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News and Announcements

Current Scholar Spotlight

Mitesh PatelMitesh Patel, MD, MBA (Internal Medicine) is a 2nd year UPenn Robert Wood Johnson Clinical Scholar. One area of his work is focuses on how to address cardiovascular risk factors such as obesity and physical inactivity to improve population health. He is the lead investigator of several clinical trials that leverage innovations in technology to passively monitor activity and utilizes financial, social incentives, and comparative feedback to motivate behavior change. The UPHS Weight Loss Study is a 12-month randomized controlled trial that evaluates how innovations in health benefit design incentives can motive obese employees to lose weight. This project is supported by a grant from the University of Pennsylvania Health System. Dr. Patel is also interested in evaluating how health policy design can impact health behaviors at a national level. More about this work can be found here.

Dr. Patel also studies how to improve the delivery of high-value, cost-conscious health care. His prior work has been published in the New England Journal of Medicine, JAMA Internal Medicine and featured in the New York Times. He was a member of the ACP’s Curriculum Development Committee on High-Value, Cost-Conscious Care and has published The VALUE Framework as a tool for physicians to integrate these concepts into patient care. He is currently evaluating national adoption of physician workforce training on cost-conscious care initiatives and how information technology interventions can be leveraged to reduce the use of low-value services. More about this work can be found here.

Research Spotlight

Inglis House

During Summer 2013, the 2013-2015 University of Pennsylvania Robert Wood Johnson Clinical Scholars set out to provide recommendations to improve the quality of life for residents at long-term care facilities. Working in partnership with the Pennsylvania Empowered Expert Residents (PEERs) of Inglis House and the Center for Advocacy for the Rights and Interests of inglis house 2the Elderly (CARIE), the Scholars created a set of recommendations in in response to the following charge:

  1. Understand the elements that impact quality of life for individuals living in long-term specialty care facilities
  2. Develop strategies for individuals living in long-term specialty care facilities to actively partner with staff and administration to improve quality of life
  3. Identify ways in which these findings may be disseminated locally and/or nationally

Inglis House is a specialty nursing care facility providing long-term, residential care for 297 adults with physical disabilities, including multiple sclerosis, cerebral palsy, spinal cord injury and stroke, among others. Residents receive rehabilitative medical and nursing care; physical, occupational and speech therapies; and a selection of more than 20 social enrichment and therapeutic recreation programs every day.

The Scholars conducted a needs assessment through interviews with Inglis House residents, staff, and community stakeholders. Through this process, three core principles relating to quality of life were identified: communication, autonomy, and accountability. Subsequent recommendations were organized around these core principles:

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Communication. The Scholars recommended using one or more of the following approaches to improving communication:

  • Implement new education curriculum
  • Focus on conflict resolution
  • Integrated resident & staff training

Autonomy. The Scholars recommended implementing the following changes to increase resident autonomy:

  • Create a bed-bound team to provide outreach and social enrichment to residents isolated due to medical illness
  • Improve resident profiles
  • Promote self-advocacy

Accountability. Inglis House residents, staff, and administrators believed that accountability to each other, and to themselves, was critically important to quality of life. The Scholars therefore recommended clarifying the feedback options and training the PEERS as guides to facilitate residents working through the feedback loop:

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The newly proposed suggestions to improve quality of life at Inglis House were presented to the Inglis House community at the end of the summer. After the final presentation, the Scholars used a community-engaged model (learning circle composed of residents, staff, and administrators) to discuss prioritization of recommendation implementation. Out of this meeting, the following recommendations were identified as community priorities:

  1. inglis house 3Implementing conflict resolution and self-advocacy curricula
  2. Promoting discussion around sensitive topics
  3. Clarifying feedback processes

Since the summer, the PEERs have reported that the administration, staff, and PEERS have been working as a team to implement the changes suggested in the Scholars’ report, The View from Here: Resident Quality of Life at Long-Term Care Facilities.

