
Division of General Internal Medicine....
Internal Medicine and CVP team, she worked with Dr. Chesla and Dr. Chun for 4 years on
a qualitative study on Chinese Amer...
APPENDIX C

CURRENT CVP RESEARCH MENTORING AND TEACHING
                 ACTIVITIES




                    33
Kirsten Bibbins-Domingo
Dr. Bibbins-Domingo is the Associate Director of the Clinical and Translational Sciences
Institute...
RECENT JUNIOR FACULTY   MENTORED
Dates Name              School – Program   Role                     Current Position
2007...
Dean Schillinger
Over the past few years, Dr. Schillinger has taken on increasing responsibilities for
mentoring research ...
APPENDIX D
NEWSLETTERS AND ARTICLES




           37
UCSF Newsletter
December 17, 2009


UCSF/SFGH Project for Diabetes Patients Wins Award for Innovation, Quality

A UCSF pro...
for public hospitals, but for all of our health care systems to provide improved care at
lower costs.”

Based on the posit...
UCSF Today
October 8, 2009

Schillinger Awarded for Outstanding Research Contributing to Effective
Communication

Dean Sch...
practitioners and health systems to improve health communication for patients with
communication barriers (e.g. language a...
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
" Click here
Upcoming SlideShare
Loading in...5
×

" Click here

1,928

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
1,928
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "" Click here"

  1. 1. UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center 2009 Annual Report
  2. 2. UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center 2009 Annual Report Table of Contents I. Executive Summary…………………………………………………………………………….. 2 II. Background and Introduction……………………………………………………………….. 5 III. Center Plans and Development……………………………………………………………. 5 IV. CVP Research Projects…………………………………………………………………………. 7 V. Dissemination…………………………………………………………………………............. 14 VI. CVP Awards and Recognition……………………………………………………………… 25 VII. Policy Impacts…………………………………………………………………………………….. 25 VIII. Appendices…………………………………………………………………………………………. 28
  3. 3. I. CVP ANNUAL REPORT EXECUTIVE SUMMARY The UCSF Center for Vulnerable Populations (CVP), directed by Dean Schillinger, MD (Director) and Kirsten Bibbins-Domingo MD, PHD, MAS (co-Director) was founded in 2006 and is the only UCSF research center dedicated to chronic disease. Its mission is to carry out innovative research to prevent and treat chronic disease in populations for whom social conditions often conspire to both promote chronic disease and make its management more challenging. CVP is based within the UCSF Department of Medicine located on the campus of San Francisco General Hospital and Trauma Center, the public health hospital of the City and County of San Francisco. CVP has distinguished itself as a practice-based research center whose work has helped translate research into community and public health practice, as well as infuse local practice back into research. CVP faculty has coordinated 7 randomized trials in community settings. Beyond the local communities it serves, CVP is nationally and internationally known for its research in health communication and health policy to reduce health disparities, with special expertise in the social determinants of health, including literacy, food policy, poverty and minority status, and with a focus on the clinical conditions of pre-diabetes, diabetes, and cardiovascular disease, including hypertension, chronic kidney disease and heart failure. In 2009, the CVP successfully recruited new faculty and staff and launched a new website http://cvp.ucsf.edu. In addition, thanks to the vision of the San Francisco General Hospital Foundation and a gift from an individual donor, we developed space plans for a 2600 square foot space to permanently house the CVP and its two future programs-- Health Communications and Health Policy and Chronic Disease Prevention. The CVP has now grown to include 8 multidisciplinary faculty investigators, 3 biostatisticians, 1 mathematician a Center manager, project coordinator and 6 research and administrative staff. During 2009, the CVP received several prestigious awards including the 14th Annual George Engel Award for Outstanding Research Contributing to the Theory, Practice and Teaching of Effective Health Care Communication and Related Skills awarded to Dr. Dean Schillinger. CVP faculty and staff were also recognized as Quality Leaders from the California Association of Public Hospitals/Safety Net Institute (CAPH/SNI) for the “Automated Telephone Self-Management Support Model for Diabetes Project”. In 2009 alone, CVP faculty 1st-authored 15 peer-reviewed papers and co-authored 36 more, in several prestigious journals that include the New England Journal of Medicine, Annals of Internal Medicine, and American Journal of Public Health and broadened dissemination efforts to reach diverse audiences including the Spanish-language radio station Radio Bilingüe; an NBC-affiliated show, Comunidad del Valle; a CBS local station, KTVU, and through the ethnic media consortium, New America Media. The CVP also created and distributed fact sheets that highlighted key research findings to diverse groups. This year the CVP further expanded its research portfolio with grants from the Center for Disease Control and Prevention, the National Institutes of Health (National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases), the American Heart Association, the Robert Wood Johnson Foundation, the 2
  4. 4. California Program on Access to Care, the California Endowment and others that contribute to a research portfolio of over $10 million. The CVP embarked on several pioneering research projects including partnering with the San Francisco Health Plan in a scaled-up automated telephone diabetes management program; adapting a heart disease policy model to explore impacts on minorities and the poor; assessing chronic disease risk in young adults; exploring the relationship between food insecurity and chronic disease; and strengthening binational disease prevention efforts between US and Mexico. The CVP also continues to play an active role in translating research into public policy. Dr. Schillinger continues his role as Chief of the California Diabetes Prevention and Control Program; Dr. Bibbins-Domingo has worked with the Center for Disease Control and other state and local agencies to advise on policies related to salt intake in the US diet; she is also a member of an Institute of Medicine Committee making recommendations on vaccine safety; Dr Urmimala Sarkar serves in an advisory capacity for the National Patient Safety Foundation; and Dr. Seligman advances policies around food insecurity by participating in the Food Security Task Force and the Southeast Food Access Program of the City and County of San Francisco. The CVP spent much of last year strengthening and forming new partnerships both within and beyond UCSF. The CVP continues to play leadership roles in UCSF’s Clinical and Translational Sciences Institute (CTSI), advancing community engagement and dissemination sciences, helping direct the training program for the CTSI mentored scientist awards, and participating in the San Francisco Health Improvement Project to improve collaborations between UCSF, local health departments and the broader community. The CVP also collaborated with UCSF Global Health Sciences to pilot a medical residency exchange program in Tanzania, Africa. Lastly, CVP is collaborating on a planning process to improve collaborations between UCSF faculty based at SFGH and the San Francisco Unified School District. The CVP is building momentum to generate even broader impact in 2010. The Center will focus programmatic efforts on space renovation and fundraising, and will refine and further realize our vision for two new CVP programs in Health Communications and Health Policy and Chronic Disease Prevention. The CVP will also increase its visibility and impact by 1) launching a UCSF Health Communications Research Seminar series; 2) coordinating a larger initiative to bring together research expertise on the SFGH campus to improve the health of vulnerable populations; and 3) holding symposia that showcase work related to vulnerable populations both at SFGH and in the larger UCSF community. The CVP is expanding its role as a premier translational research home for a range of trans-disciplinary scientists dedicated to reducing the burden of chronic disease in vulnerable populations. 3
  5. 5. Annual Report Section Summary Faculty 20 Faculty and Staff Members -1 Constance B. Wofsy Professor -1 Professor -1 Associate Professor -5 Assistant Professors -3 Biostatisticians -1 Mathematician -1 Center Manager -1 Project coordinator -1 Administrative Assistant -5 Staff Research Associates Research projects CVP faculty members are principal investigators or co-investigators on 24 projects. The projects with CVP faculty as PIs represent $10,103,799 in total costs Publications 51 peer-reviewed articles in 31 academic journals 17 additional research abstracts 7 non-peer reviewed publications Presentations/Symposia 52 Presentations and Invited Lectures -19 national -28 regional -5 international Awards and recognition 5 Awards or nominations -1 national award -1 program award -1 abstract finalist -1 abstract award -1 national research award finalist Research mentoring and 27 Mentees training -14 Faculty members -Primary mentorship on two K Awards -Secondary mentorship on VACD Award -Secondary mentorship on K Award -Secondary mentorship on ACR junior faculty award -11 Postdoctoral fellows and residents - 2 Predoctoral students 4
  6. 6. II. BACKGROUND AND INTRODUCTION Established in October 2006, the UCSF Center for Vulnerable Populations (CVP http://cvp.ucsf.edu) is the only research center at UCSF dedicated to chronic disease. With its academic home in the UCSF Department of Medicine, its mission is to carry out innovative research to prevent and treat chronic disease in populations for whom social conditions often conspire to promote chronic disease and make its management more challenging. CVP has distinguished itself as a practice-based research center whose work has helped translate research into community and public health practice, as well as infuse local practice back into research. Beyond the local communities it serves, CVP is nationally and internationally known for its research in health communication and health policy to reduce health disparities, with special expertise in the social determinants of health, including literacy and language, food policy, poverty and minority status, and a focus on the clinical conditions of pre-diabetes, diabetes, hypertension and heart failure. The following report focuses on CVP activities and accomplishments for 2009 only. We will present an overview of the Center’s infrastructure development; current research projects and grants; dissemination efforts; and policy impacts. III. CENTER PLANS AND DEVELOPMENT A. NEW DESIGNATED SPACE The CVP recently secured a 2,600 square foot shell space on 25 th Street and Potrero Avenue (two blocks south of the hospital) to renovate and house the CVP. This new space will allow the CVP to support and centralize its current operations and house two new programs--Health Communications and Health Policy and Chronic Disease Prevention--that further the CVP mission of translating innovative research into effective clinical and public health practice. The CVP Health Communications Program is dedicated to improving health communications science for the most vulnerable populations. This program incorporates health information technology, media production, telemedicine, disciplinary collaborations and policy/advocacy to improve health outcomes for vulnerable groups. Research projects include San Francisco Health Plan “Smart Steps” Project on Improving Diabetes Self-Management for High Risk Patients with Diabetes; Interactive Health IT to Promote Ambulatory Safety among Vulnerable Diabetes Patients; and Development of an Instrument to Measure Health Literacy. Health Policy and Chronic Disease Prevention Program will focus on health policy prevention efforts to reduce chronic disease in the most vulnerable groups. Research projects in this program focus on three main areas: 1) examining the biological, behavioral, environmental, and health systems factors that place vulnerable groups at high risk for chronic illness, 2) evaluating policy interventions for their impact on the development of chronic illness in these groups, and 3) designing new policy interventions aimed at chronic disease prevention. The space will also be a planning and management hub for a larger initiative at San Francisco General Hospital and Trauma Center that brings together different disciplines on campus with innovative and synergistic approaches to improving health for vulnerable populations. This includes laboratory researchers engaged in discovery related to mechanisms of diseases in vulnerable patients treated at SFGH and clinical researchers engaged in behavioral interventions for diverse patients. 5
