Patricia S. Levinson Fellowship for Community Oriented Research and Service
2013 Projects
1. Health Services Research
This project is patient-physician communication about healthcare costs. The aim of the work is to identify barriers to communication about costs between doctors and patients and improve access to medications, health care services and assistance programs for older patients with financial barriers to care. I'm also examining cost-effective prescribing of hypertension medications.
Preceptor: Alex D. Federman, MD, MPH
Department of Medicine/General Internal Medicine
E-mail: alex.federman@mountsinai.org
Tel: 212-241-8605
2. Health Insurance Choices among Low and Middle Income Seniors
Seniors face many challenges to selecting optimal health insurance or prescription coverage. The purpose of this study is to identify characteristics of individuals that influence this selection process and use this information to develop interventions to facilitate insurance decision making. A major focus of this study is the effects of health literacy and cognitive function on plan choice, hence we have collected extensive data on health plans, preference for coverage, cognitive function, education and literacy, and health status and function, among others. The parent study for this project is a survey of 454 seniors from 30 community-based settings New York City that was conducted in the summer of 2007.
Preceptor: Alex D. Federman, MD, MPH
Department of Medicine/General Internal Medicine
E-mail: alex.federman@mountsinai.org
Tel: 212-241-8605
3. Community-Based Health-Related Applied Research from a Behavioral/Social Science Perspective
Projects available deal with culture and health; health literacy; substance mis-use/abuse, and barriers to access to care from the provider's and recipient's perspective.
Preceptor: Mary Foley, EdD
Department of Community and Preventive Medicine
E-mail: mary.foley@mssm.edu
Tel: 212-241-6430
4. Growing Up Healthy in East Harlem - Environmental Determinants of Childhood Obesity
Our Community-Based Participatory Research (CBPR) project is studying structural features of the urban built environment of East Harlem, New York City with particular attention to: 1) accessibility of parks and recreational areas 2) opportunities and spaces for physical activity 3) safety 4) neighborhood aesthetics and 5) accessibility to healthy foods. We are measuring diet, body size, family stressors, physical activity levels, environmental chemicals in urine, and neighborhood environmental factors ("built environment"). Our goal is to characterize features in the built environment of East Harlem associated with overweight and obesity in girls and boys and to design evidence based prevention strategies.
Preceptors: Maida Galvez, MD, MPH and Barbara Brenner, DrPH
Department of Pediatrics and Preventive Medicine
E-mail: maida.galvez@mssm.edu
Tel: 212-824-7148
5. The Doctor is Out!
This project is in development and plans to capture the true spirit of Community Pediatrics by bringing pediatric well child visits into the great outdoors. General Academic Pediatrics Faculty/Fellows along with Pediatric Residents from Mount Sinai will schedule bimonthly outings with families so they can receive counseling on the importance of regular physical fitness with the goal of promoting the concept that every step counts! Pediatric providers along with Sinai families will walk, hop, skip and run in local parks including Central Park's Harlem Meer and the Conservatory Garden, resources that while present 5 minutes from Mount Sinai, many families don't know they exist.
This project aims to advance the concept of primary prevention by providing a direct means for pediatricians to assess and promote four season outdoor physical fitness. An anticipatory guidance curriculum will be developed along with an evaluation protocol that assesses families' knowledge, their resources used and general fitness measures including step counts as measured by pedometers. The evaluation component will be based on protocols in place in Growing Up Healthy and Cyclopedia.
Principal Investigators: Cappy Collins, MD, MPH, Maida Galvez, MD, MPH
Department of Pediatrics and Preventive Medicine
E-mail: cappy.collins@mssm.edu
E-mail: maida.galvez@mssm.edu
Tel: 212-824-7148
6. Green Building Project
We are conducting a project on the health impacts of living in a LEED certified affordable Green building that has active design health credits. The building, Forest House, is being built in the South Bronx and we intend to interview new tenants before and after they move into the building using validated questionnaires on exercise had nutrition. We will assess the impact of the environmental design as well as the rooftop community supported agriculture program on their health. Also to be interviewed, as a comparison group, are the tenants of Melrose House, a LEED certified affordable apartment building without active design health credits in the same neighborhood. Investigators include the Department of Preventive Medicine, NYCDOHMH and BlueSea Development.
