Implementing Effective Smoking Cessation Pharmacotherapy for Hospitalized Smokers with Cardiopulmonary Disease
- PI: Quinn Pack
- Dates: 2022-2027
Although smoking is the leading cause of premature noncommunicable death in the United States and contributes to millions of hospitalizations annually, most hospitalized smokers are rarely prescribed any kind of smoking cessation medication to help them quit. In this project, we will employ a nurse practitioner-led, hospital-based tobacco treatment team to prescribe effective medications, counsel patients on how to use them properly, and manage a text messaging system to support patients after discharge. Our goal is to maximize medication use, medication adherence, and smoking cessation. We anticipate demonstrating the effectiveness, feasibility, acceptability, cost- effectiveness, and sustainability of this program, so that, in the future, more hospitals will be able to capture the “teachable moment” of hospitalization to help smokers quit permanently.
Funding: NHLBI (R01HL156851)
A mixed methods study to identify and refine implementation strategies to increase use of cardiac rehabilitation for patients with heart failure
- PI: Tara Lagu
- Dates: 2019-2024
Cardiac rehabilitation (CR), a secondary prevention program that includes exercise training and risk factor education, improves outcomes in patients with heart failure (HF), but few patients with HF participate in CR. Through statistical analyses of the records of Medicare beneficiaries with HF, qualitative interviews, and a Delphi panel of experts, we will describe the organizational strategies and contextual factors that have improved risk-standardized CR participation rates for patients with HF. The results of this study will inform practice, policy, and future research.
Funding: NHLBI (R01HL19014)
Improving Participation in Pulmonary Rehabilitation through Peer-Support and Storytelling
- PI: Peter Lindenauer
- Dates: 2021-2022
Chronic Obstructive Pulmonary Disease (COPD) affects approximately 16 million Americans, and is characterized by recurrent exacerbations that lead to 1.5 million Emergency Department visits and 700,000 hospitalizations annually. Pulmonary rehabilitation (PR) is a structured program of exercise and self-management support that has been proven to relieve shortness of breath and increase quality of life when initiated after an exacerbation, but unfortunately, few eligible patients participate. This project will compare the effectiveness of two novel strategies – one involving video narratives of other patients telling their story of how they overcame challenges and completed PR, the other involving telephonic peer-coaching – to enhanced usual care, and to each other, at increasing patient participation in PR after an exacerbation.
Funding: NHLBI (R61HL157847)
Identifying effective strategies used by Medicare Accountable Care Organizations to improve outcomes for patients with heart failure: A mixed-methods study
- PI: Tara Lagu
- Dates: 2018-2022
Accountable Care Organization (ACO) enrollment is expected to expand rapidly in upcoming years, resulting in an urgent need to understand the impact that ACOs have on processes of care and outcomes for the more than 5.7 million Americans with heart failure (HF). Through statistical analyses of the records of Medicare beneficiaries with HF, qualitative interviews, and a survey of all ACOs participating in the Medicare Shared Savings Program (MSSP), this study will describe the organizational strategies and contextual factors of ACOs that have, over time, reduced their risk-standardized acute admission rates for patients with HF. The results of this study will inform policymakers and health system and ACO leaders as they develop and refine novel organizational strategies for improving care for patients with HF.
Funding: NHLBI (1R01HL139985)
De-Implementation of Low Value Imaging in Pulmonary Embolism (DELVE PE)
- PI: Lauren Westafer
- Dates: 2021-2026
Computed tomographic pulmonary angiograms (CTPA) for pulmonary embolism (PE) are ordered in nearly 2% of all 120 million Emergency Department visits in the United States each year; however, many of these are avoidable. Despite prior research in this area, unnecessary testing remains common and subjects patients to additional costs, ionizing radiation, risk of anaphylaxis from contrast dye, and harms from overdiagnosis and overtreatment. To improve the quality and efficiency of care for patients with suspected PE, this investigation will refine, pilot, and evaluate the acceptability and appropriateness of an empirically-derived multi-dimensional strategy that targets unique barriers to de-implementing low-value imaging.
Funding: NHLBI (K23HL155895)
Development and Feasibility Assessment of a Train-the-Trainer Model to Improve Access to an Evidence-Based Parenting Intervention for Mothers in Recovery from Substance Use Disorders
- PI: Elizabeth Peacock-Chambers
- Dates: 2021-2022
Parents with substance use disorders face unique challenges and require targeted supports. “Mothering from the Inside Out” (MIO) is an evidence-based parenting program shown to both support a parent’s recovery and strengthen the parent-child relationship. In order to bring this intervention to scale and make it more readily accessible to parents in recovery, a new training model was needed. This pilot award brings together a multi-disciplinary team to develop and test the feasibility of training community-based providers to deliver the training for MIO.
Funding: Tufts University Clinical and Translational Science Institute Pilot Award Program (UL1TR002544)
Shared Decision-Making for the Promotion of Patient-Centered Imaging in the Emergency Department: Suspected Kidney Stones
- PI: Elizabeth Schoenfeld
- Dates: 2018-2023
The use of advanced diagnostic imaging has risen dramatically in the past decade, to over 70 million CT scans performed annually, or approximately one CT scan performed each year for every 4.2 Americans. Although appropriate in many cases, CT scans increase health care costs and Emergency Department length of stay, expose patients to ionizing radiation, and increase patients’ risk of future cancer. As patients with kidney stones are at high risk for repeated exposure to radiation, this project aims to increase patients’ participation in decision-making and safely decrease CT utilization for this population, decreasing their exposure to radiation and therefore reducing their future cancer risk.