  7. 7. During 2009, with support from an individual donor we met with architects (Tsao Designs) and engineers to develop space design plans. The new space will house 7 offices and 8 work stations, and have a multi-media conference room. Please see Appendix A for space plans. B. NEW WEBSITE The CVP collaborated with the Elfenworks Foundation to create a new website http://cvp.ucsf.edu highlighting CVP projects, new publications, faculty and staff profiles, and important links and resources. The Elfenworks Foundation provided critical expertise in website design development and overall implementation for this project. C. FACULTY AND STAFF ADDITIONS The CVP has prioritized creating and expanding a cadre of top-notch clinical scientists from Medicine and related disciplines dedicated to generating new knowledge to improve the health for vulnerable populations. In 2009, Dr. Neil Powe, MD, MPH, MBA, joined UCSF as the Constance B. Wofsy Distinguished Professor, Vice-Chair of Medicine at the University of California San Francisco and Chief of Medical Services at San Francisco General Hospital and Trauma Center. Formerly, Dr. Powe was the director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins University. We are excited and humbled to have Dr. Powe’s guidance, stewardship and membership with the CVP. Laura Plantinga, ScM, also joined the CVP as Assistant Adjunct Professor of Medicine. Ms. Plantinga brings expertise in processes and quality of care, patient outcomes and quality of life, and epidemiology of chronic disease, particularly related to chronic kidney disease. Additionally, the CVP filled two staff research associates to support new research projects. New staff and faculty bios are included in Appendix B along with a complete list of CVP faculty and staff. C. MENTORING AND TRAINING The CVP recognizes the importance of training new leaders to help meet its larger goals. Drs. Bibbins-Domingo and Schillinger have devoted much of their time to mentoring junior faculty, fellows, residents and other emerging leaders in research, practice and policy related to vulnerable populations, and they play key roles in UCSF’s clinical research training programs. Their teaching portfolio has included areas like designing clinical research, dissemination and implementation sciences, epidemiology, and health communication. Dr. Handley is director of the Training Program in Implementation and Dissemination Sciences, which focus on the art and science of translating evidence into practice, policy and public health. Please see Appendix C for a list of teaching and mentoring responsibilities during 2009. 6
  8. 8. IV. CVP PROJECTS In 2009, CVP researchers were involved in 10 innovative research projects ranging from developing communication tools to improving diabetes management, advancing health literacy, creating a policy model to monitor and reduce disparities in heart disease, developing community education to prevent lead poisoning, and piloting innovative surveillance strategies for ambulatory diabetes patients. Faculty was also involved in a number of other UCSF and multi-site projects as co-investigators (information available upon request). CVP-directed projects and their associated Principal Investigators (PIs) are designated in bold. 1. Promoting Lead Education to High Risk Community Members through a Community- Based Participatory Education and Dissemination Model PIs: Margaret Handley, PhD, MPH Maricel Santos (SF State, and Paul Heavenridge, Literacyworks) Funder: Public Health Trust; 10/1/08-6/30/10 The goals of this project are to develop a regional dissemination model to integrate existing county-level community education programs (ESL, Cooperative Extension and Library-Based Adult Literacy programs) with health communication expertise, to promote community-developed lead educational materials. These materials will then be disseminated to diverse communities in a high risk county for lead poisoning using epidemiological strategies to identify community ‘hot spots’. The investigators will develop a state-wide plan to scale up this model across state chapters of the local community education programs and other environmental justice coalitions. 2. Interactive Health IT to Promote Ambulatory Safety among Vulnerable Diabetes Patients PI: Urmimala Sarkar, MD, MPH Funder: Agency for Health Research Quality (K-08) 9/30/2008-9/29/13 This career development award aims to support Dr Sarkar in her progress to become an independent investigator in the areas of ambulatory patient safety in chronic diseases among vulnerable populations. Her projects will leverage self-management support technology for diabetes to assess patient safety between visits for ambulatory patients, and to compare this to other surveillance strategies. 3. Adapting the Coronary Heart Disease Policy Model to Address Disparities in Heart Disease PI: Kirsten Bibbins-Domingo, PhD, MD Funder: UCSF CTSI Resource Allocation Program 9/1/08-6/30/09 This pilot project will seeks to develop race/ethnic and income stratified versions of the Coronary Heart Disease Policy Model, a computer simulation of heart disease among adults in the US and to use this Model to examine the impact of public health interventions on cardiovascular health in US minority populations. 4. Chronic Kidney Disease and Cardiovascular Risk in Young Adults PI: Kirsten Bibbins-Domingo, PhD, MD Funder: National Institute of Diabetic and Digestive and Kidney Disease (R-01) 8/1/08-7/31/11 7
  9. 9. This project examines the role of early declines in kidney function and the development of cardiovascular risk using a longitudinal study of cardiovascular disease development in young adults and cystatin C as a marker of kidney function. 5. Evaluating the Missouri Health Literacy and Diabetes Communication Initiative PI: Dean Schillinger, MD CVP Co-Investigator: Hilary Seligman, MD, MAS Funder: American College of Physicians Foundation 11/1/07-10/30/10 This project will implement and evaluate the effects of a patient centered diabetes guide among diabetes patients in Missouri community health centers. 6. San Francisco Health Plan “Smart Steps” Project on Improving Diabetes Self- Management for High Risk Patients with Diabetes PI: Dean Schillinger, MD CVP Co-Investigators: Margaret Handley, PhD, MPH, Neda Ratanawongsa, MD, MPH Funder: Agency for Healthcare Research and Quality (AHRQ) 9/01/07 – 8/31/11 This is an evaluation of a large Automated Telephone Self Management/health IT initiative at the San Francisco Health Plan (SFHP) among 500 English, Chinese, and Spanish speaking patients with diabetes. The evaluation will focus on the effects of health IT on both patient-centered and clinical outcomes through a “real-world” effectiveness study, as well as explore impacts on patient safety. This project builds on a prior CVP study, the IDEALL Project, which demonstrated the value of automated telephone self-management support for high risk populations. 7. Biomarkers for the diagnosis of heart failure in young African Americans. PI: Kirsten Bibbins-Domingo, PhD, MD Funder: Hellman Family Award 1/1/07 – 12/31/08 NCE Goal: To explore the role of novel prognostic markers to aid in the diagnosis of heart failure among young African Americans. 8. Health Literacy and Self-Management in Heart Failure Site PI: Dean Schillinger, MD CVP Co-Investigator: Kirsten Bibbins-Domingo, PhD, MD Funder: NIH/National Heart Lung and Blood Institute (NHLBI) 9/1/06 – 5/31/11 To conduct a multi-site randomized controlled trial of a diuretic self-management intervention among a sample of 660 English and Spanish speaking patients with heart failure and limited health literacy. Grants with CVP faculty as Co-investigators 1. Coronary Artery Risk Development In young Adults (CARDIA) PI: Steve Sidney; CVP Co-Investigator: Kirsten Bibbins-Domingo, PhD, MD Funder: National Heart Lung and Blood Institute Kaiser Oakland Field Center 10/1/08-9/30/13 8
  10. 10. This project will examine the development of cardiovascular risk in black and white young adults. 2. Clinical and Translational Science Institute PI: Mike McCune; CVP Co-Investigators: Kirsten Bibbins-Domingo, PhD, MD and Dean Schillinger MD Funder: Clinical and Translational Science Institute 9/30/06 – 6/30/11 To create an integrated academic home that transforms training in and conduct of clinical and translational research at UCSF and the greater Bay Area community. Components of the CTSI include formal didactic programs, career development, consultative and technical cores, and community outreach. V. NEW GRANTS In 2009, CVP researchers successfully competed for 14 additional grants either as principal investigators or co-investigators. These grants cover a range of areas including modifying a heart disease policy model, assessing chronic disease risk in young adults, exploring the relationship between food insecurity and chronic disease, and strengthening binational disease prevention efforts. These projects involve collaborations with a range of investigators across UCSF Divisions, Departments and Schools, and also involve multiple disciplines from other universities and community groups. Below is the list of grants that were awarded to CVP faculty in 2009. 1. Cardiovascular Risk Reduction in Diabetes Care Among Vulnerable Populations PI: Dean Schillinger, MD Co-Investigator: Neda Ratanawongsa, MD, MPH Funder: San Francisco General Hospital Foundation (McKesson Foundation Award) 1/1/10 – 12/31/10 This grant will help identify factors affecting patient preferences for cardiovascular risk reduction therapies, evaluate patient and provider decisions about medication adherence, and identify outcomes of a telephone diabetes self-care management program vs. counseling. 2. Strengthening Indigenous Food Identity and Minimizing Chronic Disease Risk among Transnational Oaxacan Communities PI: Margaret Handley, PhD, MPH Funder: UC MEXUS 9/1/09-8/30/10 The goals of this project are to conduct a mixed methods assessment to identify potential protective components to the Oaxacan traditional diet that can be integrated into binational disease prevention efforts. 3. Medication Communication among Vulnerable Cardiology Patients PI: Urmimala Sarkar, MD, MPH Funder: National Institute on Aging/Center for Aging in Diverse Communities 9/01/09-09/01/11 9
