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Archive for July, 2013

Southern Heart Specialists Merges Into Emory Specialty Associates

Wednesday, July 31st, 2013

Southern Heart Specialists, P.C. (SHS) has merged into Emory Specialty Associates (ESA), a wholly owned subsidiary of Emory Healthcare. With this merger, SHS joins forces with Emory Healthcare and Emory University School of Medicine.

Opening its doors in 1975, SHS was the first office in south metro Atlanta to provide cardiovascular care on an outpatient basis. The practice has grown to include 13 physicians and a large group of nurses, technologists and staff members. SHS offers a wide range of cardiovascular specialties, including angiography, vascular ultrasound, coronary angioplasty, stenting, echocardiography, nuclear cardiology and electrophysiology.

SHS will continue to offer cardiology services and provide direct patient care at their offices in Riverdale, Stockbridge, Locust Grove and Fayetteville.

 

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Morehouse School of Medicine Addresses Health Needs of the Indigent Through Partnerships

Tuesday, July 30th, 2013

From ATLANTA Medicine, 2013, Care for the Underserved, Vol. 84, No. 2

By Rachel Harris, M.D., M.P.H.

The categorization of indigent in the United States has been the mainstay for many Americans as they are “deficient in what is required”1 to live long, happy and prosperous lives. There are many dynamic elements which play integral roles in this ongoing game of chess, if you may, and delivery of healthcare is one piece among the set. The focus on the indigent has been a long road initially undertaken in the late 1700s – early 1800s and further refined by the 1900s. However, after over 300 years, the predicament of caring for these members of society remains a dilemma.

When one ponders who the indigent person is: a small business owner,  the recently unemployed,  an aspiring student, the mother of five children with a low paying job, or even a family member or neighbor, the call is overwhelming and clear. A resounding cacophony of lack of access, insufficient funds, and untrained healthcare workers to meet these needs, can be replaced by the concerto of collaborative efforts between primary care providers, specialists, medical students, volunteers, community advocates, and hospitals/clinics who all pledge to deliver the best care possible in the most humanistic form imaginable.

In the articles from distinguished faculty at the Morehouse School of Medicine (MSM), the passion is felt from those who care for the young pediatric patient and their families at Healthcare Without Walls: A Medical Home for Homeless Children, to the pride of accomplishment in developing community programs with neighborhood involvement by the MSM Preventive Research Center (PRC) and on to the hope in reducing and finally eliminating disparities that exist by focusing on neglected diseases and underserved populations by the Satcher Health Institute and Transdisciplinary Collaborative Center.

Reference

1 indigent. (n.d.). Collins English Dictionary – Complete & Unabridged 10th Edition. Retrieved February 01, 2013, from Dictionary.com website: http://dictionary.reference.com/browse/indigent

Rachel Harris, M.D., M.P.H., joined the faculty of Morehouse School of Medicine, Section of Cardiology as an Assistant Professor in July 2011 and as Staff Cardiologist at the Atlanta VA Women’s Center of Excellence East Point Outpatient Clinic in September 2012. She enjoys teaching and also serves as one of the Morehouse School of Medicine Internal Medicine Residency Associate Program Directors. Dr. Harris is Board Certified in Cardiovascular Diseases, Internal Medicine, Nuclear Cardiology and Echocardiography. She serves as the Echocardiography Lab Co-Director at Grady Memorial Hospital in Atlanta, GA.

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The Satcher Health Leadership Institute’s Transdisciplinary Collaborative Center for Health Disparities

Tuesday, July 30th, 2013

From ATLANTA Medicine, 2013, Care for the Underserved, Vol. 84, No. 2

By Rachel Harris, M.D., MPH, Elizabeth Ofili, M.D., FACC, David Satcher, M.D., Ph.D., and Rachel Harris, M.D., MPH

The Determinants of Health are the “range of personal, social, economic, and environmental factors that influence health status” and involve the interaction between policy making, social factors, health services, individual behavior and biology/genetics.(1) The World Health Organization, Centers for Disease Control and Prevention, Department of Health and Human Services, as well as numerous state and local level agencies have led the way in redefining care of healthy populations to include social factors that address inequities and the physical conditions in the environment in which people are born, live, learn, play, work and age.(2,3)

The 2011 National Healthcare Quality Report by the Agency for Healthcare Research and Quality (AHRQ) found overall health care quality has improved for the general population between the years of 2002 to 2008, . howeverHowever, of the 250 health care measures tracked, there are persistent challenges in access to health care among racial and ethnic minorities, with 50%  percent showing no improvement in this population as well as 40%  percent of the core measures in this group declining.(4)

The Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine (MSM) was established in 2006 to develop a diverse group of public health leaders, foster and support leadership strategies, and influence policies toward the reduction and ultimate elimination of disparities in health. Led by David Satcher, M.D., Ph.D., and a team of dedicated faculty and staff, the Institute has several programs, including which includes the Center of Excellence for Sexual Health; Community Voices: Healthcare for the Underserved; the Division of Behavioral Health; the Division of Health Policy; and the Division of Health Promotion and Disease Prevention.