Alumni Spotlight

matthew o'brien photoMatthew O’Brien, MD, MSc (Internal Medicine) is an alumnus of the UPenn Robert Wood Johnson Clinical Scholars Program (2007-2010). Dr. O’Brien is currently an Assistant Professor of Medicine and Public Health at Temple University in its Center for Obesity Research and Education. While a Clinical Scholar, Dr. O’Brien co-founded Puentes de Salud (“Bridges of Health”), a nonprofit organization providing primary health care and a variety of other health-related programs in the South Philadelphia Latino community. He currently serves as a regular provider at Puentes de Salud and is also the medical director, overseeing its clinical programs. Dr. O’Brien has developed a research agenda around this workpuentes to improve general knowledge about Latino health and generate best practices to reduce Latino health disparities nationwide. As part of a 5-year NIH grant, his group is currently developing and studying an intervention to prevent diabetes delivered by Puentes de Salud’s community health workers. Starting in 2007, Puentes de Salud’s community health worker program was the first of its kind in Philadelphia. And since then, Dr. O’Brien and his community health workers have helped organizations throughout the region develop similar health outreach and education programs.

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Previous Spotlights

Scholar Spotlights

chilesheChileshe Nkonde-Price, MD (Cardiology) is a 2nd year UPenn Robert Wood Johnson Clinical Scholar who is pursing research designed to improve the health and healthcare of African American Women with heart disease. Dr Nkonde-Price is conducting a study of women enrolled in the VIRGO study that seeks to highlight the patient and community level factors that influence outcomes in women recovering from MI. The VIRGO study is the first prospective study of young black and white women hospitalized and recovering from MI. This project is supported by grants from the Eisenberg Award and Robert Wood Johnson Clinical Scholars Grant.

 

change my steps

Dr Nkonde-Price is also the principal investigator on a community based qualitative study¬† “Using storytelling and digital technology to understand and promote ideal cardiovascular health: The ChangeMySteps Project”. This study involves interviewing African Amercian women in hair salons to understand the barriers and design the promising solutions chilesheto physical inactivity, healthy eating and smoking cessation. Using data from the project, Dr Nkonde-Price conducted a pilot study, The ChangeMySteps Walking Challenge that tested the ability to use mobile technology (namely mobile phones applications) and twitter to promote physical activity among African American women. This project is supported by grants from the Eisenberg Award and Robert Wood Johnson Clinical Scholars Grant and a Robert Wood Johnson Health and Society Scholars Grant.

More information about the ChangeMySteps Project can be found here.

 

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Shreya Kangovi, MD (Internal Medicine/Pediatrics) is a 2nd-Year UPenn Robert Wood Johnson Clinical Scholar who is pursuing community-based research that will lay the groundwork for establishing an infrastructure of community health workers (CHW) who can improve health outcomes for socioeconomically vulnerable patients. During her time on the program, Shreya has designed and implemented a randomized-controlled trial of The Patient-Centered Transition (PaCT) Project. PaCT is a novel intervention which utilizes community health workers (CHWs) to provide socioeconomically vulnerable patients with advocacy, social support and navigation through the transition from hospital to primary care. PaCT is supported by grants from the Bach Fund, the Clinical and Translational Sciences Award for Community-Based Research Small Grants Program, the Eisenberg Award, the Penn Medicine Department of Internal Medicine and the Presbyterian Medical Center Department of Medicine Fund. More information about the PaCT program can be found here. photo

Dr. Kangovi is also the principal investigator on a qualitative study, 'Patient Perceptions of Transition'. This study explores the perceptions that underinsured patients have of their post-hospital transition to primary care. This study is supported by a grant from the Leonard Davis Institute. In addition, Dr. Kangovi has created a survey instrument focused on the challenges patients face after being discharged from the hospital. This survey is currently being administered by nurses, social workers and clinical resources managers to all patients readmitted to any Penn Medicine hospital. Read more about Shreya’s work in the Philadelphia Inquirer and NPR’s Marketplace.

