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Current Projects & Initiatives
CHEQR has brought together the following research teams to collaborate on the following areas of health disparities:
- Adolescent Health Care Transition
Research Team Members: David Wood M.D. M.P.H. (UFCOM-J/DCHD), William Livingood Ph.D. (UFCOM-J/DCHD), Greg Sawicki M.D. M.P.H. (Boston Children’s Hospital), I-Chan Huang Ph.D. (UFCOM-Gainesville), Katryne Lukens Bull M.P.H. (UFCOM-J), Nathan Demars M.S. (Boston Children’s Hospital), Xiaoping Yin M.S. (DCHD) - Health Literacy and Stroke
Research Team Members: Scott Silliman M.D. (UFCOM-J), Nader Antonios M.D. (UFCOM-J), Kalina Sanders M.D. (Resident, UFCOM-J), David Wood M.D. M.P.H. (UFCOM-J/DCHD), William Livingood Ph.D. (UFCOM-J/DCHD), Edwidge Bryant Ph.D. (UF College of Education – Gainesville) - Diabetes Translational Research
Research Team Members: Arshag Mooradian M.D. (UFCOM-J), Linda Edwards M.D. (UFCOM-J), Carlos Palacio M.D. (UFCOM-J), Kent Wehmeier M.D. (UFCOM-J), David Wood M.D. M.P.H. (UFCOM-J/DCHD), William Livingood Ph.D. (UFCOM-J/DCHD), Katryne Lukens Bull M.P.H. (UFCOM-J), Rebecca Filipowicz M.S. M.P.H. (DCHD), Elena Reuter M.P.H. (DCHD) - Cancer Survivorship
Research Team Members: Betsy Shenkman Ph.D. (UFCOM – Gainesville), David Wood M.D. (UFCOM-J/DCHD), Patricia Sheerer M.D. (UFCOM- Gainesville)
The goals of these collaborations are: 1) to generate evidence and insights that lead to improvement in the health of the people of Northeast Florida, 2) to disseminate the results of research in the form of scholarly presentations, abstracts and articles in peer-reviewed publications and 3) to prepare and submit grant applications. These collaborative teams work through a process that includes:
- Identify one or more research questions related to health disparities
- Develop a research protocol and submit the protocol for IRB review
- Pursue one of the following two options:
- Conduct the research protocol within available resources and produce scholarship
- Collect preliminary data that can be used to develop grant proposals to conduct the research
Each collaborative team is at a different stage of this process. Additional research teams are currently being formed on topics including developmental assessment of children in subsidized day care, childhood obesity, and multiple sclerosis.
Adolescent Health Care Transition
The stage of emerging adulthood is one in which youth face a number of challenges and transitions in their path to independent adulthood, including transitioning from high school to college, work or vocational training; forming more independent romantic relationships or independent households, having Children and transitioning from the pediatric health care system to the adult health care system. Youth with special health care or educational needs face significant obstacles as they age out of highly supportive child health care and educational services and need to:
- Assume responsibility for their own health care utilization
- Assume responsibility for their own disease management
- Pursue educational/vocational goals
- Develop independent living skills
Youth are at various stages of readiness to assume these responsibilities. Transitioning behaviors can be supported through science-based assessment and interventions.
Transition Readiness Assessment Questionnaire (TRAQ) 3.0
David Wood, M.D., and William Livingood, Ph.D., developed the TRAQ based on a review of the existing literature and on a theoretical framework of skills needed to navigate health care transition successfully. For each identified area or skill they have applied as a measurement scale the five-stage Stages of Change model. The instrument was sent to experts in the field of health care transition and they were asked to prioritize items and provide feedback on item content. A revised version was administered to 15 youths and tested for readability and clarity. The resultant questionnaire has 11 subscale scores and is organized in the following three domains: managing your own healthcare, interacting with healthcare providers, and other translation activities.
The questionnaire has been administered to over 200 adolescents. Patient and staff scores were tested for agreement using t-tests, correlations and the Kappa statistic for agreement. Factor analysis was conducted on both patient and staff subscale scores.
Wood is collaborating with a number of other investigators to field and test the TRAQ 3.0, including Gregory Sawicki, M.D., instructor in pediatrics at Harvard Medical School and associate director of the Pediatric CF Center Division of Respiratory Diseases at Children's Hospital Boston, as well as Patricia Shearer, M.D., an associate professor of pediatrics and director of the Cancer Survivor Program at the University of Florida in Gainesville.
Health Literacy and Stroke
Stroke is a common and significant cause of morbidity and mortality. Stroke is the third leading cause of death, after heart disease and cancer and is the most common life threatening neurologic condition. Approximately 700,000 cases of stroke are reported in the USA each year. Of these cases, 200,000 represent stroke recurrence. The risk of stroke recurrence, with its potential for development of further morbidity and mortality, depends on follow up care to minimize or eliminate contributing risk factors. Therefore, the ability of patients who have experienced a stroke to understand and adhere to stroke prevention measures is crucial to preventing subsequent stroke. We propose to investigate the levels of health literacy among patients who recently experienced a stroke and have participated in the in-patient stroke service at UF&Shands, Jacskonville. We will explore the relationship between the populations’ demographic and clinical characteristics, level of health literacy and their comprehension and retention of stroke prevention education content. Subsequent studies will follow this cohort of patients to determine their health outcomes related to their health literacy pre and post stroke.
Immunization Levels Among Inner City Children Enrolled in Subsidized Childcare
Data on the timely receipt childhood immunizations by inner city, preschool children is not readily available. We measured immunization rates among preschool children in subsidized child care as a window into the inner-city, poor preschool population. The subsidized child care populations was geographically representative of the general population of inner-city, poor, preschool children (r.0.94). Only 73.3% were up-to-date at 3 months and 44.2% at 12 months of age (3 DTaP, 2 HIB, 2 IPV, 3 Hep B). This study suggests that children enrolled in subsidized child care are both potentially underserved and an accessible window into the inner-city preschool population.
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