  11. 11. Goal: The aim of this study is to investigate the extent of medication regimen concordance between ethnically diverse patients and their providers where there are frequent medication changes; we will use previously collected data from the Video Medical Interpretation Cardiology Clinic Study, which investigated different modes of language interpretation in ambulatory cardiology encounters in an urban, safety-net setting. 4. Supplement to Chronic Kidney Disease and Cardiovascular Risk in Black and White Young Adults. PI: Kirsten Bibbins-Domingo, PhD, MD Funder: NIDDK 8/1/09-7/31/11 Goal: To provide career development support to Dr. Vanessa Grubbs, a junior nephrologist, to conduct research with Dr.Bibbins-Domingo examining genetic factors influencing decline in early kidney function in black and white young adults in the CARDIA study. 5. Adaptation of the Coronary Heart Disease Policy Model to US Subpopulations PI: Kirsten Bibbins-Domingo, PhD, MD Funder: American Heart Association 07/01/09-06/30/11 Goal: To adapt an established, validated computer simulation of heart disease in US adults (the CHD Policy Model) to describe differences by race/ethnicity in California and the US in order to examine disease trends in obesity and the impact of public health interventions on US Subpopulations. 6. Role of Food Insecurity as a Mediator of Socioeconomic Disparities in Health PI: Hilary Seligman, MD, MAS Funder: NIH/CTSI 7/1/09-6/30/13 This career development award supports Dr. Seligman's research in the area of food insecurity, or the inability to reliably afford access to nutritious food. Using a combination of primary data collection and secondary data analysis, this project will establish the extent to which food insecurity is related to the incidence of obesity, pre-diabetes, and diabetes among young adults, and establish the extent to which food insecurity predisposes adults with diabetes to poor diabetes control. 7. A Pilot Intervention to Increase Fruit and Vegetable Intake among WIC Beneficiaries PI: Kirsten Bibbins-Domingo, PhD, MD CVP Co-Investigators: Hilary Seligman, MD, Dean Schillinger, MD Funder: Robert Wood Johnson Foundation Health and Society Scholars Program 5/14/09-5/13/10 Goal: Diets high in fruit and vegetable intake are associated with lower cardiovascular disease (CVD) and cancer risk. Fruit and vegetable-poor diets may contribute to known race/ethnic and income health disparities through a variety of mechanisms including, increasing blood pressure and increasing body weight. This pilot study will inform the development of a larger intervention providing vouchers of varying dollar amounts redeemable for fresh fruits and vegetables to Supplemental Nutrition Program for 10
  12. 12. Women, Infants, and Children (WIC) beneficiaries. Outcomes will include fruit/vegetable intake, blood pressure, and antioxidant levels. 8. Health Literacy Team Toolkit Project PI: Hilary Seligman, MD, MAS CVP Co-Investigator: Neda Ratanawongsa, MD, MPH Funder: American College of Physicians 5/14/09 – 5/13/10 The goal is to promote patient self-management for those experiencing post myocardial infarction. 9. California Diabetes Prevention and Control Program* PI: Dean Schillinger, MD Funder: CDC 4/01/09-3/28/14 * this award was processed through the UCSF Institute for Health and Aging The goal is to work to prevent, detect, and intervene among persons at risk for diabetes mellitus and its complications to reduce the adverse personal and public impact of diabetes on California's diverse communities. 10.Diabetic retinopathy (DR) screening in California and Health Information Technology Applications- Status Review and Recommendations for Overcoming Barriers to Improving Access for Vulnerable Populations PI: Margaret Handley, PhD, MPH Funder: California Program on Access to Care (CPAC) 3/1/09-12/30/09 Goal: Primary care-based retinal screening and eye imaging have been shown to be an effective screening method for the detection of DR. However, despite the growing evidence for digital screening and the potential to improve access, there has been limited implementation in safety net settings that disproportionately serve at risk populations. The goals of the policy paper are to describe the scope of the problem regarding an un- met need for DR screening in California among vulnerable populations receiving care in safety net settings, such as the uninsured and Medi-Cal patients and to develop recommendations to reduce the barriers to implementing primary care based DR screening in California safety net settings. Grants with CVP faculty as Co-investigators 1. Development of a Patient-Centered, Literacy-Appropriate Self-Management Guide for Patients with Coronary Heart Disease PI: Terry Davis (University of Louisiana Health Sciences Center, Shreveport) CVP Co-Investigator: Hilary Seligman, MD, MAS Funder: American College of Physicians Foundation 5/14/09-5/13/10 This project aims to produce materials for post-MI patients in a format that is easy for them to understand and follow. Our team has used many of the strategies that we will be using to accomplish this task in similar projects addressing other common diagnoses, such as diabetes and COPD. We will focus on identifying key messages by reviewing 11
  13. 13. existing Post-MI self-management educational materials and consulting cardiologists. We will conduct focus groups with patients and physicians to identify key messages. We aim to understand the emotions related to coronary artery disease as well as the barriers to effective CAD management and patient-centered strategies for overcoming such barriers. Another component of making this project successful is understanding the opinions and priorities of physicians and practice work-flow issues. The information gathered will be used to develop a prototype guide. UCSF will take primary responsibility for co- development of the Spanish language guide. Participants will review the self- management guide and will be asked questions about its content. 2. Development of Multilingual Prescription Drug Instructions for Pharmacy Practice California Endowment Site PI: Dean Schillinger, MD CVP Co-Investigator: Urmimala Sarkar, MD, MPH 7/1/2009 – 6/30/2011 This study seeks to examine barriers pharmacies in California face in printing multilingual prescription labels and to explore the challenges associated with implementing recommendations issued in SB 472. 3. Adherence and the Economics of Colon Cancer Screening PI: John Inadomi, MD CVP Co-Investigator: Neda Ratanawongsa, MD, MPH Funder: National Cancer Institute 9/30/09 – 9/29/11 Goals: 1. Determine whether there exists heterogeneity in adherence between different CRC screening tests, 2. Utilize prospective rates of adherence to calculate the true incremental cost-effectiveness between competing CRC screening strategies, 3. Identify factors associated with non-adherence to screening. 4. Specialty Access Initiative PI: Hal Yee, MD CVP Co-Investigator: Hilary Seligman, MD, MAS Funder: Kaiser Permanente Benefit Programs, Northern California Region 1/1/09-12/1/10 The goal of this project is to improve access and quality of specialty care in San Francisco through the collaborative development of formalized primary/specialty care co-management strategies that will be informed by and implemented through our novel eReferral system. The current model of specialty care depends on an in-person patient visit with the specialist. Even when non-indicated or premature visits are eliminated through using eReferral, limited specialty care visit capacity represents our chief impediment to prompt quality specialty care. We hypothesize that a new specialty care model – in which formalized primary/specialty care co-management strategies informed by and implemented through eReferral largely replace the traditional face-to- face specialty visit for select medical conditions – will improve access to and quality of specialty care. 12
  14. 14. VI. DISSEMINATION A central part of the CVP mission is to disseminate research and innovations to clinicians and patients to improve clinical and public health practice. The CVP is also committed to disseminating key findings to diverse stakeholders including scientists, allied health professionals, policymakers, community groups and community members. During 2009, the CVP disseminated results widely through peer-reviewed publications, newsletters, and international, national, state, and local presentations. We plan to broaden our dissemination efforts for 2010 through ethnic media outlets, social marketing approaches, symposia, and community forums to better reach diverse audiences most affected by chronic disease. A. PUBLICATIONS During 2009 the CVP published 51 articles in 31 peer-reviewed journals and presented 17 additional research abstracts at national meetings. Journals included New England Journal of Medicine, Archives of Internal Medicine, and American Journal of Public Health. Below is an alphabetical list of peer reviewed publications. Appendix E contains published abstracts from 2009 that are currently being prepared for publication. Amarasingham R, Plantinga L, Diener-West M, Gaskin DJ, Powe, NR. Clinical information technologies and inpatient outcomes: a multiple hospital study. Arch Intern Med. 2009;169:108-114. Argyropoulos C, Chang CC, Plantinga L, Coresh J, Fink N, Powe N, Unruh M. Considerations in the statistical analysis of hemodialysis patient survival. J Am Soc Nephrol. 2009;20:2034-2043. Barton J, Criswell L, Kaiser R, Chen Y, Schillinger D. A Systematic Review and Meta- Analysis of Patient Self-Report vs. Trained Assessor Joint Counts in Rheumatoid Arthritis. In press. J Rheumatol. 2009. Bibbins-Domingo K, Chertow GM, Coxson PG, Moran AE, Lightwood JM, Pletcher MJ, Goldman L. Population reductions in Coronary Heart Disease and Stroke associated with modest reductions in salt intake. In Press. N Eng J Med. 2009. Bibbins-Domingo K, Pletcher MJ, Lin F, Vittinghoff E, Gardin JM, Arynchyn A, Lewis CE, Williams OD, Hulley SB. Racial Differences in Incident Heart Failure among Young Adults. N Engl J Med. 2009 Mar 19;360(12):1179-90 Bodenheimer T, Handley MA. Goal-setting for behavior change in primary care: an exploration and status report. Patient Educ Couns. 2009 Aug;76(2): 174-80. Casalino LP, Dunham D, Chin MH, Bielang R, Kistner EO, Karrison TG, Ong MK, Sarkar U, McLaughlin MA, Meltzer DO. Frequency of failure to inform patients of clinically significant outpatient test results. Arch Intern Med. Jun 22 2009;169(12): 1123-9 Dewalt DA, Davis TC, Wallace AS, Seligman HK, Bryant-Shilliday B, Arnold CL, Freburger J, Schillinger D. Goal setting in diabetes self-management: Taking the baby steps to success. Patient Educ Couns. 2009 Nov;77(2):218-23. DeWalt DA, Broucksou KA, Hawk V, Baker D, Schillinger D, Ruo B, Bibbins-Domingo K, Holmes M, Weinberger M, O’Connell AM, Pignone M. Comparison of a one-time 13