The role of SHLI/MSM in caring for the underserved is a pivotal one, not simply from the individual provider-patient standpoint, but also from the national and local perspective of health care leadership and policy. In keeping with the mission to reduce and ultimately eliminate disparities in health, the formula for continued success is by focusing on neglected diseases and underserved populations, while giving priority to health promotion and disease prevention.

In examining underserved populations, there are several factors which that contribute to the inequities that preponderate. Those individuals with inadequate access to health care providers who meet their needs, low socioeconomic status, lack of insurance or affordable access to medical care, and limited English proficiency and health literacy have the most health disparities, with ethnic and racial minority groups frequently found among this population.(4)

The SHLI/MSM will implement a regional approach to address persistent health inequities by leading a Health Policy Transdisciplinary Collaborative Center (TCC) for Health Disparities Research, with the unifying theme of a comprehensive and meaningful approach to the development, advancement and implementation of health policy that harnesses the power of collaboration to bolster innovation, cost reduction and health equity. This recent award by the National Institute on Minority Health and Health Disparities (NIMHD) has been an honor and great achievement by the faculty, researchers and community at large. The TCC will focus on collaborations in the Health and Human Services’ (HHS) region IV, which encompasses Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee.

The SHLI/MSM TCC and its partners will address social inequities that affect child outcomes, mental health, health and health outcomes in vulnerable and high-risk populations, as well as continued implementation of health information technology “meaningful use” in through  academic/community partnerships.

Child Outcomes
Actions to reduce health disparities must start before birth and continue through the life span to reduce inequities due to socioeconomic status or disparate opportunities that deprive a fair and healthy start for all children. Evidence has shown a strong association between poverty and health disparities, including mental health, education and child outcomes.(5) Additional evidence from neuroscience and early childhood development research has shown that early childhood, particularly a child’s first five years, lays the foundation necessary for the complex skills they will need as adults to become successfully employed, lawful, cooperative and productive.(6)

Although there is demonstrable evidence showing that even when policies are in place, written policies alone do not adequately address health inequities until they are supported with effective local delivery systems and community participatory action. Thus, to effectively reduce and ultimately eliminate disparities, the SHLI/MSM TCC will engage nine states’ members of the Centers for Disease Control and Prevention’s Racial and Ethnic Health Disparities Action Institute (REHDAI) to evaluate the extent to which the outcomes of quality parenting impacts healthy child development, and how state and local policies ensure that every child receives quality parenting and early child development through supportive programs and public service delivery systems with community participation in decision-making.

Mental Health and Health Outcomes
Addressing the multi-faceted health and mental health needs of the U.S. population is a complex issue that warrants attention from policymakers, clinicians, researchers, scientists and public health professionals that can offer unique perspectives and strategies to support efforts for greater well-being among individuals.

With growing diversity concerning different ethnicities, nationalities and sexual orientation, and with significant changes in the constellation of the myriad of risk factors that can influence health and health outcomes, it is imperative that we delineate strategic health policies, focused community-based programs, and innovative research that include an examination of evidence-based models that can improve individuals’ longevity and quality of life. These issues have particular relevance for vulnerable and high-risk populations, including veterans, ex-offenders, uninsured, homeless individuals, lesbian, gay, bi-sexual and transgender individuals (LGBT), and racial/ethnic minorities.

There are several key pieces of federal legislation passed by Congress that were designed to have positive health and behavioral health implications for underserved populations, including the Mental Health Parity Act (1996), Second Chance Act (2008), Mental Health Parity and Addiction Equity Act (2008), and the Patient Protection and Affordable Care Act (2010). Although collectively, these health policies support the promotion of better access and utilization of health and behavioral healthcare services, the extent to which policies related to these legislative mandates are implemented remains questionable, and health disparities continue to plague our communities. The SHLI/TCC will implement strategies that integrate mental health in primary care practice settings. Through novel culturally-centered approaches targeted to ethnically and culturally diverse adults, the goals of reducing health and mental health disparities, improving health equity, and enhancing the quality of life for individuals, families, and communities will be accomplished.

Health Information Technology
Using shared learning to enhance academic/community partnerships by leveraging Health Information Technology (HIT) is crucial in developing, informing, and implementing public policies that impact health disparities relative to healthcare quality improvement. The use of shared information in underserved or understudied populations has been successfully implemented in a multi-institutional, multidisciplinary collaboratory model with a focus on key diseases and health conditions which that disproportionately and adversely exist among racial and ethnic minorities.(7)

This model of information sharing has helped in professional validation, transdisciplinary integration,  and improved communication/interventions and as a result has had policy implications and improved health outcomes.(8) Key areas for quality improvement measures include insurance delivery and payment system reforms, health promotion and disease prevention, appropriate data collection and reporting, and comparative effectiveness research based on the health equity agenda of the Affordable Care Act.

Future Leaders
The SHLI currently has two SHLI health policy training programs: SHLI Health Policy Leadership Fellowship Program for postdoctoral professionals and the SHLI Community Health Leadership Program for community leaders and students.