Preceptors: Elizabeth Garland, MD and Sadie Sanchez, MD
Department of Community and Preventive Medicine
E-mail: elizabeth.garland@mssm.edu
Tel: 212-824-7056
7. Gardasil Vaccination Rate Improvement Project
CDC's national teen vaccination data shows that far too few U.S. girls are getting the human papillomavirus (HPV) vaccine. We are partnering with the Mount Sinai School Health Program to use electronic health records and the New York Citywide Immunization Registry (CIR) to establish current HPV vaccine rates in the East Harlem school population and subsequently develop and implement interventions to improve HPV vaccine coverage in this community.
Preceptors: Elizabeth Garland, MD and Kristin Oliver, MD
Department of Community and Preventive Medicine
E-mail: elizabeth.garland@mssm.edu
Tel: 212-824-7056
8. Community-Based Research and Education Related to Diabetes and Obesity
A dynamic community-academic partnership dedicated to preventing and controlling diabetes in East Harlem has been awarded a large CDC REACH grant to conduct community based approaches to tackle these problems. We will be developing a variety of local assessments and interventions focused on environmental, behavioral and clinical factors. Interested students would have an opportunity to take on one of many important roles in this project. Students could be paired with a researcher and community leader on a planned project. We also welcome ideas from students who want to work with researchers and community leaders on diabetes and obesity prevention and treatment.
Preceptor: Carol Horowitz, MD
Departments of Health Policy and Medicine
E-mail: carol.horowitz@mssm.edu
Tel: 212-659-9567
9. Stroke Prevention in Harlem
Adults who have had strokes are likely to have another stroke, unless their risk factors (such as high blood pressure and high cholesterol) are controlled. We are beginning a community-based intervention to help adults control these risk factors and avoid future strokes. Students would have an opportunity to work with project leaders (researchers and community leaders) to develop our strategies to engage local people in these efforts, to develop a peer-led educational program, and conduct screenings throughout Harlem to identify people at highest risk for having a stroke.
Preceptor: Carol Horowitz, MD
Departments of Health Policy and Medicine
E-mail: carol.horowitz@mssm.edu
Tel: 212-659-9567
10. The Witness Project of Harlem and Esperanza y Vida
These are culturally competent breast and cervical cancer education program for African American and Latina women. Each is designed to increase adherence to recommended screening guidelines. For each program, we train breast cancer survivors, referred to as Witness Role Models (WRMs), to share their own experience of cancer diagnosis and treatment. Other women from these communities are trained as Lay Health Educators, to teach breast and cervical cancer facts as well as to dispel known myths. Together, the women go as teams, into the community, raising awareness of the importance of screening and the location of places to go for screening. The project aims to increase the number of African American and Latinas who understand the importance of early detection. Our goals also include understanding the factors which serve as barriers or facilitators of cancer screening, research participation by community members, and increasing physician support of cancer screening and research, thereby increasing support and enrollment of community members.
Preceptor: Lina Jandorf
Department of Oncological Sciences, Cancer Prevention and Control
E-mail: lina.jandorf@mssm.edu
Tel: 212-659-5506
11. African American Colorectal Cancer Research Study
This study seeks to understand the most effective method of assisting African American primary care patients in completing their physician recommended colorectal cancer screening. Through screening a substantial amount of deaths may be prevented. In a randomized clinical trial we are comparing the use of professional-led patient navigation (PN-PRO) and peer-led navigation (PN-PEER) to help participants manage (i.e., navigate) the health care system in order to complete screening. Key outcome measures will include adherence to CRC screening and the relative cost-effectiveness of PN-PRO, PN-PEER, and usual care (UC).This research brings together public health professionals and researchers in cancer prevention from Mount Sinai Medical Center, the Internal Medicine Associates (IMA) health clinic.
Interns will be an instrumental part of this research by:
- Completing interviews with study participants
- Performing statistical software data entry
- Maintaining a filing system
- Conducting literature reviews on minority participation in research and health based interventions
- Developing an annotated bibliography from the literature review
Preceptor: Lina Jandorf
Department of Oncological Sciences, Cancer Prevention and Control
E-mail: lina.jandorf@mssm.edu
Tel: 212-659-5506
12. Family Groups to Reduce Youth Behavioral Difficulties - MFG Project
The Multiple Family Group Project (MFG) is a research study that examines the effectiveness of a multiple family group (MFG) service delivery strategy on child mental health service use and mental health outcome for urban, low-income children of color. The study is specifically targeted to children, between the ages of 7 to 11 years with disruptive behaviors, and their families. MFGs are in several mental health clinics, preventive agencies, and schools within primarily African-American and Latino communities throughout New York City, Long Island, and Westchester County. Students' work will include consenting and screening families and conducting periodic assessments. Students may be responsible for tracking assigned families and addressing any barriers to continued participation. Spanish language abilities are preferred but not required. A willingness to work with a broad group of people from different backgrounds (professionals, parents, children, etc.) required.
