The Crisafi-Monte Endowment Fund
The Crisafi-Monte Endowment
Fund has supported a number of research projects including:
A Summer
Medical Student Research Participation Program
PI: Patricia
M. Schwirian, PhD, RN
Time Period:
9/1/06 – 10/31/06
Amount Awarded:
$18,686
Abstract: The purpose of this project was to provide a
supervised clinical research learning opportunity for six medical students.
These Medical Student Researchers participated for six weeks in the MOMS
Project study, “Can Changing How Moms Eat Prevent Obesity in Toddlers?” (1 R21
HD50944001 National Institute of Child Health & Development). This study
was a cooperative venture between Children’s Hospital Department of Ambulatory
Pediatrics and The Ohio State University Department of Family Medicine.
The
students were provided with three types of learning opportunities. First, they
worked in one of the three participating Children’s Hospital Clinics (Westside,
Whitehall,and
Primary Care). They recruited mothers of newborns for the study, conducted a
base-line interview, and entered the data into the MOMS Project database.
Second, the Medical Student Researchers participated in a weekly
research-focused seminar led by members on the MOMS Project research team.
Finally, the Medical Student Researchers participated in the weekly MOMS
Project research team meetings. This combination of learning opportunities
afforded the students a glimpse into the philosophy and processes involved in
the conduct of primary care research in a clinical setting.
The Correlation
of Health Literacy, Diabetes Knowledge, Diabetes Self-Management, and Glycemic
Control in Patients with Diabetes Mellitus
PI: W. Fred
Miser, MD
Time Period: 2/1/07 – 10/31/08
Amount Awarded: $ 39,732
Abstract: Diabetes mellitus is a leading
cause of morbidity, diminished quality of life, and mortality in the United States. Considered a cardiac risk equivalent,
diabetes is a major cause of cardiovascular disease, and is often associated
with hypertension and dyslipidemia.
Clinical guidelines exist that aim for better glucose, blood pressure,
and lipid control in those with diabetes, yet most individuals do not achieve
targeted goals. Although the reason for
this lack of good control is multifactorial, the role of health literacy has
recently been raise. Health literacy is
a constellation of skills that constitute the ability to perform basic reading
and numerical tasks for functioning in the health care environment and acting
on health care information. Recent
studies have suggested that further research is required to determine whether
health literacy is associated with diabetes knowledge and with diabetes
self-management, and whether these three factors are associated with improved
glycemic control.
This cross-sectional survey of
over 500 adults with type 2 diabetes mellitus consisted of administering a
battery of previously validated health literacy, diabetes knowledge, and
diabetes self-management tests and the collection of health information related
to diabetes care from the subjects and their medical records. The purpose of this study was to determine the
strength of relationships, if they exist, of health literacy, diabetes
knowledge, diabetes self-management, and glycemic control. Specifically, the researchers determined the
relationships between: 1) health literacy and diabetes knowledge, 2) health
literacy and diabetes self-management, 3) diabetes knowledge and diabetes
self-management, 4) health literacy and glycemic control, 5) diabetes knowledge
and glycemic control, and 6) diabetes self-management and glycemic control. The
researchers then determined which of these relationships (health literacy,
diabetes knowledge, and diabetes self-management) had the strongest correlation
with glycemic control.
Urban Diabetic Cardiovascular F.I.T.N.E.S.S. Program – Pilot Study Fitness Improved Through Nutrition and Exercise Sustained by Support of Family and Friends
PI: Leon
McDougle, MD
Time Period: 1/1/08 – 6/30/09
Amount Awarded: $ 41,023
Abstract: Study Objective: To determine the
effectiveness of a culturally sensitive lifestyle modification program in an
urban African American adult population. Design: Randomized,
translational, pilot study over a 6-month period. Setting: OSU Family Practice at
University Hospital East located in Near East Columbus. Intervention: Enrollment of 200 Near East Columbus diabetic
patients along with two family members or friends who sign a support agreement
to 1) undergo nutrition and physical activity education modeled after the
Diabetes Prevention Program and 2) volunteer to walk with the diabetic patient
at least 3 to 5 times weekly for 30 to 60 minutes. In this way both primary
prevention of diabetes and cardiovascular disease for friends and family, and
secondary prevention of diabetic and cardiovascular morbidity for the diabetic
patient is promoted. Measurements and
Main Results: All baseline and demographic information from the
participants, both diabetics and family/friends, were summarized. The change in attitudes, physical activity,
body weight and BMI, blood pressure, fasting blood glucose measurements, and
fasting lipids and Hemoglobin A1C (for diabetics) after completing the training
program were summarized and tested using simple paired tests and regression
analysis.
Development of
Culturally Acceptable Patient Centered Self Management Materials for African
American Patients with Hypertension
PI: Randy
Wexler, MD
Time Period: 7/1/07 – 6/30/09
Amount Awarded: $ 33,266
Abstract: Hypertension
is a major cause of morbidity and mortality in the United States especially in African
American patients. The self-management of chronic disease (which includes
medication adherence and lifestyle changes) are recommended for all patients
with hypertension. Unfortunately,
control of blood pressure in the United States is poor and more so
within the African American population.
Although not used at significant levels, patient lifestyle changes or
self-management of chronic disease such as hypertension provides a multitude of
benefits, including improved disease control.
The researchers developed culturally acceptable educational materials to
improve self-management of hypertension in African American patients.
Lifestyle
Behaviors and Correlates of Hypertension in U. S. African American Adults
PI: Chris A.