 

brandiBrandi Kaye Freeman, MD (Pediatrics) is a 2nd year UPenn Robert wood Johnson Clinical Scholar who is pursuing research in two areas that are grounded in trying improve care delivery in the 21st century. Dr. Freeman is conducting a pilot study to try to improve the pediatric telephone triage process using videos obtained by parents via mobile phones. This study is grounded in trying to integrate how we use available technology (namely mobile phones) to provide visual information to clinicians to improve communication in care delivery. This project is supported by grants from the Eisenberg Award and a Robert Wood Johnson Health and Society Scholars Pilot Grant.

 

busDr. Freeman is also the principal investigator on a qualitative study, “Understanding Challenges in the Health Professional Pipeline.” This work inspired by Dr. Freeman’s advocacy efforts geared at supporting and improving diversity in the health professional pipeline. The project is in partnership with the grassroots organization formed by formed medical student leaders, Tour for Diversity in Medicine, which brings physicians, dentists, medical students and health professions advisors from diverse backgrounds to disadvantaged undergraduate institutions to “inspire, cultivate and mentor” students.

mentorsMore information about the Tour for Diversity in Medicine can be found here (www.tour4diversity.org). The goal of Dr. Freeman’s work with the Tour for Diversity is not only improve this program but to influence the institutions and policymaking bodies that train and support the healthcare workforce.

 

 

 

Alumni Spotlight

ZachZachary Meisel, MD, MPH, MS (Emergency Medicine) is an alumnus of the UPenn Robert Wood Johnson Clinical Scholar program (2008-2010) and is now a faculty member at the University of Pennsylvania and a frequent contributor to discussions on health services, both in peer-reviewed journals and online forums like Time.com. Dr. Meisel’s areas of interest and research expertise include Narrative Medicine, Health Services Research, Emergency Care Access and Utilization, Patient Safety, Emergency Medical Services, Medical Journalism, Medical Writing, Communication, Dissemination and Translation of Health Services Research Results, Comparative Effectiveness Research Funding and Federal Policy. Beginning in Summer 2013, Dr. Meisel will co-teach HPR 600: Introduction to Health Policy and Health Services Research for all incoming RWJ Clinical Scholars and his roles at UPenn include Senior Scholar in the Leonard Davis Institute of Health Economics, Medical Editor of The Health Economist, a policy journal from the Leonard Davis Institute of Health Economics, and Patient Safety Officer at the Hospital of the University of Pennsylvania. In addition, he is an Associate Editor at Academic Emergency Medicine and an advisor to the PCORI methods committee for incorporating narratives in to methodology standards for comparative effectiveness research.

Dr. Meisel contributes to a regular Medical Insider column for Time.com. His articles have included:

He has also published work in JAMAabout the importance of storytelling in the world of health service research. Dr. Meisel and Dr. Jason Karlawish wrote: "Evidence from social psychology research suggests that narratives, when compared with reporting statistical evidence alone, can have uniquely persuasive effects in overcoming preconceived beliefs and cognitive biases. Therefore, although narrative is often maligned as anecdote and thus scrubbed from the toolbox of guideline developers, epidemiologists and regulatory scientists, these experts should consider narrative to develop and translate evidence-based policies."

 

photoRaina Merchant, MD (Emergency Medicine) is an alumna of the UPenn Robert Wood Johnson Clinical Scholar program (2007-2010) and is now a faculty member at the University of Pennsylvania and a Penn RWJ CSP Associate Director. Dr. Merchant’s research is focused on improving survival from cardiac arrest. She is specifically interested in implementation of existing resuscitation therapies and tracking the diffusion of cardiac arrest interventions. In the in-patient setting, she is interested in using administrative data sets to identify disparities in post-resuscitation care.