  15. 15. educational intervention to a teach-to-goal educational intervention for self-management of heart failure: Design of a randomized controlled trial. BMC Health Services Research. 2009 Jun 11;9:99. Fagnan L, Handley M, Rollins N, Mold J. Voices from Left of the Dial: Practice-Based Research Network Clinicians’ Perspectives on Participation, Motivation and Connection. In Press. J Am Board of Family Med. 2009. Fang M, Panguluri P, Machtinger EL, Schillinger D. Language, literarcy, and characterization of Stroke Among Patients Taking Warfarin for Stroke Prevention: Implications for Health Communication. Patient Ed Counsel. 2009 Jun;75(3):403-10. Gozu A, Nidiry MA, Ratanawongsa N, Wright SM. Patient Factors Associated with Following a Relocated Primary Care Provider Among Older Adults. Am J Manag Care. 2009 Mar;15(3):195-200. Handley MA, Santos M, McClellan J. Engaging learners as interpreters for developing lead poisoning prevention materials: Designing the Familias Sin Plomo English as a Second Language Curriculum Project. Glob Health Promot. 2009 Sep;16(3):53-8. Haywood C, Lanzkron S, Ratanawongsa N, Bediako SM, Lattimer-Nelson L, Beach MC. Hospital Self-Discharge Among Adults with Sickle Cell Disease: Associations with Trust and Interpersonal Experiences with Care. Accepted for Publication. Am J Med. 2009. Haywood C, Lanzkron S, Ratanawongsa N, Bediako SM, Lattimer-Nelson L, Beach MC. Hospital Self-Discharge Among Adults with Sickle Cell Disease: Associations with Trust and Interpersonal Experiences with Care. Accepted for publication. Journal of Hospital Medicine. 2009. Haywood C, Lanzkron S, Ratanawongsa N, Bediako SM, Lattimer-Nelson L, Beach MC. The Association of Provider Communication with Trust Among Adults with Sickle Cell Disease. Accepted for publication. J Gen Intern Med. 2009. He G, Sentell T, Schillinger D. A New Public Health Tool for Abnormal Glucose Risk Assessment: The AGRA-6. In press. Prev Chronic Disease. 2009. Jaar BG, Plantinga LC, Crews DC, Fink NE, Hebah N, Coresh J, Kliger AS, Powe, NR. Timing, causes, predictors and prognosis of switching from peritoneal dialysis to hemodialysis: a prospective study. BMC Nephrol. 2009 Feb 6;10:3. Jhamb M, Argyropoulos C, Steel JL, Plantinga L, Wu AW, Fink NE, Powe NR, Meyer KB, Unruh ML, for the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study. Correlates and outcomes of fatigue among incident dialysis patients. In press. J Am Soc Nephrol. 2009. Kantsiper ME, Ratanawongsa N, Wright SM, Smith CG, Levine RB. Factors That Influence Professional Satisfaction in Hospital Medicine: A Review for Prospective Hospitalists. Hospital Physician. 2009 May/June;45(4):2328. Kalogeropoulos A, Georgiopoulou V, Kritchevsky SB, Psaty BM, Smith NL, Newman AB, Rodondi N, Satterfield S, Bauer DC, Bibbins-Domingo K, Smith AL, Wilson PWF, Vasan RS, Harris TB, Butler, J. Epidemiology of incident heart failure in a contemporary elderly 14
  16. 16. cohort: The Health, Aging, and Body Composition study. Arch Intern Med. 2009;169 (7):708-15. Kim Y, Situ M, Handley M, McLean I, Schillinger D. Ecology Matters: Patient Perspectives of Diabetes Self-Management Support Strategies in a Safety-Net Health System. In press. Asia Pacific Journal of General Practice. 2009. Lightwood J, Bibbins-Domingo K, Coxson P, Wang YC, Goldman L. Forecasting the future economic burden of current adolescent overweight: An estimate of the Coronary Heart Disease Policy Model. Am J Public Health. 2009 Dec;99(12):2230-7. Lightwood J, Coxson P, Bibbins-Domingo K, Williams L, Goldman LG. Coronary heart disease attributable to passive smoking: CHD Policy Model. Am J Prev Med. 2009; 36(1):13-20. Moffet HH, Adler N, Schillinger D, Weintraub JA, Selby JV, Liu JY, Karter AJ. Dental Insurance and Utilization Among Medically Insured Patients with Diabetes (DISTANCE). In press. Am J Prev Med. 2009. Peralta C, Risch N, Li F, Shlipak M, Reiner A, Ziv E, Tang H, Siscovick D, Bibbins- Domingo K. The association of African ancestry and elevated creatinine in the Coronary Artery Risk Development in Young Adults (CARDIA) study. In press. Am J Nephrology. 2009. Plantinga LC, Fink NE, Finkelstein FO, Powe NR, Jaar BG. Association of peritoneal dialysis clinic size with clinical outcomes. Perit Dial Int. 2009; 29:285-291. Plantinga LC, Miller ER, III, Stevens LA, Saran R, Messer K, Flowers N, Geiss L, Powe NR; for the Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team. Blood pressure control among persons without and with chronic kidney disease: U.S. trends and risk factors 1999-2006. Hypertension. 2009 Jul;54(1):47-56. Plantinga LC, Fink NE, Coresh J, Sozio SM, Parekh RS, Melamed ML, Powe NR, Jaar BG. Peripheral vascular disease-related procedures in dialysis patients: predictors and prognosis. Clin J Am Soc Nephrol. 2009; 4:1637-45. Pletcher MJ, Lazar L, Bibbins-Domingo K, Moran A, Rodondi N, Coxson P, Lightwood J, Williams L, Goldman L. Comparing impact and cost-effectiveness of primary prevention strategies for lipid lowering. Ann Intern Med. 2009;150 (4):243-54. Ratanawongsa N, Zikmund-Fisher BJ, Couper MP, Van Hoewyk J, Powe NR. Race, Ethnicity, and Shared Decision Making for Cardiovascular Disease Risk Reduction Treatment. Accepted for Publication. Medical Decision Making. 2009. Sarkar U, Wachter RM, Schroeder SA, Schillinger D.Refocusing the lens: patient safety in ambulatory chronic disease care. Jt Comm J Qual Patient Saf. 2009 Jul;35(7):377-83, 341 Sarkar U, Handley M, Gupta R, Tang A, Shojania KG, Schillinger D. Opening the Black Box: Exploring Patient Safety Threats Among Ambulatory Chronic Disease Patients. In press. Int J Health Qual Safety. 2009. 15
  17. 17. Sarkar U, Ali S, Whooley MA. Self-efficacy as a marker of cardiac function and predictor of heart failure hospitalization and mortality in patients with stable coronary heart disease: findings from the Heart and Soul Study. Health Psychol. Mar 2009;28(2):166-173. Sarkar U, Handley M, Gupta R, Tang A, Shojainia K, Schillinger D. What Happens Between Visits? Adverse and Potential Adverse Events Among a Low-Income, Urban, Ambulatory Population with Diabetes. In press. Qual Safety Health Care. 2009. Schenker Y, Fernandez A, Sudore R, Schillinger D. Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: A Systematic Review. In press. Med Dec Making. 2009. Schenker Y, Karter A, Schillinger D, Warton EM, Adler NE, Moffett HH, Ahmed AT, Fernandez A. The impact of limited English proficiency and physician language concordance on reports of clinical interactions among patients with diabetes: the DISTANCE Study. In press. Patient Educ Couns. Schickedanz AD, Schillinger D, Landefeld CS, Knight SJ, Williams BA, Sudore RL. A clinical framework for improving the advance care planning process: start with patients' self-identified barriers. J Am Geriatr Soc. 2009 Jan;57(1):31-9. Schillinger D, Sarkar U. Numbers don't lie, but do they tell the whole story? Diabetes Care. 2009 Sep;32(9):1746-7. Schillinger D, Handley M, Wang F, Hammer H. Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes: a three-arm practical clinical trial. Diabetes Care. 2009 Apr;32(4):559-66. Seligman HK, Laraia BA, Kushel MB.Food Insecurity Is Associated with Chronic Disease among Low-Income NHANES Participants. J Nutr. 2009 Dec 23. Seligman HK, Grossman MD, Bera N, Stewart AL. Improving physical activity resource guides to bridge the divide between the clinic and the community. Prev Chronic Dis. 2009 Jan;6(1):A18 Singh HS, Bibbins-Domingo K, Ali S, Wu AHB, Schiller NB, Whooley MA. N-terminal pro-B-type Natriuretic Peptide and inducible ischemia in the Heart and Soul Study. Clin Cardiol. 2009;32(8):447-53. Steinman MA, Schillinger D. Drug Detailing in Academic Medical Centers: Regulating for the Right Reasons, with the Right Evidence, at the Right Time. Response to Open Peer Commentary “The Pitfalls of Deducing Ethics from Behavioral Economics: Why the Association of American Medical Colleges is Wrong about Pharmaceutical Detailing”. Am J Bioeth. 2010 Jan;10(1):21-3. Sudore RL, Landefeld CS, Pérez-Stable EJ, Bibbins-Domingo K, Williams BA, Schillinger D. Unraveling the relationship between literacy, language proficiency, and patient-physician communication. Patient Educ Couns. 2009 Jun;75(3):398-402. 16
  18. 18. Sudore R, Schillinger D. Interventions to Improve Care for Patients with Limited Health Literacy. J Clin Outcomes Manag. 2009 Jan;16(1):20-9. Taché S, Schillinger D. Health worker migration: time for the global justice approach. Am J Bioeth. 2009 Mar;9(3):12-4. Villalobos M, Merino-Sánchez C, Hall C, Grieshop J, Gutiérrez-Ruiz M.E, Handley M. Lead (II) detection and contamination routes in environmental sources, cookware and home prepared foods from Zimatlan, Oaxaca, Mexico. Sci Total Environ. 2009 Apr 1;407(8):2836-44. Wallace AS, Seligman HK, Davis TC, Schillinger D, Arnold CL, Bryant-Shilliday B, Freburger JK, DeWalt DA. Literacy-appropriate educational materials and brief counseling improve diabetes self-management. Patient Educ Couns. 2009 Jun;75(3):328-33. Wang E, Pletcher MJ, Vittinghoff E, Kertesz SG, Kiefe CI, Bibbins-Domingo K. Incarceration, incident hypertension, and access to health care: Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Arch Intern Med. 2009;169(7):687-93. Westfall JM, Fagnan LJ, Handley MA, Salsberg J, McGinnis P, Zittleman LK, Macaulay AC. Practice-Based Research is Community Engagement. J Am Board Fam Med. 2009 Jul- Aug;22(4):423-7. Non-peer reviewed publications 1. Dean Schillinger, MD and Hliary Seligman, MD, MAS helped develop a Living with Diabetes Guide supported by the American College of Physician (ACP) Foundation. Over 1,000,000 copies of these guides have been distributed and are available through ordering at the following link: http://foundation.acponline.org/hl/diabguide.htm Hilary Seligman appears on the video highlighting this work. http://foundation.acponline.org/hl/diabguide.htm 2. Seligman H, Davis T, and Kalmbach L. Living with COPD: An Everyday Guide for You and Your Family. Published by the American College of Physicians Foundation. 3. Handley M, Schillinger D, Cu C, Richardson V, He G, Cuadros J. Diabetic Retinopathy In California – A Status Report And Review Of Telemedicine Strategies To Overcome Health Disparities In Type II Diabetes-Related Vision Loss. 4. Handley, M, Potter, M, & Goldstein, E. Community-Engaged Research with Community-Based Clinicians. http://ctsi.ucsf.edu/files/CE/manual_for_researchers_clinicians.pdf 5. Sarkar U, Schillinger D. Health Literacy Chapter UpToDate. Waltham, MA: UpToDate; 2009. Available at www.utdol.com. 6. Through a grant from the Public Health Trust, Dr. Margaret Handley, local community- based organizations and residents in Monterey/Santa Cruz Counties created a 17
  19. 19. fotonovela highlighting lead poisoning prevention for vulnerable populations in Monterey and Santa Cruz counties http://cemonterey.ucdavis.edu/EFNEP122/_b__i_Fotonovelas__b___i_.htm. 7. Research from the CVP was referenced in a Robert Wood Johnson Foundation Commission to Build a Healthier America report entitled Education Matters for Health. The report highlights educational attainment as a key social determinant of health, with references to CVP research on health literacy (17 and 24). http://www.commissiononhealth.org/PDF/c270deb3-ba42-4fbd- baeb-2cd65956f00e/Issue%20Brief%206%20Sept%2009%20-%20Education%20and %20Health.pdf B. PRESENTATIONS In 2009, CVP faculty delivered 52 presentations to research, policy, and community audiences. Kirsten Bibbins-Domingo National 1. University of Texas Health Science Center, San Antonio, Fredic C. Bartter Visiting Professorship 2. American Heart Association Epidemiology Council Annual Meeting, Tampa, Florida. Finalist for the Sandra Daugherty Award for Hypertension Research. Population wide reductions in dietary salt and resulting reductions in coronary heart disease. 3. American Heart Association Annual Conference, Orlando, Florida. Best Imaging Abstract Award: Echocardiographic Predictors of Incident Heart Failure in Young Black Adults: The CARDIA Study Regional 1. Thinking Outside the Box: New Ideas for Changing Times: Targeting Salt Reduction to Prevent Chronic Disease. California Diabetes Leadership Summit, Sacramento, CA. 2. Global Health Implications of Chronic Disease. UCSF Global Women’s Health NIH Presentation. 3. UCSF Center on Social Disparities and Health--Chronic Disease in Young and Middle Aged Adults. Margaret Handley International 1. Linking practice-based research with implementation sciences: Which approaches can lead to best practices for CTSA and community partnerships? North American Primary Care Research Group, Montreal, QU. 2. Getting the ’Community’ out of Community-based participatory research. North American Primary Care Research Group, Montreal, QU. 3. Integrated Primary Health Care and Workforce Training in Zomba District Malawi – Health Systems Strengthening. 4. Meeting on Population Health Implementation and Training Partnerships-Doris Duke Foundation, Zomba, Malawi 18