Since its inception, the SHLI Health Policy Leadership Fellowship 10-month program for postdoctoral professionals has 13 alumni and five current fellows, with numerous additional previous summer program and workshop attendees. It is the goal of the fellowship program to develop a diverse group of health leaders who “care enough, know enough, do enough, and are persistent enough” to help realize global health equity.

The Community Health Leadership Program (CHLP) is a 12-session program focused on developing community health leaders with an interactive and community-based curriculum. An important part of the CHLP curriculum is its community-based research and practicum component. The community participants and MSM MPH students partner in developing community projects that must be relevant to community needs, show evidence of sustainability and impact health disparities.

Through a coordinated effort to identify health policy leaders’ training needs for developing, implementing, and changing policies to address disparities in health, the SHLI will continue to work on the behalf of millions of Americans who are affected daily by disparate health challenges and outcomes.

Conclusions
Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative that is shared by the Satcher Health Leadership Institute. The SHLI/MSM TCC proposes transformative health policy goals that will positively impact and sustain health equity across this regional transdisciplinary collaborative.

The ultimate goal of the SHLI is emerging as the preeminent, national health policy center focused on innovation, cost reduction and health equity, emerging as the ‘collaborator of choice’ in leading-edge health policy research focused on health equity, training the next generation of leaders in health policy research, and expanding the diversity of the health policy workforce. SHLI TCC and its partners across HHS Region IV, will significantly impact the health outcomes of participating communities through policy development and implementation.

For more information, visit the Satcher Health Leadership Institute

Rachel Harris, M.D., MPH. joined the faculty of Morehouse School of Medicine, Section of Cardiology as an Assistant Professor in July 2011 and as Staff Cardiologist at the Atlanta VA Women’s Center of Excellence East Point Outpatient Clinic in September 2012. She enjoys teaching and also serves as one of the Morehouse School of Medicine Internal Medicine Residency Associate Program Directors. Dr. Harris is Board Certified in Cardiovascular Diseases, Internal Medicine, Nuclear Cardiology and Echocardiography. She serves as the Echocardiography Lab Co-Director at Grady Memorial Hospital in Atlanta, GA.

David Satcher, M.D., Ph.D, is Director of The Satcher Health Leadership Institute which was established in 2006 at the Morehouse School of Medicine in Atlanta, Georgia. Dr. Satcher was sworn in as the 16th Surgeon General of the United States in 1998 and served until 2002. He also served as the 10th Assistant Secretary for Health in the Department of Health and Human Services making him only the second person in history to have held both positions simultaneously. His tenure of public service also includes serving as Director of the Centers for Disease Control and Prevention (CDC). He was the first person to have served as Director of the CDC and then Surgeon General of the United States. Dr. Satcher has held top leadership positions at the Charles R. Drew University for Medicine and Science, Meharry Medical College, and the Morehouse School of Medicine.

Elizabeth O. Ofili, M.D., MPH, FACC, is a Professor of Medicine, and Chief of Cardiology, at Morehouse School of Medicine. She also serves as the Associate Dean of Clinical Research, and Director of the Clinical Research Center.  Dr. Ofili is known for her expertise in the field of cardiovascular medicine and health disparities with a focus on translating discoveries to benefit patients through community engagement. She has been continuously funded by the National Institutes of Health (NIH) since 1994; Dr. Ofili is the national PI of the WARFARIN study, which was recently approved by the Center for Medicare and Medicaid (CMS) as the first large scale randomized clinical trial to evaluate gene identification ability to predict patient response and improve safety when dosing warfarin, the world’s leading anti-blood clotting drug. A passionate advocate for the inclusion of minorities in biomedical research, she has helped to raise over $150 million in research funds, to support research infrastructure and training at Morehouse School of Medicine.

References
1.    Department of Health and Human Services (US) Healthy People 2020 Framework [cited 2013 Feb]. Available from: URL: http://www.healthypeople.gov/hp2020.
2.    World Health Organization. Report from the Commission on Social Determinants of Health. Geneva: WHO; 2008. [cited 2013 Feb]. Closing the gap in a generation: health equity through action on the social determinants of health. Also available from: URL:http://www.who.int/social_determinants/thecommission/finalreport/en/index.html.
3.    Satcher, D. Include a Social Determinants of Health Approach to Reduce Health Inequities. Public Health Rep. 2010; 125(Suppl 4): 6–7.
4.    U.S. Department of Health and Human Services Agency for Healthcare Research and Quality National Healthcare Quality Report 2011.. AHRQ Publication No. 12-0005. March 2012. [cited 2013 Feb]. Available from: URL: www.ahrq.gov/qual/qrdr11.htm
5.    Briggs-Gowan MJ, Carter AS, et al. Are Infant-Toddler Social-Emotional and Behavioral Problems Transient? J Am Acad Child Adolesc Psychiatry. 2006 Jul;45(7):849-58.
6.    National Scientific Counsel on the Developing Child. The Science of Early Childhoon Developmentt: Closing the Gap Between What We Know and What We Do. Center on the Developing Child at Harvard University;2007. [cited 2013 Feb] Also available from: URL: http://www.developingchild.harvard.edu
7.    Fleming E, Perkins J, Easa D, et al. Addressing Health Disparities through Multi-institutional, Multidisciplinary Collaboratories. Ethn Dis. 2008 Spring; 18(2 Suppl 2): S2–161-7.
8.    Massie LC et al. Measuring collaboration and transdisciplinary integration in team science. Am J Prev Med 2008;35(2S):S151–S160