Principal Investigator: Mary M. McKay, PhD
Project Director: Kara Dean-Assael, LMSW; Lydia Franco, LMSW
Department of Community and Preventive Medicine
E-mail: mary.mckay@mssm.edu
E-mail: anil.chacko@mssm.edu
E-mail: mary.cavaleri@mssm.edu
Tel: 212-659-8836
13. Racial Disparities in the Quality of Prostate Cancer
For younger men (<65 years of age) with high risk locally advanced (>stage 2C), active treatment with surgery or radiotherapy appears to improve disease-free and overall survival as compared to active surveillance (no active treatment). Minority men are less likely to receive active treatment but the reasons for this haven't been evaluated in younger men. Since black men with prostate cancer are younger at diagnosis, more likely to have poorly differentiated tumors, less likely to receive active treatment and more likely than white men to die of prostate cancer, it is possible that the quality of prostate cancer care delivered may be contributing to the racial disparity in mortality. While it is clear that physician recommendation and physician specialty affects the type of prostate cancer treatment recommended and ultimately received, little is known about racial differences in which treatments are offered to minority vs. nonminority men and why. Nor are there data explaining younger minority men's lower rates of active treatment in circumstances when active surveillance does not achieve the same benefits of active treatment. This study seeks to measure the quality of prostate care received by men attending a teaching hospital with faculty, clinic, and community-based practices serving men from Harlem with a new prostate cancer and seeks to identify both patient-based and physician-based reasons for the treatments received.
Preceptor: Nina Bickell, MD, MPH
Departments of Health Policy and Medicine
E-mail: nina.bickell.mssm.edu
Tel: 212-659-9567
14. Insulin Resistance and Breast Cancer Prognosis in Black & White Women
Despite improvements in breast cancer diagnosis & treatment, Black women with breast cancer continue to have a worse prognosis than White women. The purpose of this study is to determine whether differences in insulin resistance can explain in part the disparities in breast cancer survival between Black and White women. Insulin resistance is an important component of obesity, the metabolic syndrome and early stage type 2 diabetes, conditions associated with more aggressive breast cancer subtypes & increased mortality. We aim to recruit 936 white women & 350 black women with a newly diagnosed breast cancer, to investigate the links between insulin resistance, breast cancer aggression, and race. Measures of insulin resistance, the metabolic syndrome and obesity will be collected to investigate whether insulin is a key mechanistic link in the association between obesity and breast cancer aggressivity, and how race affects this association.
Preceptor: Nina Bickell, MD, MPH
Departments of Health Policy and Medicine
E-mail: nina.bickell@mssm.edu
Tel: 212-659-9567
Derek LeRoith, PhD
Medicine, Endocrinology, Diabetes and Bone Disease
E-mail: derek.leroith@mssm.edu
Tel: 212-241-6306
Funded by the National Cancer Institute
15. Engaging Neighborhoods in General And personalized Genomics Education
This study will be developing, evaluating and disseminating informational modules for community members regarding the role of genomics in health and the use of personal genetic information by community members and their healthcare providers.
Preceptor: Lynne D. Richardson, MD
Department of Emergency Medicine
E-mail: lynne.richardson@mssm.edu
Tel: 212-824-8066
16. The ACED Study - Achieving Blood Pressure Control in ED Patients with Undiagnosed or Uncontrolled Hypertension
This study will enroll ED patients with undiagnosed or uncontrolled hypertension into a randomized, controlled interventional trial of a care management program tailored for Black and Latino patients from the East and Central Harlem communities.
Preceptor: Lynne D. Richardson, MD
Department of Emergency Medicine
E-mail: lynne.richardson@mssm.edu
Tel: 212 824-8066
17. Early Life (Prenatal and Early Childhood) Predictors of Developmental
Dr. Wright's focus is on early life (prenatal and early childhood) predictors of developmental diseases including asthma, obesity, neurobehavioral development, and lung growth and development. A particular interest has been on population-based studies considering the role of both social (e.g., psychosocial stress) and physical (e.g., air pollution, allergens) environmental factors in explaining health disparities among urban, ethnic minority populations
Preceptor: Rosalind Wright, MD
Department Pediatrics, Pulmonary and Critical Care
and Department of Preventive Medicine
E-mail: rosalind.wright@mssm.edu
Tel: 212-241-7788