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Evaluation of Expecting Success
The Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation’s program, Expecting Success, is designed to bring quality improvement techniques to bear on the problem of racial and ethnic disparities in health care. In the program, up to 10 hospitals will participate in a collaborative effort to improve the quality of inpatient care for African American and Latino patients with coronary artery disease and congestive heart failure. At the same time, through a less prescribed set of demonstration projects, the grantees will also address the broader continuum of cardiovascular care outside the walls of the hospital. CHPSR has been asked to evaluate this new initiative in partnership with the Center for the Evaluative Clinical Sciences at Dartmouth (CECS). The evaluation will have multiple components and use a multidisciplinary approach to understand program implementation and outcomes.
Principal Investigator(s): John Billings
Co-Principal Investigator(s): Carolyn Berry
Collaborator(s): Jan Blustein, Steven Finkler, Sue Kaplan
Health Literacy
United Hospital Fund / Literacy Assistance Center
CHPSR is working with the Literacy Assistance Center and the Mayor’s Health Policy Advisor to help foster partnerships between adult education centers and health care institutions that will enhance curricula about health navigation skills, and raise awareness among providers about obstacle to health faced by populations with low levels of literacy.
Principal Investigator(s): Sue Kaplan
Optimizing Future Roles of Psychiatrists in a Changing Health Care Environment
This study is designed to (a) critically examine the future role of psychiatrists in public sector care, given transformations in health care delivery and (b) to assess the responsiveness of psychiatric residency training programs to such changes. Forces whose impact is being examined include changes in the psychiatric knowledge base (e.g., diagnostic breakthroughs, advances in neurobiology and psychopharmacology); the proliferation of non-physician professionals licensed to provide psychotherapy; the ascendancy of managed care; reductions in availability of funds for psychiatric training; and the prevalence of severe mental illness among marginalized populations in public settings. A survey of directors of all 180 residency programs in psychiatry across the country will assess the current status of training for public sector care. The content of the survey has been informed by the views of leaders in education and practice who were interviewed in depth about essential preparation for caring for public sector patients.
People with Serious Mental Illness and the Criminal Justice System
Center for the Study of Issues in Public Mental Health, Nathan Kline Institute for Psychiatric Research, National Institute of Mental Health
Several projects are underway in this area. One study seeks to describe, in-depth, the core operating principles, values, and strategies used by an innovative, and award-winning, alternative to incarceration program for felony offenders with serious mental illnesses. The goal of this study is understand and then disseminate how this unique program is successful in minimizing the incarceration of people with serious mental illness and supporting their transition to community life. Another study, based on in-depth interviews with 20 former offenders with serious mental illness who are now living independently in the community, describes the life histories of those who end up in the criminal justice system and explores the factors that have helped them make it in the community.
Principal Investigator(s): Colleen Gillespie
Social Determinants and the Environment in Pediatric Asthma
National Institute of Environmental Health Sciences (NIEHS)
This project investigates the racial disparities in pediatric asthma outcome among low income African-American, Latino and Caucasian elementary school-aged children in Chicago. The goal is to clarify the biologic and environmental, and the social and behavioral processes that lead to these disparities. An asthma screen in Chicago public schools yields three groups of children: one group that has previously diagnosed asthma and a second group that has possible, undiagnosed asthma, and a third group that has no evidence of asthma symptoms. The children screening positive will be followed every 6 months for 12 months to obtain three points of data. A random sample from those who screen negative for asthma will be recruited as a comparison group for the first data point only. Telephone and in-person surveys will gather information on child asthma control and general physical health, and caregiver life stressors, physical health and depression. Children who screened positive for asthma will have allergy testing at school for common respiratory allergies. The T2 interview is conducted during a home visit, at which time a home environmental screen is conducted and 2 dust samples collected and later analyzed for 2 dust mites, cockroach and cat antigen. The T3 interview includes questions about how parents made the decision whether or not to seek care, from whom and with what success. Selected healthcare providers will be sent a questionnaire regarding the children's care. All stages of the project include a community out reach and education plan, culminating in community meetings in the final year to share results and consider next steps.
Principal Investigator(s): Carolyn Berry