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Morehouse School of Medicine Prevention Research Center

Tuesday, July 30th, 2013

From ATLANTA Medicine, 2013, Care for the Underserved, Vol. 84, No. 2

By Tabia Henry Akintobi, Ph.D., MPH, Lisa M. Goodin, MBA, & LaShawn Hoffman

Socioeconomic status and ethnicity have been associated with a variety of health outcomes. Blacks have disproportionately higher morbidity and mortality associated with cardiovascular disease, cancer, homicide, diabetes and HIV/AIDS. These persistent trends help to explain the increased focus of public health research agendas on ethnic disparities in health.

Many clinicians and researchers agree that social and environmental factors are crucial to understanding and addressing the determinants of health outcomes that increase the likelihood of mortality and morbidity across the lifespan. Historically, academic research in communities existed in which the academic institution received significant benefit; however, the community held no control of research projects and tended not to receive any benefit.

Oftentimes, this led to the community’s distrust of researchers in communities and the communities’ ultimate lack of participation in research programs1. The evolution and application of community-based participatory research (CBPR) in communities has led to increased research participation and community ownership globally. The Morehouse School of Medicine Prevention Research Center (PRC) has empowered representatives of metropolitan Atlanta Neighborhood Planning Units (NPUs) to define their research, service and education needs to address the health of their neighborhoods.

The PRC was established in 1998 and based on the applied definition of CBPR, where research is conducted with communities in a partnership relationship. This contrasts with the older approach to community-based research in which research was conducted on communities in an arrangement that often resulted in exploitation of the communities.

This positioning of communities as central to identifying their own health priorities is directly aligned with Morehouse School of Medicine’s prioritization of service to the underserved. The PRC’s research partner communities are located within City of Atlanta NPUs V, X, Y and Z. Each City of Atlanta NPU contains  five to 10 well-defined neighborhoods. Each elects officers and holds monthly public meetings to discuss relevant and timely issues of importance to its residents (i.e. city zoning, economic and civic development, etc). The total population of PRC’s partnering communities in NPU V, X, Y and Z is 55,757, with 89.3 percent (48,701) being African Americans. 40.9 percent of African-American households within the four aforementioned NPUs live below the poverty level2.

Community-Prioritized Governance in Setting Health Agendas

The PRC’s partnering NPUs have been faced with increased poverty for decades, a lack of neighborhood resources and a plague of chronic diseases, so historically they have maintained a basic distrust in the research process. Several residents expressed their apprehension about participating in yet another partnership with an academic institution to conduct more meaningless research in their neighborhoods3. So at the outset, the PRC created a governance model in which the community would serve as the “senior partner” in its relationship with the medical school and other academic and agency collaborators.

The PRC is governed by a Community Coalition Board (CCB), to which all the identified partners belong, but community representatives hold the preponderance of power, literally putting them at the forefront of all CBPR and related approaches. Board members, including academic, agency and neighborhood representatives, truly represent the community and its priorities. Academic representatives include the faculty and staff that are frequently engaged in carrying out the research service or training initiatives affiliated with the PRC.

Agency staff (e.g., health department staff, school board representative) may not live in the community where they work, but their agencies serve the communities. Their input has value but represents the goals and objectives of their organization, rather than the lived experience of a resident. Residents of the community – “neighborhood representatives” – are in the majority, and one always serves as Board Chair, as opposed to agency or academic members of the CCB. The PRC’S CCB serves as a policy-making board– not an advisory board, which has created an opportunity for community partners to have an active voice in directing the operations of and sustainability for the Center.

The role of the CCB is to: (a) set policy and oversee the operations of the center; (b) identify priorities and approve projects; (c) provide information on center activities to the organizations and agencies represented on the Board; and (d) develop a strategic plan by which the Center may achieve its long-term objectives. The CCB established and ratified bylaws that provide a written blueprint for the governing body. Subsequently, the CCB articulated its values and priorities through the development, adoption and enforcement of community values, research priorities and evaluation criteria for projects.

The governance of the research partnership is largely through consensus decision making, in which CCB members prioritize critical needs, review them, discuss appropriate solutions and cast a vote during its bimonthly meetings. All decisions are based upon the Board’s charge that all research – past, present and future – is packaged in simple ways for everyone to understand and is disseminated to individuals, communities, organizations and institutions in partnership with the PRC and its partners. Therefore, projects, if successful: 1) will contribute to a reduction in the disparity in health status between the white population and the African American or other minority population; 2) will contribute to improving the health status of African American males; and 3) will reduce injustice, including environmental injustice.

Establishment of a governing body that ensures community-engaged research can be challenging when: 1) academicians have not previously been guided by neighborhood experts in the evolution of a community’s own natural environment, 2) community members have not led discussions regarding their health priorities, or 3) academic, agency and neighborhood experts have not historically worked together as a single body with established rules guiding roles and function. The PRC, however, has successfully engaged in community-research partnerships that have been sustained for more than a decade3.