  20. 20. Regional 1. From Immigrant Stories to Collaborative Action: A Case Study in Community Wellness, Culture and Transnational Identity. San Francisco State University Community-based Participatory Research Symposium. 2. California Diabetes Summit Presentation: Promising Approaches to Integrating Tele-Health Initiatives into Primary-Care Services for Patients with Diabetes. 3. 3rd Annual UCSF Health Disparities Symposium Poster Presentation: Staying healthy, staying connected: An empirical study of transnational health perspectives in English as a Second Language (ESL) and community high school programs Laura Plantinga Regional 3rd Annual UCSF Health Disparities Symposium Presentation: Lower Income Is Independently Associated with Disability among Persons with Chronic Kidney Disease in the United States Neda Ratanawongsa National Ratanawongsa N, Dean C, Rand C, Powe NR, Zimmet JM. “Knowledge and Attitudes about Dual Antiplatelet Therapy Among Patients Receiving Cardiac Catheterization.” 2009 International Conference on Communication in Healthcare, Miami, FL. Regional 1. 3rd Annual UCSF Health Disparities Symposium Poster Presentation: Using Health Information Technology to Triangulate the Contributions of Patient Preferences, Non-Adherence, and Need for Treatment Intensification in the Achievement of Diabetes Goals in a Vulnerable Population. 2. Davis E, Alpers L, Duffy K, Harleman E, Gelason N, Maldonado A, Jagannathan P, Komisarjevsky V, Seligman H, Newbold E, Tayo-Samoni D, Winston L, Ratanawongsa N. Teaching Residents the Value of Caring for Patients Awaiting Placement. Society of General Internal Medicine Annual Meeting, Miami, FL. 3. Ratanawongsa N, Sarkar U, Quan J, Handley M, Soria C, Tan S, Lau O, Lum A, Pfeifer K, Schillinger D. Using Health Information Technology to Triangulate the Contributions of Patient Preferences, Non-Adherence, and Need for Treatment Intensification in the Achievement of Diabetes Goals in a Vulnerable Population. 2009 AHRQ Annual Conference, Bethesda, MD; 2009 UCSF Disparities Symposium, San Francisco, CA. 19
  21. 21. Urmimala Sarkar National 1. Monitoring Patient Safety for Vulnerable Diabetes Patients using Automated Telephone Self-Management Support. National Partnership for Action to End Health Disparities, National Leadership Summit, Office of Minority Health, Washington, DC. 2. Ambulatory Safety Surveillance using Automated Telephone Technology for Vulnerable Diabetes Patients. Society of General Internal Medicine National Meeting, Miami, FL. 3. Monitoring Medication Safety via an Enhanced Personal Health Record in an Urban, Diverse, HIV Positive Population. Society of General Internal Medicine National Meeting, Miami, FL. Regional 1. Heart to heart: Inadequate Patient-Clinician Communication in Ambulatory Cardiac Care. 3rd Annual UCSF Health Disparities Symposium Poster Presentation. 2. Patient Safety in the Ambulatory Setting. San Francisco General Hospital and Trauma Center Medical Grand Rounds. Dean Schillinger International 1. Addressing the Co-Epidemics of TB and Diabetes: International Web-Based Seminar, Francis J. Curry National TB Center, San Francisco, CA National 1. Proactive Outreach Using Telephone Technology. Right Care Initiative. CA Dept of Managed Healthcare. Los Angeles CA. 2. Preventing Readmissions: Employing the “Teach-Method” at the Systems Level. Florida Hospital Association Collaborative. 3. Health Literacy and Diabetes Prevention and Control. CDC Division of Diabetes Translation. Long Beach, CA. 4. Health Literacy and Diabetes Prevention and Control. Diabetes Coalition of California. Sacramento CA. 5. What Will it Take to Fight Diabetes in California? California Diabetes Leadership Summit, Sacramento CA. 6. Addressing Social Determinants in Diabetes: What is Our Role? California Diabetes Leadership Summit, Sacramento CA. 7. A Framework for Patient Safety in the Ambulatory Setting. U Colorado Health Sciences Denver CO. 8. Literacy, Health Communication and Diabetes Disparities. U Colorado Health Sciences Grand Rounds, Denver CO. 9. Overcoming Diabetes Disparities in Safety Net Health Systems. CA Primary Care Assn Annual Conference Keynote Address. 10.Harnessing Health IT for Advancing Public Health: Populations with Limited Health Literacy. Health Literacy Annual Research Conference, Washington DC. 20
  22. 22. Regional 1. UCSF Center for Social Disparities in Health Seminar Literacy, Health Communication, and Chronic Illness to the Center on Social Disparities and Health. 2. Kaiser-Permanente Care Management Institute. 3. Asian Health Services, Oakland CA. 4. Alta Bates Ethnic Health Institute, Oakland CA. 5. Guest speaker, Radio Bilingue Nacional (Linea Abierta): Diabetes Prevention in Latinos. [http://www.radiobilingue.org/blogairelibre/blogairelibre.htm] [http://www.archivosderb.org/?q=es/node/2267] 6. Diabetes Center Retreat: Health Services Research: Diabetes in Underserved Populations Hilary Seligman National 1. Davis E, Alpers L, Duffy K, Harleman E, Gleason N, Maldonado AM, Jagannathan P, Komisarjevsky V, Seligman H, Newbold E, Tayo-Samoni E, Winston L, Ratanawongsa N. Poster presentation. Teaching Residents the Value of Caring For Patients Awaiting Placement. Society of General Internal Medicine, Miami, FL, May 2009. 2. Maldonado AM, Gleason N, Davis E, Irby R, Shao L, Seligman H. Poster presentation. Nothing to Do, Awaiting Placement: Teaching the Prevention of Hospital Acquired Complications in Pts with Prolonged Hospitalizations, A Multidisciplinary Resident Integrated Approach. Society of General Internal Medicine, Miami, FL. Regional 1. Plenary Presentation. Improving Health Promotion Counseling for Patients with Limited Health Literacy. Regional Diabetes Collaborative (RDC) of Monterey, San Benito and Santa Cruz Counties, Diabetes Forum, Watsonville, CA. 2. Invited Lecture. Health and Hunger in America. Mission Mental Health Clinic, noon conference for providers, San Francisco, CA. 3. Plenary Presentation. Health and Hunger in America. Bi-Annual Professional Practice Group Conference, San Francisco, CA. 4. Riley L, Saad N, Seligman HK. Poster Presentation. Postpartum Diabetes Insipidus: An Interesting Path to a Rare Diagnosis. Society of General Internal Medicine Regional Meeting. 5. Riley L, Saad N, Seligman HK. Poster Presentation. Postpartum Diabetes Insipidus: An Interesting Path to a Rare Diagnosis. American College of Physicians Foundation. 6. Invited Lecture. How I Became an Expert in Food Insecurity, or How to Become an Activist Leader in 5 Steps. Social Activism in Medicine Class, UCSF, San Francisco, CA. 7. Invited Lecture. Food Insecurity. UC-Berkeley, Nutritional Epidemiology (Public Health 206C), San Francisco, CA. 8. 3rd Annual UCSF Health Disparities Symposium Poster Presentation: Food Insecurity is a Risk Factor for Poor Diabetes Self-Management 9. Health and Hunger in America. SFGH and Moffit-Long Hospital-Medical Grand Rounds on February 10, 2009. 21
  23. 23. 10. Guest interview appearance, Hunger in America on KTVU Channel 2. C. COMMUNITY FORUMS/Town Hall Meetings a. KTVU: Hunger in America Hilary Seligman, MD, MAS was interviewed for a news piece on how America could be simultaneously facing an epidemic of obesity and an epidemic of hunger. The interview was broadcast on KTVU Channel 2 news on December 24, 2009. b. World Diabetes Day Dr. Dean Schillinger, Chief of the California Diabetes Program and Director of the Center for Vulnerable Populations was a speaker for World Diabetes Day, on November 14th, 2009 in Sacramento, CA. This event was co-hosted by the California Diabetes Program and gathered a global and local community around diabetes prevention. Dr. Schillinger was interviewed on the Channel 13 News. c. UCSF Third Annual Health Disparities Symposium CVP investigators presented during the third annual UCSF Annual Health Disparities Symposium on October 23, 2009. Laura Plantinga, ScM, gave a presentation entitled Lower Income is Independently Associated with Disability among Persons with Chronic Kidney Disease in the United States. Posters were presented by Margaret Handley, PhD, “Staying healthy, staying connected: An empirical study of transnational health perspectives in English as a Second Language (ESL) and community high school programs”; Neda Ratanawongsa, MD, MPH “Using Health Information Technology to Triangulate the Contributions of Patient Preferences, Non-Adherence, and Need for Treatment Intensification in the Achievement of Diabetes Goals in a Vulnerable Population”; Urmimala Sarkar, MD, MPH “Heart to heart: Inadequate Patient-Clinician Communication in Ambulatory Cardiac Care”; and Hilary Seligman, MD, MAS “Food Insecurity is a Risk Factor for Poor Diabetes Self-Management”. d. California Diabetes Leadership Summit, Sacramento, CA CVP researchers presented at the first annual California Diabetes Leadership Summit. Dr. Dean Schillinger who is also the Chief of the California Diabetes Program gave a talk entitled “What Will it Take to Fight Diabetes in California?” Dr. Schillinger also facilitated a discussion with Linda Rudolph, MD, MPH, Deputy Director, California Department of Public Health, Center for Chronic Disease Prevention and Health Promotion during a session entitled “Addressing Social Determinants in Diabetes: What is Our Role?” CVP researchers presented during a break out session entitled Thinking Outside the Box: New Ideas for Changing Times: Dr. Kirsten Bibbins-Domingo gave a talk entitled “Targeting Salt Reduction to Prevent Chronic Disease” and Dr. Margaret Handley gave a talk entitled “Promising Approaches to Integrating Tele-Health Initiatives into Primary- Care Services for Patients with Diabetes.” e. Drs. Schillinger and Handley were interviewed on a Bay Area-wide television program, Comunidad del Valle, which reaches a primarily English-speaking audience whose influence reaches large segments of the Latino community. The interview focused on the work at the Center for Vulnerable Populations that centers on innovative 22