Funding: AHRQ (1K08HS025701)
SPOiLER: Safer Prescribing of Legal Opioids from the Emergency Room
- PI: William Soares
- Dates: 2018-2023
Prescription opioid medications, although an important treatment option for acute painful conditions, have contributed to the opioid epidemic through nonmedical use, dependence and addiction. Despite attempts to regulate opioids, including state legislation such as the 2016 Massachusetts (MA) Opioid Law that restricts initial opioid prescriptions, there remains a lack of evidence to adequately assess the impact of such controls, in part because the factors that influence opioid prescribing behaviors and subsequent adverse patient outcomes remain poorly understood. Using the theory of planned behavior, the proposed mentored research project will evaluate how factors, including provider characteristics, cultural and social norms, and external controls like the 2016 MA Opioid Law, influence opioid prescribing behaviors and the development of patient- level opioid related adverse clinical events for emergency department patients presenting with an acute painful condition.
Funding: NIDA (1K08DA045933)
A Mixed Methods Study to Analyze the Use of Pulmonary Rehabilitation Following Hospitalization for COPD, and to Identify Effective Strategies for Increasing Rates of Participation
- PI: Peter Lindenauer
- Dates: 2017-2022
Chronic obstructive pulmonary disease (COPD) affects as many as 24 million individuals in the US and is responsible for more than 800,000 hospitalizations each year. Patients who require hospitalization suffer profound reductions in functional status and health-related quality of life that can take months to recover from. Pulmonary rehabilitation (PR) is a structured set of interventions that includes exercise training, education, behavior change and support, designed to improve the physical and psychological well-being of patients with chronic respiratory disease. Our long-term goal is to improve the quality of life of patients with COPD by optimizing participation in PR. The objective of this R01 is to analyze the translation of PR into routine clinical practice among Medicare beneficiaries following hospitalization for COPD, and to identify the factors and strategies that enable some hospitals to achieve higher rates of participation than others.
Funding: NHLBI (5R01HL133046)
The University of Massachusetts Medical School Center for Clinical and Translational Science (CCTS)
The University of Massachusetts Medical School Center for Clinical and Translational Science offers educational programs to expand the critical mass of expert scientists undertaking clinical and translational research through innovative education, training, and mentoring programs. They also offer mentoring support grants (KL2, K12, TL1) fellowships, and forums for junior faculty. This includes:
Research Career & Writing Group "K-Club"
The UMCCTS Research Career & Writing Group (K-Club) was established in 2007. Most individuals who participate and apply for a research career award have been very successful in getting funded (>80% success). K-Club meets every other week to provide information and feedback on academic career development and on preparing a Research Career Award application (NIH K Awards, VA Research Career Awards, CTSA K grants, etc.).
Tufts Clinical and Translational Science Institute
Tufts Clinical and Translational Science Institute (CTSI) offers a wide array of courses, workshops, and seminars in topics such as clinical and translational research, career development, grant writing, quality improvement, and regulatory affairs. They also offer mentoring support grants, fellowships, and a forum for junior faculty.
The Tufts CTSI also offers a Research Collaboration (RC) Team. The RC Team meets monthly and is comprised of Tufts CTSI Navigators and representatives from partner organizations with a wide variety of research and grant writing expertise. The team offers grant critiquing services, known as “Research Studios,” to help researchers hone their research proposals.
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of databases, software tools and related products developed through a Federal-State-Industry partnership and sponsored by AHRQ. HCUP databases are derived from administrative data and contain encounter-level, clinical and nonclinical information including all-listed diagnoses and procedures, discharge status, patient demographics, and charges for all patients, regardless of payer (e.g., Medicare, Medicaid, private insurance, uninsured), beginning in 1988. These databases enable research on a broad range of health policy issues, including cost and quality of health services, medical practice patterns, access to health care programs, and outcomes of treatments at the national, State, and local market levels.
The Research Data Assistance Center (ResDAC) provides free assistance to academic and non-profit researchers interested in using Medicare, Medicaid, SCHIP, and Medicare Current Beneficiary Survey (MCBS) data for research. Primary funding for ResDAC comes from a CMS research contract. ResDAC is a consortium of faculty and staff from the University of Minnesota, Boston University, Dartmouth Medical School, and the Morehouse School of Medicine. ResDAC offers a number of services for researchers with all levels of experience using or planning to use CMS data. Services include technical data assistance, information on available data resources, and training.
UMass Chan Medical School–Baystate, 3601 Main Street, 3rd Floor
Physician-investigators, epidemiologists, and biostatisticians on our DHDPS faculty are available to help Baystate faculty develop research protocols, write grants, and design evaluations of health system initiatives intended to improve care quality, value, or reduce disparities.
We are available for consultation by appointment—in person, through videoconference, or phone.
Work with us to:
- Refine your research question
- Develop specific aims and hypotheses
- Choose the right study design
- Plan a data collection strategy
- Conduct sample size and power calculations
- Plan the statistical analysis
- Visualize results
(Photo: Dr. Elizabeth Schoenfeld Receiving New Investigator Award. L to R: Drs. Lindenauer, Baevsky, Schoenfeld, Friedmann)
Schedule a Research Help Session
If you would like to schedule an appointment, please email DHDPS@baystatehealth.org.