According to the former CCB Chair, Ella Heard Trammell, community members allow researchers conditional access to communities in order to engage in research, training and/or service initiatives with established community benefit. To that end, engagement of community partners involves an investment of time, dialogue, compromise and consensus toward selective participation in activities with bi-directional value. The PRC’s ability to actively engage the CCB in a meaningful way (where they see value in the Center’s work and positive impacts within their communities) has led to the retention of community partners since the PRC was founded.

Community health priorities assessment surveys are conducted by the PRC staff and partnering communities at least every two years. CCB members are trained to conduct the surveys in their communities, and the results are disseminated throughout community-based venues, e.g., CCB and NPU meetings; PRC newsletters, website; and via CCB member communication in their communities.

PRC core research and other PRC projects are also developed specifically in response to priorities identified through the assessment surveys. The most recent (and prior) community health needs assessments identified HIV/AIDS prevention as the top priority, with cancer and heart disease/stroke prevention following closely. Therefore all MSM PRC core research projects target HIV/AIDS prevention among African Americans including the projects titled HIV/AIDS Prevention among African American Women [1998-2004]; HIV/AIDS Risk Reduction among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Project (2004-2009); and Prevention Intervention: Meeting Them at the Gate (An African American male targeted detainee release HIV/AIDS prevention project, 2004-2014).

Cancer research projects were also sought, written with CCB review and recommendations, resulting in funding of cancer-focused projects like the Cancer Prevention and Control Research Network (2004-2009), Ethno-cultural and Regional Variations in Prostate Cancer Knowledge, Attitudes and Screening Behaviors of African American and Jamaican Black Men (2006-2010), and the Southeastern United States Collaborative Center for the Elimination of Health Disparities (SUCCEED), which focused on breast and cervical cancer screening (2007-2012), and the Colorectal Cancer Screening Intervention Project (2004-2009).

These projects were incorporated into the expansion of the PRC research design by developing the PRC Community-based Cancer Unit, which is also advised by the CCB and works in tandem with the Atlanta Cancer Awareness Partnership (a city-wide community board that guides cancer research efforts) to increase its cancer-focused outreach in communities.

The PRC is an award-winning center that has been nationally recognized for its sustained collaborations with the CCB in effective community-based participatory research (CBPR). The organization Community-Campus Partnerships for Health honored the PRC in 2002 in recognition of the Center’s community partnership’s “exemplary contribution towards improving health professions education, civic responsibility, and the overall health of communities.” A Certificate of Appreciation for “outstanding dedication to communities with the REACH for Wellness Program” was awarded by the Fulton County Department of Health and Wellness in 2005. Georgia Healthcare Foundation’s presented the PRC with its 2010 Joseph D. Greene Community Service Award for “continued extraordinary commitment to improving the quality of health.”

The PRC also received four Centers for Disease Control and Prevention (CDC) awards: Outstanding Community-Based Participatory Research Award in 2004, Award for Excellence in Community-Based Research in 20054; an award for effective implementation of CBPR in 2010, and Best Practice Award in Community-Based Participatory Research in April 2011.

Community Partner Benefits

The employment of community persons on the core HIV research projects is a tangible benefit of the community’s participation as a partner. Other benefits community members have gained are research development, training and evaluation of core HIV research skills through training by PRC researchers and staff. Further, community-based radio broadcasts on a local Atlanta radio station, WYZE 1480 AM, have facilitated real-time dialogue between metropolitan Atlanta community members and researchers to increase awareness regarding HIV and other community health issues through which communities can be empowered to improve their health.

Other benefits have been the creation or expansion of jobs and health promotion initiatives through grants for community-led health initiatives, like the recent award of the Minority Men’s Oral Health and Dental Access Program – a community-campus project led by a community-based organizations, funded to increase an understanding of oral health issues and to increase access to oral healthcare among African-American men living in NPUs V, X, Y and Z.

An expansion of the research goals beyond HIV afforded the PRC with an opportunity to apply for and receive diverse grant funding, resulting in other projects benefitting the community. One such program involved decreasing the “digital divide” among communities in which few people had computers. Now the community area has a technology center that is still operational. This allows people in the community who did not have access to computers and the internet with the opportunity to expand their knowledge and develop skills to improve their standard of living.

The Colorectal Cancer Screening Intervention Project involved seniors in an education series on colon cancer screening tests. The information was disseminated to senior citizens facilities, recreational centers, YMCAs and churches in PRC’s partnering communities. The funding of evaluation projects has led to the establishment of our Evaluation Unit, in which evaluation leadership in partnership with community-based organizations has resulted in communities’ capacity to assess their own programs.

Academic Partner Benefits

The implementation of the CBPR model has been the cornerstone of the PRC’s success in building effective community-campus partnerships. This model is being used as the guide for other federally and privately funded grants that foster community-driven health initiatives designed to addressing health disparities and to also guide researchers on the processes critical to effective CBPR.

