Federal Grants Help UC Researchers Improve Care for Chronically Ill Patients

CINCINNATI—Researchers at the University of Cincinnati have received several grants from the Health Resources and Services Administration (HRSA) to help create and maintain programs for the health care of vulnerable and chronically ill populations.

The department of family and community medicine received a $1 million grant to develop a curriculum to teach family medicine residents how to work with the community and improve the health of the underserved populations. Additionally, researchers in the department of internal medicine received a $1.2 million renewal grant to expand the Ohio Valley Sickle Cell Network.

The family medicine award will fund a five-year project, led by Joseph Kiesler, MD, aimed at helping medical residents identify factors that contribute to the burden of disease in populations at risk for certain chronic illnesses, like diabetes and cardiovascular disease, and to communicate with peers and community stakeholders effectively to spread the message.

"Increasing cultural diversity and socioeconomic disparities creates vulnerable patient populations who have unique health care needs and different health outcomes,” says Kiesler, an associate professor in the department. "Having a primary care physician reduces these disparities, and exposing family physicians in training to these populations increases the likelihood that they will care for these patients in the future.”

Shannon Bolon, MD, an assistant professor and co-director of the project along with Kiesler and Phil Diller, MD, PhD, says the curriculum will help develop physicians who are active in the community by teaching residents to assess the problems that affect these populations and equip them to become engaged in their communities to improve health outcomes.

"As part of this project, we want family medicine residents to design and execute a community-based participatory project to assess and improve disease in a vulnerable population,” Bolon says. "Residents will teach their peers using interactive seminars, provide feedback to one another, form partnerships with community stakeholders and members and practice communicating outside of the traditional clinical setting.

"This will all be part of a scholarly portfolio that will be used for program evaluations.”

Kiesler says this project has the opportunity to improve the way physicians are trained by giving them hands-on experience and could make a large impact on the way health care is practiced in the community.

"Access to care is just one of the determinants of health,” he says. "There are many health disparities in our communities, and physicians must know how to identify and address them, as well as how to work with individuals in the community to make the necessary changes happen.

"This is just one step in learning how to work together to improve health care in our community and beyond.”

Tiffiny Diers, MD, director of the Ohio Valley Sickle Cell Network and an assistant professor of medicine and pediatrics, says the funding allotted to her program will help to expand its reach and impact.

"This grant will help us improve access to and quality of care for patients living with sickle cell disease via the creation of networks,” she says. "We must include primary care providers and sickle cell centers to aid with the subspecialty of care and partner with consumers and community-based organizations to truly impact patient care.”

As part of the grant, Diers says they are expanding partnerships to include the Health Care Connection—a network of community health center sites that includes the Lincoln Heights Health Center—and the Cincinnati State Community Health Worker training program.

Other partnerships include the Pediatric Comprehensive Sickle Cell Center at Cincinnati Children’s Hospital Medical Center, the local chapter of Sickle Cell Affected Families, the Adult Sickle Cell Center and the medicine and pediatrics practice at UC, and Winton Hills Medical and Health Center, now known as WinMed.

The program, which began in 2006, supports collaboration among sickle cell experts for the maintenance of a comprehensive treatment network in Cincinnati, helping patients of all ages optimally manage care on their own.

Sickle cell disease is an inherited disorder in which red blood cells are abnormally shaped. This abnormality can result in episodes of severe pain, serious infections, chronic anemia and organ damage.

Diers says the program focuses mainly on establishing primary care medical homes—or comprehensive care models—for patients with sickle cell disease, self-management programming to coach patients in day-to-day health behaviors and pediatric-to-adult transitional treatment.

"With this grant, we hope to expand our community partnerships which will in turn help us reach more patients,” says Diers, "We will continue to develop a medical home and resource for patients, creating a better care system for those living with the disease.”