On January 31, 2012, Dr. Merchant kicked off National Heart Month by launching the MyHeartMap Challenge (MHMC). The MyHeartMap Challenge was a social media, mobile media, crowdsourcing contest to find automated photoexternal defibrillators (AEDs) in Philadelphia. Through this initiative, Dr. Merchant hopes to create a map and database that can be used to help victims of cardiac arrest, improve access to emergency care, and hopefully save lives. Contestants won by submitting the most AEDs ($10,000) or select special unmarked "Golden" AEDs ($50 per AED). More information about the contest can be found at myheartmap.org.

Follow the MyHeartMap Challenge on Twitter (@myheartmap) or read how the contest has gone global in the Philadelphia Inquirer.

 

Research Spotlight

2012 Summer Project

chpaWorking in partnership with Covenant House Pennsylvania (CHPA) this past summer, the 2012-2014 UPenn Robert Wood Johnson Clinical Scholars set out to develop a life skills curriculum for homeless youth entering CHPA. Specifically, their aim was to create an evidence-informed life skills curriculum that could be delivered over a 30-day period (the average length of stay for residents at CHPA) to help youth transition to stable housing and employment.

The Scholars conducted a needs-assessment through interviews with CHPA residents, staff, and community stakeholders and identified three main content areas for the life skills curriculum: personal hygiene, budgeting/finance, and soft skills (including motivation, handling conflicts, adjusting to change, and responding to external pressures). Based on the community input, the Scholars provided CHPA with a sustainable and engaging life skills curriculum incorporating web-based resources, youth-generated educational content, and peer mentorship in partnership with Rights of Passage, CHPA’s transitional living program. Each content area with the corresponding recommendations are summarized below:

Personal hygiene. The Scholars recommended using one or more of the following approaches to teaching personal hygiene:

  • Referring residents to an online repository of health provider-approved patient information websites and You-tube videos developed by the youth at CHPA.
  • Holding a contest (“Cov’s Got Talent”) for CHPA residents to compete against each other (as individuals or groups) to create their own 3-minute You-tube video on an adolescent hygiene topic. The contest will culminate with an airing of all videos to peers and staff, who will vote for the video that best conveys accurate and relevant health information in a creative way. The winning video will be uploaded onto the CHPA server, generating a sustainable repository of health videos - created by residents, for residents. The contest could be repeated every few months with variations in health topics.
  • Providing periodic trainings to the Youth Advisors, Social Workers, and other non-medical staff on health and hygiene related topics to allow them to individually address CHPA residents’ needs and concerns.

Budgeting and Finance. The Scholars recommended implementing a new budgeting/finance curriculum using the following strategies:

  • Replacing didactics with interactive, Youth Advisor-led group sessions to be held weekly.
  • For example, engaging residents to create a board game modeled after Monopoly or The Game of LIFE that teaches real-life budgeting/financial decision-making and skills necessary for the transition from the CHPA Crisis Center to independent living.
  • Referring residents to Youth Advisor-approved finance game websites.

Soft Skills. The Scholars recommended a new peer mentor-facilitated curriculum addressing four domains felt to be essential for youth transitioning to stable housing and employment:

  • Four interactive, group modules: Motivation, handling conflicts, adjusting to change, and responding to external pressures.
  • Each module to be facilitated by Social Workers and Peer Mentors (former CHPA residents) from Rights of Passage, CHPA’s transitional living program. Modules to be led in the context of a retreat for new residents upon entry to CHPA.
  • Creation of a formal peer mentorship program in partnership with Rights of Passage to promote interpersonal connections and foster enthusiastic young leaders.
  • Concrete recommendations for curriculum design and implementation provided to CHPA in consultation with Dr. Sharon Powell, founder of the Princeton Center for Leadership Training and currently with Princeton Leadership Group.

Lastly, recommendations for evaluating the efficacy of the proposed life skills curriculum were outlined.