For example, the Community Engagement and Research Program (CERP), through the Atlanta Clinical and Translational Science Institute, funded by the National Institutes of Health to Emory University, is led by the PRC. CERP unites existing academic community research partnerships, develops new bi-directional collaborations and seeks to transform research from a scientist-subject interaction that generates publishable data to a more equitable partnership – one in which the process of research, as well as the outcomes, benefit both the researchers and the community.

The PRC also leads the Community Engagement Core for the National Institutes of Health-funded Center of Excellence in Health Disparities-Reducing Health Disparities in Vulnerable African American Families and Communities. The grant has the overriding goal of building the capacity of partner communities to reduce racial and ethnic health disparities through systematic engagement in the planning, implementation and evaluation of CBPR through health priority assessment, advising community-engaged research, and connecting families to medical homes.

Conclusion

Researchers that work with community coalitions utilizing a participatory approach build trust and a sense of ownership of the prioritized health issues through identifying the most culturally relevant approaches. While not without challenges due to differing priorities and being accountabilities5, major lessons learned are that: 1) community partnerships are developed over months or years, and therefore should not ideally depend on a single grant, and 2) genuine partnership means resources and control are shared and that academic partners must be prepared to share funds or to serve in a support role with communities serving as fiscal agents for the health initiatives that they lead3, 6.

The effective use of CBPR has helped the PRC and the CCB to develop collaborative solutions that have brought the community and the institution together as equal partners in developing targeted approaches to addressing health disparities.

For more information, visit Morehouse School of Medicine Prevention Research Center.

Acknowledgment

NIH: ULIRR025008, Clinical and Translational Science Award; CDC: U48DP000049, Health Promotion and Disease Prevention Research Center; U58DP000984, Racial and Ethnic Approaches to Community Health (REACH); U57CCU42068, Community Cancer Control

References

1Blumenthal, D.S. A Community Coalition Board Creates a Set of Values for Community-Based Research
Preventing Chronic Disease [serial online] Available from: URL: http://www.cdc.gov/pcd/issues/2006/jan/05_0068.htm, 2006.

22005-2009 American Community Survey [Georgia]/prepared by the U.S. Census Bureau, 2011.

3Henry Akintobi, T, Goodin, L., Trammel, E., Collins, D., & Blumenthal, D. “How do you set up and maintain a community advisory board?” Section 4b of “Challenges in Improving Community Engagement in Research,” Chapter 5 of The Clinical and Translational Science Awards Community Engagement Key Function Committee Task Force on the Principles of Community Engagement. Principles of Community. Engagement, 2nd Edition. Washington, DC: U.S. Department of Health and Human Services, 2011.

4Centers for Disease Control and Prevention. Prevention Research Center 20th Anniversary Program. Accessed 4/25/07

5Blumenthal, D. Is community-based participatory research possible? American Journal of Preventive Medicine, 40(3), 386-389.2011.

6Blumenthal, D. “How do you start working with a community?” Section 4a of “Challenges in Improving Community
Engagement in Research,” Chapter 5 of The Clinical and Translational Science Awards Community Engagement Key Function Committee Task Force on the Principles of Community Engagement. Principles of Community Engagement, 2nd Edition. Washington, DC: U.S. Department of Health and Human Services, 2011.

Tabia Henry Akintobi, PhD, MPH received her Master of Public Health degree and Doctorate of Philosophy in Public Health from University of South Florida’s College of Public Health. She is an Associate Professor of Community Health and Preventive Medicine at the Morehouse School of Medicine and Director of its Prevention Research Center. She has over a decade of experience in the conduct and evaluation of community-based participatory research, training and service initiatives.

Lisa M. Goodin, MBA is the Associate Director for the Morehouse School of Medicine Prevention Research Center.  Ms. Goodin has responsibility for the management of the Center’s participatory community‐based research projects, development of community partnerships, management of evaluation programs, and health promotion and disease prevention initiatives. She led the Center’s Core HIV Risk Reduction project focused on African American women. She produces and serves as a co‐host on MSM PRC’s Community Health Connections radiobroadcast (designed to promote health and aid in eliminating health disparities) and is at the helm of the Center’s social media development and implementation.

LaShawn M. Hoffman is one of Atlanta’s most distinguished young civic leaders. An 10-year resident of the city’s southwest neighborhoods, Mr. Hoffman lives and works in Atlanta’s historic Pittsburgh community. He currently serves as Chief Executive Officer (CEO) of the Pittsburgh Community Improvement Association, Inc. (PCIA) a neighborhood-based not for profit community development corporation.Through his leadership, this neighborhood-based community development corporation is preparing for thoughtful development, both human and physical, as the Pittsburgh community embraces a city that is constantly changing.  LaShawn’s other numerous civic activities includes Chairperson for the Morehouse School of Medicine Prevention Research Coalition Community Board.

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Georgia Psychiatric Physicians Association Summer CME Meeting

Friday, July 26th, 2013

July 26-27, 2013, Amelia Island, Fla. For more information, visit Georgia Psychiatric Physicians Association

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Researchers Seek Clues to Progression of Parkinson’s Disease

Thursday, July 25th, 2013

Emory researchers are conducting a prospective clinical study to examine the possibility of diagnosing Parkinson’s disease (PD) before motor symptoms occur. The study is an arm of the Parkinson’s Progression Markers Initiative (PPMI), which was launched in 2010 by The Michael J. Fox Foundation for Parkinson’s Research to help define one or more biomarkers of PD.