Taylor, PhD, RD, LD
Time Period: 7/1/09 – 6/30/10
Amount Awarded: $ 30,759
Abstract: Background: Hypertension continues to be a serious public health
concern in the U.S.,
with complications resulting in congestive heart failure, stroke, and chronic
renal failure. African Americans suffer
a disproportionate risk for hypertension, which affects over a third of adults
in this population. Lifestyle behaviors, specifically diet, physical activity,and
smoking, are significant contributors to etiology; these behaviors are targeted
for disease treatment and prevention. An analysis of nationally-representative
sample provided the opportunity to identify key factors related to hypertension
in the African American community. Methods:
The study examined data from the 1999-2006 National Health and Nutrition
Examination Survey (NHANES) to identify the correlates of hypertension in
African American adults. A nationally representative sample of approximately
4,700 African American participants was stratified by hypertension status to
identify differences in sociodemographics, access and utilization of
healthcare, dietary intakes, physical activity habits, smoking status and
presence of comorbidities by hypertension. Hypertension status was evaluated
using: 1) a self-reported diagnosis of hypertension; 2) measured blood pressure
values by a trained examiner; and 3) use of an anti-hypertensive medication.
Individuals were classified into normotensive, pre-hypertensive and
hypertensive (Stage I or Stage II) using Joint National Commission guidelines.
Sociodemographic characteristics were compared across hypertension status to
describe the subpopulations at greatest risk for hypertension. Dietary and
physical activity habits were compared across hypertension status to assess
factors that may explain disease prevalence.
The presence of comorbities, including obesity and metabolic syndrome, were
also assessed to describe the profile of African Americans with hypertension.
Finally, an exploratory objective of the proposed study was to examine the
differences in lifestyle behaviors and other risk factors by severity using
stage of hypertension. Analyses described the populations more likely to
progress to advance stages of hypertension, identify the prevalence of known
long-term consequences and estimate the potential benefits in blood pressure
from the adoption of therapeutic lifestyle behaviors. Conclusion: Understanding
the current lifestyle behaviors of African Americans provided valuable
formative data for the development of culturally-specific lifestyle
modification interventions for the prevention and treatment of hypertensive
African Americans in central Ohio.
Efficacy of Quinapril plus Alpha-lipoic Acid (ALA) on Patients with
Insulin Resistance Syndrome – A Randomized Cross Over Study
PI: Gowrishankar Gnanasekharan, MD, MPH
Time Period: 9/1/09 – 8/31/11
Amount Awarded: $ 63,350
Abstract: The renin-angiotensin system (RAS) is a critical
component for maintenance of physiological homeostasis. However, its
over-activity can lead to the development of pathological cardiovascular
processes such as inflammation, increased oxidative stress and Insulin
Resistance (IR) syndrome. Preliminary data from our group has suggested that
targeted blockade of the RAS with an ARB may improve vascular function, insulin
resistance and prevent premature aging of blood vessels. Further data from our lab has shown
that ALA
which is a common neutricetical when administered to humans with an ACE
inhibitor can potentiate endothelial function and decrease inflammatory
markers. In this study, we hypothesize that the combination of the ACE
inhibitor and ALA
can improve insulin sensitivity, vascular compliance and inflammatory markers
in patients with Insulin Resistance (IR) syndrome. Subjects who are 65 years
and older will be recruited for the study purpose. This study will analyze the
effects of 12 week administration of quinapril plus lipoic acid versus
quinapril plus placebo on indices of insulin sensitivity, vascular compliance,
inflammatory markers and adiponectin. This crossover study will consist of 2
treatment arms, (Treatment A: Quinapril and Treatment B: Quinapril+ ALA), each
12 weeks in duration with a 4 week washout period followed by cross-over.The
change in insulin sensitivity (Homeostasis Model Assessment, HOMA-IR) and vascular compliance will be primary end-points for
the study while change in inflammatory markers and adiponectin will be
secondary end points. Arterial compliance will be measured using a validated
system that measures pulse wave velocity and augmentation index. The proposed
studies have the potential to develop new preventive treatment paradigms for
the elderly that are cheap inexpensive and free of side-effects.
Medical Student Partners in Health
PI: Douglas
M. Post, PhD
Time Period: 9/1/09 – 8/31/10
Amount Awarded: $ 40,000
Abstract: Preparing medical students to care for an aging population
with chronic disease is critically important to the future of health care in
the U.S. Future physicians need to understand how to establish long-term
relationships with older patients and how to help them effectively manage their
disease. In 2001, an educational program on geriatrics for OSU medical students
was established, titled the “Senior Partners Program.” In this curriculum, students
are paired with healthy seniors in the community and complete a series of
assignments. Some students have benefited from an understanding that aging is
not synonymous with infirmity, but have not learned key concepts in this
program , such as health care delivery systems, aging and chronic disease
management. The proposed study aims to enhance their learning in these key
areas. Its purpose is to develop and test an innovative education curriculum
designed for first-year students and investigate the effects of this program on
patient and medical student outcomes, and to examine primary care physicians’
responses to the educational intervention. During the first three months of the
project, a group of OSU primary care physicians will be recruited to
participate in the pilot study. Those who agree to participate will be asked to
refer patients from their practices to help create a cohort of 30 patients who
are age > 65 years and have been diagnosed with uncontrolled Type 2 diabetes.
These patients will be paired with 30 first-year medical students randomly
selected from all students who express interest in the new curriculum. Students will receive training on the
effective delivery of the curricular intervention prior to implementation. The
intervention program will be delivered over the next eight months of the study.
Students will perform a needs assessment with their senior partner and will
work with the patient to develop and implement a personalized chronic disease
management program. The effects of the intervention on patient and medical
student outcomes will be investigated in a quasi-experimental two group
pretest-posttest design. Participating primary care physicians will be asked to
respond to a survey to assess their responses to the intervention. The final
month of the project will focus on the completion of data analysis and writing
of study reports. Pilot data from this project will be an important component
of a proposal to the National Institute of Aging for support of a full-scale
implementation of our innovative curriculum.