The new proposed life skills curriculum was presented to CHPA at the end of the summer. Since then, the RWJ Scholars helped to set up a training of CHPA staff and youth by Dr. Powell. The one day training included topics and activities on group facilitation, self esteem building, leadership development, life skills and soft skills. The CHPA staff and youth who attended the training have partnered to begin to facilitate various groups. In early March, the staff and youth completed a practice run of the groups. It is expected that the groups will be in full swing by the end of the month.

A copy of the Scholars’ full report can be found here.

 

2011 Summer Project

photoWorking in partnership with Bartram High School and Tilden Middle School this past summer, the 2011-2013 Robert Wood Johnson Clinical Scholars at University of Pennsylvania set out to develop a comprehensive understanding of bullying in selected schools in Southwest Philadelphia and to identify strategies and best practices for bullying prevention and remediation. To achieve this, they conducted stakeholder interviews of teachers, administrators, parents, local community organizations, government and national bullying experts, as well as focus groups of local middle and high school students. They supplemented these perspectives with a review of the relevant biomedical and social science literature. From these sources, they identified a number of common themes, potential leverage points for intervention and resources that could support implementation of anti-bullying best practices and program development at Bartram and Tilden.

photoThe themes from stakeholders generated five specific target areas on which the Scholars’ recommendations focus: measurement and reporting, prevention, remediation, awareness, and cyber-bullying. In their full report, the Scholars provided background from content experts and recent literature on each theme followed by recommendations specific to Bartram and Tilden. Each theme and its corresponding recommendation are summarized below:

 

 

  • Measurement and Reporting. Without knowledge of the complexity and severity of schooling bullying, one cannot target efforts at the root cause of the problem. School stakeholders must first determine the size and scope of the bullying problem within the school, utilizing innovative strategies to encourage reporting and creating tools to continually monitor the problem. Recommendations included establishing a web portal, “Text-A-Teacher”, to report bullying incidents and behavior and establishing a web-based survey to assess current bullying rates at each school.
  • Prevention. The complex nature and diverse factors that lead to school bullying make designing effective prevention programs extremely challenging. Even the most effective whole-school based approach to-date, the Olweus Bullying Prevention Program (OBPP), demonstrates varying degrees of efficacy when administrators attempt to adapt it to their schools. Given this, the Scholars recommended that Bartram develop an anti-bullying task force to lead adoption of proven community, school, classroom, and individual-based prevention strategies, tailored to their specific needs.
  • Remediation. The success of anti-bullying programs depends on establishing effective prevention strategies, but school administrators will inevitably continue to manage active bullying behavior while addressing the needs of the bullied. Bartram has a strong foundation in this realm. The school has established and consistently enforced consequences for bullying behavior and has developed working relationships with health care organizations in Southwest Philadelphia. The Scholars recommended building upon this system of discipline and remediation for bullies and victims of bullying and bolstering behavioral health supports for each group. Screening for behavioral health needs and social crises of persistent bullies and victims should be performed early and targeted services using a multidisciplinary approach should be provided when indicated. For the victims of bullying, they also recommended establishing skills-based programs aimed at improving the social skills of at risk children.
  • Awareness. Any anti-bullying initiative will be aided by increasing awareness of students, staff, and community about bullying and its negative effects. The Scholars recommended initiating an awareness program targeted at students, staff, and the Southwest Philadelphia community. This awareness program would ideally be incorporated into the school curriculum starting with a kickoff event, incorporate the resources and support of the community and parents using social media and internet and elicit concerns and suggestions of teachers and staff, while providing in-services for continuing education on anti-bullying efforts.
  • Cyber-bullying. Cyber-bullying has become an issue of particular concern for schools. The Scholars’ recommendations focused on increasing the capacity of schools and parents to track online activity through training sessions, such as a “Facebook Education Night” and encouraging online communication of key stakeholders by creating a school Facebook page to publicize school policies, programs and new initiatives to students, staff, parents and community leaders.

A copy of the full report can be found here.

 

Past Events

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