The PPMI study included early, untreated PD patients, and this arm of the study will include pre-symptomatic patients. The study will examine biomarkers indicative of conversion from no motor symptoms to the typical neurological disorder. Patients will undergo Single-Photon Emission Computed Tomography (SPECT) and Magnetic Resonance Imaging (MRI), and have tests to examine brain proteins that mark the disease, and possibly mark the conversion to symptomatic disease.

“Presently, there is no test for diagnosing Parkinson’s,” says Stewart Factor, professor of neurology at Emory University School of Medicine and principal site investigator of the study. “It is a clinical diagnosis based on history and clinical examination findings.

“Since Parkinson’s disease is a progressive disorder, we believe that by learning to recognize pre-motor symptoms for PD, we may be able to develop therapies that would delay or prevent the onset of the impaired movements, tremor and gait problems in PD patients.”

In PD, the nerve cells that produce dopamine, a chemical messenger in the brain that is responsible for movement, are degenerating. As time goes on, the dopamine decreases to a threshold level that leads to problems with motor coordination and muscle control. The time from the start of degeneration to the development of symptoms could be as long as 10 years.

The pre-motor arm of PPMI will enroll participants who do not have motor symptoms of Parkinson’s disease, but are living with one of three potential risk factors for PD:  a reduced sense of smell; rapid eye movement sleep behavior disorder (acting out one’s dreams); or a mutation in the LRRK2 gene — the single greatest genetic contributor to PD known to date. Then the participants will be followed over several years to see if, or when, they develop Parkinson’s disease.

Volunteers who participate in the Emory trial will complete a brief online survey about their sense of smell. Some of the participants will then be mailed a scratch-and-sniff smell test and brief questionnaire to be completed at home and returned to the researchers.

Once the researchers have collected the information, some individuals may be asked to undergo a SPECT imaging scan to examine the integrity of the dopamine system. If abnormal, they will be asked to participate in the study for the next few years. Alternatively, if they have rapid eye movement sleep behavior disorder, a sleep study will be reviewed and if confirmed they will have the SPECT imaging study done.

“While most people with a reduced sense of smell will not develop PD, the loss or reduction of the ability smell is a common early feature in people with Parkinson’s,” Factor explains. “Decreased sense of smell is demonstrated in 90 percent of early-stage PD cases. Smell loss begins an average of four years before being diagnosed with the disease.”

Factor is director of the Emory Comprehensive Parkinson’s Disease Center, and director of the movement disorders program in the Department of Neurology at Emory.

A consortium of 13 industry partners funds the Parkinson’s Progression Markers Initiative. Emory is one of 23 official sites involved in the trial.

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Emory Nurse Practitioner Wins Award for Exemplary Care

Wednesday, July 24th, 2013

Emory Healthcare nurse practitioner Christine Nell-DybDahl, MSN, MPH, was recently awarded the 2013 Life Changer Award presented in partnership by the American Association of Nurse Practitioners (AANP) and Health Monitor Network.

The award recognizes and honors outstanding service to patients and community care by nurse practitioners. Nell-Dybdahl was nominated by two of her patients at the Emory Center for Heart Disease Prevention (ECHDP) where she practices.

Nell-Dybdahl is the Clinical Nurse Director of the ECHDP, a member of Emory Women’s Heart Program, as well as the founder and clinical director of the Emory Women Living with Angina Support Group.

Nell-Dybdahl has been a nurse since 1994 and a nurse practitioner since 1999. She graduated from the Emory Nell Hodgson School of Nursing (SON) with a dual masters degree in nursing and public health. She is also adjunct faculty with the SON and assists with the training of nurse practitioner students.

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CTCA at Southeastern Regional Medical Center Grows Physician Roster

Wednesday, July 24th, 2013

Cancer Treatment Centers of America® (CTCA) at Southeastern Regional Medical Center (Southeastern) continues to add its clinical team, which has grown to more than 420 employees in less than a year of operation. The group of new physicians is board certified and includes specialists in medical oncology, radiation oncology and internal medicine.

John McKnight, MD, MBA, is a medical oncologist with more than 25 years of experience in oncology care. Dr. McKnight earned a medical degree from Howard University College of Medicine in Washington, D.C., and is board certified in medical oncology by the American Board of Internal Medicine. He completed an internship and residency at District of Columbia General Hospital and University of Pittsburgh Medical Center Presbyterian Hospital, and a fellowship in medical oncology at the National Cancer Institute in Bethesda, Md. Dr. McKnight worked in private practice for 23 years while also serving as vice chairman of the department of medicine at Washington Hospital Center and senior staff oncologist at the center’s Washington Cancer Institute, all in Washington D.C. He also earned an MBA with a focus on medical management from The Johns Hopkins University in Baltimore.