  24. 24. communication strategies between primary care centers and vulnerable populations in the community who don’t receive the information they need to manage chronic illnesses, due to such factors as limited literacy, language barriers and lack of health insurance. f. Radio Bilingüe - Living with Diabetes; Innovative Communication Strategies. Dr. Dean Schillinger was featured on the Radio Bilingüe program, Linea Abierta, a non-profit radio network with Latino control and leadership that is the only national distributor of Spanish-language programming in public radio. The shows featured a panel of patients sharing their experiences living with diabetes. Dr. Schillinger discussed health promoting behaviors to prevent and control diabetes, the type 2 diabetes epidemic as it affects Latinos and effective tools to improve communication between doctors and diabetes patients. There was also a Q and A period at the end where callers joined the discussion from Merced, Bakersfield, Chicago, Washington State and other areas. Below are links to two shows conducted in Spanish • archivosderb.org - June 18, 2009 • archivosderb.org - July 23, 2009 6. Special Medical Grand Rounds: Health Inequities for Undocumented Immigrants. Co-sponsored by the UCSF Medical Humanities Initiative, the CVP hosted a Medical Grand Rounds featuring attorney, acclaimed writer and San Francisco State University associate professor, Peter Orner. Orner discussed health inequities raised by the Voices of Witness oral history book “Underground America” which tells the stories of “illegal” immigrants in the U.S. Orner was joined by LA Times journalist Sandra Hernandez and, via satellite, by one of the undocumented immigrants depicted in the book. Topics covered included health and human rights in prison, occupational injuries and social vulnerabilities (e.g. overcrowded living environments, food scarcity, violence, social isolation, and delayed medical care due to lack of health insurance and immigration-related fears). 7. Margaret Handley, PhD, MPH presented at the Meeting on Population Health Implementation and Training Partnerships-Doris Duke Foundation, iZomba, Malawi (February, 2009) to an audience of NGOs. 8. Margaret Handley, PhD, MPH gave a presentation at San Francisco State University for the spring series of Community Engaged Scholarship/Community-based Participatory Research. The presentation was entitled “From Immigrant Stories to Collaborative Action: A Case Study in Community Wellness, Culture and Transnational Identity”. Dr. Handley’s presentation explored the power of stories as a vehicle for community- based research around immigrant wellness. Dr. Handley co-presented an adult ESL case study that highlighted new stories on immigrant identity in which struggles to stay healthy are in unintentional conflict with hopes to stay connected to the home culture. A collaborative project between adult ESL practitioners and public health researchers working on sources of lead poisoning within Latino immigrant communities in Northern California, this case study embeds community literacy practices, and a community strengths approach to boost the likelihood that environmental health messages and research designs will respect cultural practices around food and support immigrants in their efforts to preserve ties to home. 23
  25. 25. VII. AWARDS AND RECOGNITION Below is a list of awards and recognition presented to CVP faculty and staff in 2009. 1. CVP team members were honored with the 2009 California Association of Public Hospitals and Health Systems/ Safety Net Institute (CAPH/SNI) Award. This award recognizes innovative programs developed by California’s public hospitals and health systems to meet the needs of the communities they serve. The CVP team received this award for work on the “Automated Telephone Self-Management Support Model for Diabetes Project” presented on Thursday, December 3, 2009 during the CAPH Annual Conference. 2. Dean Schillinger, MD was selected as the recipient of the 14th Annual George Engel Award for Outstanding Research Contributing to the Theory, Practice and Teaching of Effective Health Care Communication and Related Skills. This award was presented during the International Conference in Communication in Healthcare in Miami Beach, Fl on October 2nd-3rd, 2009. The American Academy on Communication in Healthcare presents this award in honor of Dr. George L. Engel, an internist with psychoanalytic training whose articulation of the "biopsychosocial model" in the 1970s and widespread recognition in the 1980s had a profound impact on the clinical approach to patients, the medical interview, and the patient-doctor relationship. The Academy’s mission is to foster “best patient care by advocating a relationship centered approach to healthcare communication, education and research.” 3. Pam Coxson, PhD, presented the abstract “Sugar-Sweetened Beverage Consumption and the Attributable Burden of Diabetes and Coronary Heart Disease” at the Bay Area Clinical Research Conference on October 28th, 2009. The abstract was a finalist for the best abstract by a junior investigator award. 4. Kirsten Bibbins-Domingo, PhD, MD, MAS was a finalist Sandra Daugherty Award for Research, American Heart Association and was honored with the Best Imaging Abstract (Mentee J. Ho) during the American Heart Association Scientific Session. VIII. POLICY IMPACTS The CVP recognizes policy as a critically important vehicle to address the burden of chronic disease for vulnerable populations. Below are some examples of ways in which the CVP has advanced the public policy agenda for vulnerable populations faced with chronic disease and in support of the practitioners and systems that disproportionately serve these populations. Kirsten Bibbins-Domingo 1. CVP co-director, Dr. Kirsten Bibbins-Domingo is conducting a study entitled Adapting the Coronary Heart Disease Policy Model to Address Disparities in Heart Disease. This study has great potential to drive public policy because national, state and local health policy is often evaluated for the ability to eliminate health disparities between different sub-populations. This study will be adapting the Coronary Heart Disease Policy Model to examine coronary heart disease rates by race/ethnicity and income level which will 24
  26. 26. enable a more accurate description of disease trends over diverse populations and evaluation of interventions that target vulnerable groups. 2. Dr. Bibbins-Domingo presented salt policy work to the California Department of Public Health. Drs. Bibbins-Domingo delivered a talk entitled “Targeting Salt Reduction to Prevent Chronic Disease and Death”. 3. Dr. Bibbins-Domingo served as co-chair for a NIH Office of Research on Women’s Health session. This session focused on global health and chronic disease during a scientific workshop to update the NIH Women’s Health Research Agenda NIH Office of Research on Women’s Health event. 4. Dr. Bibbins-Domingo was appointed to an Institute of Medicine Committee evaluating policies to compensate those with adverse side-effects from vaccinations. Margaret Handley 1.Dr. Handley has worked on a grant from the California Program on Access to Care in collaboration with the State Diabetes Program, Medi-Cal, and optometrists at UC Berkeley to assess barriers to screening for diabetic retinopathy among vulnerable populations in California. A policy brief is being drafted for widespread dissemination. Dean Schillinger 1.Dr. Dean Schillinger gave testimony to California Legislature: Protecting the Health of Children and Adolescents with Diabetes in California Schools 2.Dr. Schillinger appeared in the California Association of Public Hospitals (CAPH) Diabetes Issues Brief, December 2009. He was quoted about the role of public hospital systems in caring for vulnerable populations with diabetes. 3.The Agency for Health Research Quality and Safety (AHRQ) interviewed Dr. Dean Schillinger on his role as a practicing clinician at a safety net hospital (San Francisco General Hospital and Trauma Center). Dr. Schillinger discussed challenges in a safety- net hospital including limited literacy and non-English communication barriers http://www.webmm.ahrq.gov/audio.aspx 4.The Improving Diabetes Efforts across Language and Literacy (IDEALL) project, led by Dean Schillinger and CVP faculty received widespread local, state, and national attention. a. The Agency for Health Research Quality (AHRQ) highlighted the IDEALL project in the Patient Safety and Health IT Professional Literature. They circulated the following citation for the IDEALL project in their Patient Safety and Health Information Technology E-Newsletter: Handley MA, Shumway M, Schillinger D. Cost-Effectiveness of Automated Telephone Self-Management Support with Nurse Care Management Among Patients with Diabetes. Ann Fam Med 2008 Nov-Dec;6(6):512-8. Select to access the abstract. 25
  27. 27. b. The IDEALL project was sited as a national model in Mitch Katz, MD director’s report for the San Francisco Department of Public Health. c. California Safety Net Institute highlighted the IDEALL project in their bulletin. Please see Appendix D for this piece. d. The National Association of Chronic Disease Directors highlighted the IDEALL project in their December ebulletin 5.Dean Schillinger, MD, co-authored a California Department of Public Health report entitled Diabetes in California Counties, Issued April 2009. This document provides background information, facts, and statistics about diabetes across California counties, through data collected from the 2005 California Health Interview Survey. The information can be used by county health departments, community-based organizations, and those providing clinical services to make strategic decisions about their current and future activities. http://www.caldiabetes.org/content_display.cfm?ContentID=1160 Urmimala Sarkar 1.Dr. Urmimala Sarkar was invited to the Advisory Council for its Ambulatory Stand Up for Patient Safety (ASUPS) program by the National Patient Safety Foundation. This program is designed to deliver to its members an ongoing stream of tools and information of relevance to the patient safety work and is organized around competencies. As a leader in the patient safety field, Dr. Sarkar will share her expertise and help us identify emerging information and tools to keep the content current. 2.Dr. Sarkar was also featured on a blog for the Joint Commission Journal for Quality and Patient Safety. In this blog, she reflects on the origins of her article entitled “Refocusing the Lens: Patient Safety in Ambulatory Chronic Disease Care,” (published July 2009) and on the need to engage patients, especially the large population of patients with chronic conditions, in improving safety. http://www.jcrinc.com/Blog/2009/7/2/Thinking-about- Patient-Safety-for-Chronically-Ill-Outpatients/ 3.Dr. Urmimala Sarkar serves on a national committee entitled the National Collaborative for Health Information Technology for Underserved Populations. She leads the dissemination group for the Education and Outreach Workgroup, whose charge is to “Identify and develop effective practices for communicating HIT benefits to diverse underserved populations; identify or create models, practices or activities utilizing health IT; and identify/create and distribute materials to these communities that are culturally/linguistically appropriate. A focus of this task force will be educating individuals on HIT to improve health self-management and support consumer empowerment.” 4. Dr. Sarkar has also partnered with the California Diabetes Program to assess of practices and policies of state diabetes public health programs across the US regarding clinical guidelines for diabetes management. Hilary Seligman 1.Dr. Hilary Seligman works with the American College of Physicians Foundation to develop and enhance the quality of physician counseling about chronic disease. This work has included the development of patient education guides targeted toward patients with 26