Sean Cavanaugh, MD, is a radiation oncologist and experienced radiosurgeon for both extracranial and intracranial malignancies. He regularly performs high-dose rate and low-dose rate brachytherapy, as well as all aspects of highly conformal external beam radiation therapy. Dr. Cavanaugh received a medical degree from Texas Tech University Health Sciences Center School of Medicine in Lubbock. He completed a general pediatrics internship at the University of Texas Health Science Center at San Antonio, where he also completed the B. Leonard Holman Pathway Residency in radiation oncology. Certified by the American Board of Radiology, Dr. Cavanaugh has worked in private practice in both Texas and Georgia, and received Georgia’s Favorite Physicians Award in 2009, 2010 and 2011.

James Braude, MD, has more than 30 years of clinical experience and serves as an outpatient internal medicine physician. Dr. Braude earned a medical degree from Emory University School of Medicine, where he also completed his internship and residency, and is board certified by the American Board of Internal Medicine. Dr. Braude served as a clinical instructor at Emory University School of Medicine, and was director of clinical methods at Emory University School of Physicians Assistants. In addition to these appointments, he has worked in private practice and was director of a clinical research facility in Atlanta devoted to AIDS research.

Sanjukta Rinku Chatterjee, MD, FACP, has more than 15 years of clinical experience and serves as an outpatient internal medicine physician. Dr. Chatterjee earned a medical degree from Tufts University School of Medicine in Boston, with an internal medicine residency at Emory University School of Medicine. She has served as the faculty advisor for Emory University’s internal medicine residents’ practice improvement project, and also worked on the faculty of the International Clinic at Grady Memorial Hospital. Dr. Chatterjee has taught internal medicine courses at both Emory University and Grady Memorial Hospital, and was awarded a Joseph E. Johnson Leadership Day Grant to be a representative from Georgia at the American College of Physician’s Leadership Day on Capitol Hill, working with national lawmakers in Washington D.C. to improve healthcare. An elected fellow of the American College of Physicians, she is board-certified by the American Board of Internal Medicine.

 

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Iraq War’s Most Decorated Physician Joins Piedmont

Tuesday, July 23rd, 2013

Board-certified urologist Richard Jadick, D.O., considered the Iraq war’s most decorated doctor, has joined Piedmont Physicians Group and will be practicing in Newnan, Ga.

Dr. Jadick is part of a  team of advanced urology specialists including Micah Blackmon, M.D., Donald Finnerty, M.D. and Bob Mann, M.D. serving patients at Piedmont Physicians Urology Specialists.

Dr. Jadick is credited with saving the lives of 30 Marines and sailors during a battle in Fallujah, one of the worst urban battles since Vietnam. He volunteered his services for duty in Iraq due to a lack of doctors for the military. In January 2006, Dr. Jadick was awarded the Bronze Star with “Combat V” device for heroic valor, an award bestowed to no other Navy doctor in the entirety of the Iraq war. He later published his own account of his experiences in a book, On Call in Hell: A Doctor’s Iraq War Story.

After spending a year in Iraq, Dr. Jadick returned to the United States to complete his residency. Prior to joining Piedmont Physicians, Dr. Jadick served as the Department Head of Urology at the Naval Hospital in Jacksonville, Fl. He is board certified with the American Board of Urology.

Dr. Jadick earned his bachelor’s degree in biology from Ithaca College and his Doctor of Osteopathic Medicine degree from New York College of Osteopathic Medicine in Old Westbury, NY. He completed his residency training in Urology at the Medical College of Georgia.

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BenchMark Clinicians Receive Certification for Advanced Training

Tuesday, July 23rd, 2013

Nineteen BenchMark Physical Therapy clinicians recently received certification for advanced training.
Fifteen of these therapists sat for the board exam to earn the Orthopaedic Certified Specialist (OCS) credential placing them in the top 2.5% of therapists nationwide. As Orthopaedic Certified Specialists, they are skilled in identifying and addressing the underlying causes of musculoskeletal dysfunction. Those receiving the OCS credential include:

Jackson Ballard, PT, DPT, OCS
Steven Baptiste, PT, DPT, OCS
Anita Boyd, PT, DPT, OCS
Lindsay Caruthers, PT, DPT, OCS
Jennifer Cazeaux, PT, DPT, OCS
Megan Herzwurm, PT, DPT, OCS
Micah Hilton, PT, DPT, OCS
Aaron Honeycutt, PT, DPT, OCS
Erica Hosken, PT, DPT, OCS
Casey Kalb, PT, OCS
Caroline Lawless, PT, DPT, OCS
Tim Lonergan, PT, DPT, OCS
Danielle, Lorenz, PT, DPT, OCS
Grace Mollohan, PT, DPT, OCS
Sarah Webster, PT, DPT, OCS

In addition, Alex Herzlin, PT, DPT, SCS, CSCS. Herzlin completed a residency program and passed the board examination to earn the Sports Certified Specialist designation. Diane Coffey, PT, CHT, received her advanced training in hand-to-shoulder therapy to earn the Certified Hand Therapy (CHT) designation. Trevor Davidson, PT, OCS, MTC, and Matt Pedrotti, PT, DPT, MTC, recently took advanced training in manual therapy to earn a Manual Therapy Certification (MTC).

 

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