  28. 28. limited health literacy. Almost a million copies of the diabetes guide have been distributed throughout the country to HMOs (including Kaiser and Blue Cross), Medicaid Programs, VA Medical Centers, hospital settings, and community health centers. 2.Dr. Seligman is also active in policy work in the area of food insecurity. She participates in a number of local organizations, such as the Food Security Task Force and the Southeast Food Access Program of the City and County of San Francisco. She has worked on developing a resolution to nominate San Francisco County as a candidate for the Healthy Purchase Pilot program, which would incentivize Supplemental Nutrition Assistance (formerly Food Stamps) participants to purchase more fruits and vegetables. She has prepared an Issues Brief for the California Department of Public Health regarding the implications of food insecurity on diabetes prevention and control efforts. Laura Plantinga Laura Plantinga, ScM works with the Centers for Disease Control and Prevention (CDC) in the development and maintenance of a surveillance system for chronic kidney disease (CKD) in the United States. The data from this project, including data on the disproportionate development and progression of CKD among vulnerable groups, will provide the informational backbone for the CDC website on CKD, which will be launched in early 2010. Additionally, she also works with CDC and other partners in creating a national CKD fact sheet for use by both the public and policy makers. She has produced several papers that have influenced policy in CKD, including assessments of: awareness of CKD among those with the disease in the community, which was featured on the CDC website as part of World Kidney Day 2009 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5808a1.htm); blood pressure control according to clinical practice guidelines for those with CKD; the association of physician visit frequency with dialysis patient outcomes; and the association of patient outcomes with attainment of clinical performance targets for dialysis patients set forth by the National Kidney Foundation. She has also published an invited commentary on prevention of repeat hospitalizations in dialysis patients. IX. NEXT STEPS The CVP team is excited to build on its momentum and make more strides toward becoming a premier research center dedicated to health communications and health policy. The goal of the center is to translate research into greater community health, and to infuse community needs into research. The Center will focus programmatic efforts on the new CVP space renovation by articulating our vision for the two new CVP programs in Health Communications and Health Policy and Chronic Disease Prevention and raising funds for this new space. The CVP will also increase its visibility by 1) launching a Health Communications Research Seminar series; 2) coordinating a larger initiative to bring together expertise on the SFGH campus that relate to the health of vulnerable populations; and 3) holding symposia that showcase work related to vulnerable populations both at SFGH and in the larger UCSF community. The CVP is expanding its role as a premier research home for a range of trans-disciplinary scientists dedicated to reducing the burden of chronic disease in vulnerable populations. 27
  29. 29. APPENDIX A CVP SPACE PLANS—2789 25th Street 28
  30. 30. 29
  31. 31. APPENDIX B 2009 FACULTY AND STAFF ADDITIONS 30
  32. 32. Laura Plantinga, ScM, is Assistant Adjunct Professor in the Department of Medicine, Division of General Internal Medicine. Her primary research interests include processes and quality of care, patient outcomes and quality of life, and epidemiology of chronic disease, particularly related to chronic kidney disease (CKD). Ms. Plantinga serves as a co-investigator and project director for a CDC-funded effort to establish a CKD surveillance system in the United States. She has several published and in-press articles generated from this project, including an article on CKD awareness in the United States. Ms. Plantinga continues to work with nephrologists and fellows on on-going projects related to the CHOICE (Choices for Healthy Outcomes in Caring for ESRD) study of patient outcomes in end-stage renal disease, from which she and collaborators continue to generate published manuscripts. Additionally, Ms. Plantinga continues to mentor residents and fellows in appropriate clinical research practice, particularly analysis and presentation of study results. Neil R. Powe, MD, MPH, MBA is the Constance B. Wofsy Distinguished Professor, Vice- Chair of Medicine at the University of California San Francisco and Chief of Medical Services at San Francisco General Hospital and Trauma Center. Dr. Powe's research unites medicine and public health with the goals of saving and improving quality of human lives. It involves the knowledge of fundamental discoveries in biology and clinical medicine to advance the health of patients who ultimately make up a larger population of patients affected by a disease. Dr. Powe studies chronic kidney disease as well as many important diseases with substantial morbidity in areas of prevention and screening, clinical epidemiology, patient outcomes research, technology assessment, and cost- effectiveness analysis. He has extensive experience in developing and measuring outcomes in kidney disease using data from prospective studies, the United States Renal Data System, Medicare records, and patient surveys. Dr. Powe is principal investigator of a Center for Disease Control and Prevention sponsored study to establish a national surveillance system for chronic kidney disease in the United States. He also leads the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) study, a national study of patient outcomes in the treatment of chronic kidney disease funded by the agency for Healthcare Research and Quality and the National Institute of Diabetes and Digestive and Kidney Diseases. This was one of the first large prospective studies of incident dialysis patients. In his most recent NIH grant supporting the CHOICE cohort he is examining the role of small organic solutes retained after hemodialysis and their effect on patient outcomes. This project seeks to identify substances that lead to toxicity and poor outcomes in end stage renal disease. Dr. Powe also conducts projects on health disparities, care management, access to care, quality of care and resource allocation. Andrea Lopez currently serves as a CVP research associate, working with Drs. Urmimala Sarkar and Hilary Seligman on patient safety, food insecurity, and health access related research. Prior to joining the Division of General and Internal Medicine and CVP team, Andrea worked for Communities for a Better Environment as the coordinator of a community-based health survey in Richmond, CA. Andrea graduated from Brown University with a B.Sc. in Human Biology, where she worked on university-community partnerships in health. Phiona Tan, BS is a bilingual (Cantonese/English) research assistant working on the Self-Management Automated Real Time Telephone Support (SMART Steps) program. She is also fluent in Mandarin and Toisanese. Prior to joining the Division of General and 31
  33. 33. Internal Medicine and CVP team, she worked with Dr. Chesla and Dr. Chun for 4 years on a qualitative study on Chinese American with diabetes at UCSF School of Nursing. Phiona graduated from UC Davis with a B.S. in Bio-Psychology CVP FACULTY AND STAFF Dean Schillinger, MD Director, CVP, Professor of Medicine Kirsten Bibbins-Domingo, MD, PhD, Co-Director, CVP Associate Professor MAS of Medicine, Epidemiology, and Biostatistics Margaret Handley, PhD Assistant Professor Laura Plantinga, ScM Assistant Professor Neil R. Powe, MD, MPH, MBA Constance B. Wofsy Distinguished Professor, Vice-Chair of Medicine at the University of California San Francisco and Chief of Medical Services Neda Ratanawongsa, MD, MPH Assistant Professor of Medicine Urmimala Sarkar, MD, MPH Assistant Professor of Medicine Hillary Seligman, MD Assistant Professor of Medicine Natalie Collins, MSW Center Manager Pam Coxson, PhD Mathematician Lauren Davidson Administrative Assistant David Guzman, MSPH Senior biostatistician Aurora Hernandez Research Associate Andrea Lopez Research Associate Tekeshe Mekonnen, MS Project Coordinator Matt Ong, MPH Biostatistician Judy Quan, PhD Biostatistician Zenelia Roman Research Associate Catalina Soria Research Associate Phiona Tan Research Associate 32
  34. 34. APPENDIX C CURRENT CVP RESEARCH MENTORING AND TEACHING ACTIVITIES 33
  35. 35. Kirsten Bibbins-Domingo Dr. Bibbins-Domingo is the Associate Director of the Clinical and Translational Sciences Institute's Multidisciplinary K Scholars program. This program provides competitive career development awards to promising junior faculty from across all five schools at UCSF. The program includes career mentorship, epidemiological and statistical support, works-in-progress seminars, and methodological seminars over a 4-5 year period. Mentoring Positions 1) Attending physician – Medicine Service – SFGH 2003-present 2) Attending physician – Medicine Consult Service – SFGH 2003-present 3) Attending physician – General Medicine Clinic – SFGH 2006-present 4) Course director– Designing Clinical Research for Predoctoral students – 2005- present 5) Lecturer – SFGH Core clinical curriculum for medical students – 2008-present 6) Associate Director – CTSI KL2 Multidisciplinary Scholars Program – 2007-present 7) Research mentor/career mentor – medical students – 2005-present 8) Research mentor – residents/fellows/junior faculty DGIM and CTSI-KL2 – 2006- present RECENT PREDOCTORAL STUDENTS AND MEDICAL RESIDENTS MENTORED Dates Name School Role Current Position 2009- Margarite Undergraduate Career and project UCB Undergraduate present Changala UCB mentoring 2009- Antoinette Mason Undergraduate Career and project UC Davis present – UC Davis mentoring Undergraduate 2008- Litsa Lambrakos Resident- Supervised research Resident present Medicine project 2008- Melissa BurroughsResident - Supervised research Resident present Medicine project RECENT POSTDOCTORAL STUDENTS MENTORED Dates Name Fellow Role Current Position 2006- Stacey Jolly General Supervised research Assistant Professor present Medicine project Cleveland Clinic 2006- Emily Wang General Supervised research Assistant Professor present Medicine project Yale 2008- Eveline Oestricher Medicine - Supervised research Fellow present Cardiology project 2008- Jennifer Ho Medicine- Supervised research Fellow – Framingham present Cardiology project Heart Study 2008- Erica Wang OB-GYN Supervised research Fellow present project 2009- Michelle Odden Medicine- DGIM Supervised research Fellow present project Maya Vijayaraghavan, Medicine - 2009- MD DGIM Research mentor Fellow 2008- Vanessa Grubbs Medicine- Supervised research Assistant Professor - present Nephrology project UCSF 34
  36. 36. RECENT JUNIOR FACULTY MENTORED Dates Name School – Program Role Current Position 2007- Kristine Madsen Medicine – Career development and Assistant present CTSI-KL2 project mentoring Professor 2007- Carmen Peralta Medicine – Career development and Assistant present CTSI-KL2 project mentoring Professor 2007- Hilary Seligman Medicine - DGIM Career development and Assistant present project mentoring Professor 2007- Andrew Choi Medicine - Career development and Assistant present Nephrology project mentoring Professor 2008- Christine Medicine – Career development Assistant Dehlendorf MD Family and project mentoring Professor Community Medicine 2009- Andrew Choi Medicine - Career development and Assistant present Nephrology project mentoring Professor 35
  37. 37. Dean Schillinger Over the past few years, Dr. Schillinger has taken on increasing responsibilities for mentoring research fellows and faculty in their clinical research. This has predominantly taken place in the form of one on one counseling, project management, manuscript preparation, and grant-writing, including helping with career development awards. This work has focused on UCSF faculty, but also for non-UCSF faculty, including an International Harkness Policy Research Fellow. Additionally, Dr. Schillinger also participates in the monthly faculty research works-in-progress sessions at SFGH. In his CTSI role, Dr. Schillinger is taking increasing responsibility for fostering research capacity at UCSF in communication and dissemination sciences. He is currently the primary mentor for 2 faculty-level K awardees, and the secondary mentor for 3 others. Mentoring and Training Positions 1. Attending physician – SFGH inpatient – 1995-present 2. Attending physician – SFGH outpatient – 1995-present 3. Attending physician – and medical consultation services –1995-present 4. Lecturer – USCF/SFGH Primary Care Core Curriculum –1995-present 5. Lecturer– SFGH Primary Care Residency Program & Health Equities Residency track 6. Lecturer – ATCR course on Translational and Implementation Sciences (Epi 245): taught seminar on Case Studies in Implementation Research (Course taught by R Gonzales and M Handley) – 2008- present 7. Facilitator – Primary Care Journal Club – 1995-present RECENT POSTDOCTORAL FELLOWS AND RESIDENTS DIRECTLY SUPERVISED OR MENTORED Dates Name Position while Mentoring Role Current Position Mentored Yael Schenker Research HRSA Fellow, DGIM, 2008- MD fellow Research mentor UCSF Maya Vijayaraghava Research HRSA Fellow, DGIM, 2009- n, MD fellow Research mentor UCSF David Research HRSA Fellow, DGIM, 2009- Moskowitz, MD fellow Research mentor UCSF Pamela Research Philip Lee Institute for 2009- Stoddard PhD fellow Research mentor Health Policy Studies RECENT JUNIOR FACULTY MENTORING 2007- Maricel Santos, Junior Faculty, Research mentor Asst Prof, SFSU Dept of PhD SFSU RIMI Fellow English 2nd Language 2008- Christina Junior Faculty Research mentor Asst Prof, UCSF Dept of Dehlendorf MD Fam and Comm Med 2008- Urmimala Junior faculty Research mentor Asst. Prof. in Sarkar, MPH, Residence, Dept of MD Medicine, UCSF/SFGH Adjunct. Asst Prof., Jennifer Barton Dept of Medicine, 2008- MD MS Junior faculty Research mentor UCSF/SFGH Fulbright Health Policy Maria Soledad Scholar, Univ of Chile/ Martinez MD UC Berkeley Schools of 2009- MPH Junior faculty Research Mentor Public Health 36
  38. 38. APPENDIX D NEWSLETTERS AND ARTICLES 37
  39. 39. UCSF Newsletter December 17, 2009 UCSF/SFGH Project for Diabetes Patients Wins Award for Innovation, Quality A UCSF project that used a novel communication tool to improve health outcomes among diabetes patients was honored recently with a quality leadership award from the California Health Care Safety Net Institute. The institute, the quality improvement partner of the California Association of Public Hospitals and Health Systems, presents its Quality Leaders Award to innovative programs within California’s public hospitals and health systems that aim to meet the needs of diverse communities. At a Dec. 3 award ceremony in Monterey, the institute honored San Francisco General Hospital and Trauma Center (SFGH) for its Improving Diabetes Efforts Across Language and Literacy (IDEALL) project, which ran from 2003 to 2006 and was based at the UCSF Center for Vulnerable Populations at the UCSF-affiliated hospital. IDEALL was designed to combine accessible, multilingual communication technology with targeted interpersonal support, according to SFGH primary care physician Dean Schillinger, MD, a UCSF professor of medicine who serves as both director of the Center for Vulnerable Populations and chief of the California Diabetes Program within the California Department of Public Health. The project enrolled 339 patients with type 2 diabetes, many of whom had limited literacy skills and limited English proficiency. Participants were randomly assigned to one of three groups — automated telephone diabetes self-management, group medical visits or standard care — and were followed for a period of one year. Patients in the telephone group received weekly automated phone calls in their native language, asking them about their self-care behaviors, such as medication adherence and diet, as well as their psychological and emotional well-being. Patients responded using touch-tone commands, and any response that raised red flags was immediately followed by a call from a nurse care manager who spoke the patient’s primary language. The telephone system proved superior to group-oriented support and standard care in terms of patient engagement, improved diabetes-related health outcomes, and patient safety, Schillinger and his team found. The technology was also highly cost-effective. “We are extremely proud of the work done by the innovators of this project,” said Sue Carlisle, PhD, MD, associate dean of the UCSF School of Medicine at SFGH. “This is the kind of approach to patient care that can truly make a difference in the ability not only 38
  40. 40. for public hospitals, but for all of our health care systems to provide improved care at lower costs.” Based on the positive initial outcomes, the automated phone system is being scaled up in collaboration with the San Francisco Health Plan, the city-sponsored local health plan. This second-generation program, SMARTSteps (Self-Management Automated and Real- Time Telephonic Support), is currently being implemented among an additional 500 diabetes patients. SMARTSteps also includes access to real-time pharmacy claims data and up-to-date clinical registry data. Those tools will enable health plan counselors to support patients in their self-management and to assist them in sticking to — or in some cases intensifying — their medication regimens, Schillinger said. 39
  41. 41. UCSF Today October 8, 2009 Schillinger Awarded for Outstanding Research Contributing to Effective Communication Dean Schillinger, MD, UCSF professor of medicine, received the 14th Annual George Engel Award for Outstanding Research Contributing to the Theory, Practice and Teaching of Effective Health Care Communication and Related Skills. He received the award during the International Conference in Communication in Healthcare in Miami Beach, Florida on Oct. 5th. Schillinger is the director of the UCSF Center for Vulnerable Populations (CVP) at San Francisco General Hospital and Trauma Center (SFGH) and chief of the California Diabetes and Prevention Program. CVP is a practice-based research center where scientists’ work has helped translate research into community and public health practice, as well as infuse local practice back into research. Beyond the local communities it serves, CVP is nationally and internationally known for its research in health communication and health policy to reduce health disparities. Serving the local, regional and global communities and eliminating health disparities is part of the vision outlined in the UCSF Strategic Plan. The plan, released in June 2007, calls on the University to leverage UCSF’s research expertise, modeling best practices in clinical care and integrating content on health disparities throughout the continuum of learning. Talmadge King, MD, chair of the Department of Medicine in the UCSF School of Medicine, nominated Schillinger for this prestigious award in recognition of his enormous and impactful work. The American Academy on Communication in Healthcare presents this award in honor of Dr. George L. Engel, an internist with psychoanalytic training whose articulation of the “biopsychosocial model” in the 1970s and widespread recognition in the 1980s had a profound impact on the clinical approach to patients, the medical interview, and the patient-doctor relationship. Making an Impact Schillinger’s research has both defined the field of health literacy as well as advanced the larger discipline of health communication sciences. The impact of his work includes (1) demonstrating the disproportionately critical role that communication plays in all aspects of health care delivery for vulnerable populations, including its contributions to access, quality, and safety and (2) developing curricular and programmatic content for 40
  42. 42. practitioners and health systems to improve health communication for patients with communication barriers (e.g. language and literacy). Schillinger’s research has demonstrated the scientific links between health communication, health care quality, patient safety and clinical outcomes, as well as provided evidenced-based, systems-directed solutions to improve communications for populations with communications barriers. He has shown that for patients who are usually considered ‘“hard-to-reach,’” developing communication expertise at the individual clinician level, as well as communication capacity at the health system level, can yield disproportionate gains in health for vulnerable populations, and can help sustain the clinicians who care for them. He has applied a range of research methods geared toward vulnerable populations to demonstrate the effects of communication barriers and sub-optimal communication on health care experiences and health outcomes; identify clinician communication behaviors; and apply theory to inform literacy and language-appropriate health system interventions. This work positions Schillinger as a key member of the “translational research” community at UCSF. Schillinger’s work was one of the reasons why, in 2005, the American Medical Association recognized SFGH for developing exemplary programs to improve communication between health care professionals and patients. Schillinger also has influenced practice through his efforts to advance a health communications agenda in the health policy arena. Arguing that health literacy reflects the balance between the communication demands of the health system and the current capacities of the patients they serve (Am J Bioethics 2007), he has leveraged results of his communication research to affect change to promote systems changes in quality and patient safety at the local, state, and national levels. For example, he provided key input to the American College of Physicians Foundation Health Communication Initiative and co-created the limited-literacy communication, Living Well with Diabetes Guide, which has been distributed in English and Spanish to more than 1,000,000 people with diabetes. He has worked with public and private groups including the National Quality Forum; the American Medical Association; the Joint Commission on Accreditation of Healthcare Organizations; the National Association of Public Hospital Systems; the Institute of Medicine; and the US Surgeon General. Dr. Schillinger also has been a mentor for more than 25 research fellows and junior faculty at UCSF in the field of communication (in multiple disciplines including nursing, pharmacy, adult literacy, public health and medicine), many of whom have gone on to have successful careers in the field. He also developed curriculum and teaches medical residents in the UCSF Primary Care Training Programs on such topics as shared decision- making, health literacy, overcoming language barriers, and eliciting patient narratives. 41

×