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CVP Projects

A Pilot Intervention to Increase Fruit and Vegetable Intake among WIC Beneficiaries

  • PI:  Hilary Seligman, MD
  • Investigators: Kirsten Bibbins-Domingo, Hilary Seligman, Dean Schillinger
  • Funder: Robert Wood Johnson Foundation Health and Society Scholars Program
  • 5/14/09-5/13/10

Diets high in fruit and vegetable intake are associated with lower cardiovascular disease (CVD)and cancer risk. Fruit and vegetable-poor diets may contribute to known race/ethnic and income health disparities through a variety of mechanisms including, increasing blood pressure and increasing body weight. This pilot study will inform the development of a larger intervention providing vouchers of varying dollar amounts redeemable for fresh fruits and vegetables to Supplemental Nutrition Program for Women, Infants, and Children (WIC) beneficiaries. Outcomes will include fruit/vegetable intake, blood pressure, and antioxidant levels.

California Diabetes Prevention and Control Program*

  • PI:  Dean Schillinger, MD
  • Funder:  CDC
  • 4/01/09-3/28/14
    * this award was processed through the UCSF Institute for Health and Aging

The goal is to work to prevent, detect, and intervene among persons at risk for diabetes mellitus and its complications to reduce the adverse personal and public impact of diabetes on California's diverse communities.

Diabetic retinopathy (DR) screening in California and Health Information Technology Applications- Status Review and Recommendations for Overcoming Barriers to Improving Access for Vulnerable Populations

  • PI:  Margaret Handley, PhD
  • Funder:  California Program on Access to Care (CPAC)
  • 3/1/09-12/30/09

Primary care-based retinal screening and eye imaging have been shown to be an effective screening method for the detection of DR.  However, despite the growing evidence for digital screening and the potential to improve access, there has been limited implementation in safety net settings that disproportionately serve at risk populations. The goals of the policy paper are to describe the scope of the problem regarding an un-met need for DR screening in California among vulnerable populations receiving care in safety net settings, such as the uninsured and Medi-Cal patients and to develop recommendations to reduce the barriers to implementing primary care based DR screening in California safety net settings.

Promoting Lead Education to High Risk Community Members through a Community-Based Participatory Education and Dissemination Model

  • PIs:  Margaret Handley, PhD and Dr. Maricel Santos (SF State, and Paul Heavenridge, Literacyworks);
  • Funder: Public Health Trust
  • 10/1/08-6/30/10

The goals of this project are to develop a regional dissemination model to integrate existing county-level community education programs (ESL, Cooperative Extension and Library-Based Adult Literacy programs) with health communication expertise, to promote community-developed lead educational materials. These materials will then be disseminated to diverse communities in a high risk county for lead poisoning using epidemiological strategies to identify community ‘hot spots’. The investigators will develop a state-wide plan to scale up this model across state chapters of the local community education programs and other environmental justice coalitions.

Interactive Health IT to Promote Ambulatory Safety among Vulnerable Diabetes Patients

  • PI:  Urmimala Sarkar, MD, MPH
  • Funder:  Agency for Health Research Quality (K-08)
  • 9/30/2008-9/29/13

This career development award aims to support Dr Sarkar in her progress to become an independent investigator in the areas of ambulatory patient safety in chronic diseases among vulnerable populations. Her projects will leverage self-management support technology for diabetes to assess patient safety between visits for ambulatory patients, and to compare this to other surveillance strategies.

Adapting the Coronary Heart Disease Policy Model to Address Disparities in Heart Disease

  • PI:  Kirsten Bibbins-Domingo, MD, PhD, MAS
  • Funder:  UCSF CTSI Resource Allocation Program
  • 9/1/08-6/30/09

This project will pilot race/ethnic and income stratified versions of the Coronary Heart Disease Policy Model, a computer simulation of heart disease among adults in the US.

Chronic Kidney Disease and Cardiovascular Risk in Young Adults

  • PI:  Kirsten Bibbins-Domingo, MD, PhD, MAS
  • Funder: National Institute of Diabetic and Digestive and Kidney Disease (R-01)
  • 8/1/08-7/31/11

To examine the role of early declines in kidney function and the development of cardiovascular risk using a longitudinal study of cardiovascular disease development in young adults and cystatin C as a marker of kidney function.

Developing Prevention-Based Curriculum that Transcends Borders: Bringing English as a Second Language (ESL) and Public Health Together

  • PI:  Margaret Handley, PhD
  • Funder:  UC MEXUS
  • 3/1/08-7/1/08

Building on a series of epidemiologic investigations based on Monterey County that identified home-made imported foods from Mexico as a significant source of lead-poisoning, the goal of this project is to develop a community-based curriculum for lead poisoning prevention that can be used in adult ESL programs and in other community settings that provide services to Mexican migrants as well as to communities within Mexico that experience significant lead poisoning.

Interdisciplinary Approaches to Reducing Lead Contamination in Traditional Foods among Mexican Migrants: The Contributions of Epidemiology, Anthropology, and Community Development

  • PIs:  Margaret Handley, Jim Grieshop, Ramona Perez and Jeff Cohen
  • Funder:  UC Davis Seed Grants for Outreach & International Activities
  • 12/1/07-11/30/08

This project will combine the knowledge and skills of an international (Mexico and US) inter-disciplinary team of researchers, educators, and community developers for the first time to develop a research and action framework to analyze, understand, and address issues related to lead contamination in traditional foods found in Oaxaca that are also transported to California and the U.S. The purpose of this study is to: (1) determine the sources of lead poisoning in Mexico, that are linked to the Monterey County outbreak investigation that is a follow-up study to our original research; and (2) to develop in partnership with the binational Oaxacan community, health messages related to the specific problem of lead poisoning via contaminated food and more broadly, to the positive aspects of maintaining cultural identify through food for binational communities.

Evaluating the Missouri Health Literacy and Diabetes Communication Initiative

  • PI:  Dean Schillinger, Hilary Seligman (co-investigator)         
  • Funder:  American College of Physicians Foundation
  • 11/1/07-10/30/10

This project will implement and evaluate the effects of a patient centered diabetes guide among diabetes patients in Missouri community health centers.

Projects with CVP faculty as Co-investigators

Development of Multilingual Prescription Drug Instructions for Pharmacy Practice

  • PIs:  Mike Wolf, PhD, MPH, Dean Schillinger, MD (site PI), Alice Chen, MD, MPH, and Urmimala Sarkar, MD, MPH (CVP Co-investigator)
  • Funder:  California Endowment
  • 8/1/09-7/31/11

This study seeks to address the problem of poorly communicated Rx instructions by targeting the most tangible and frequently-used informational source: Rx label instructions.

Improving Transitions from Hospital to Home among Vulnerable Elder Adults

  • PI: Jeffrey Critchfield, MD; Urmimala Sarkar, MD (CVP Co-investigator)   
  • Funder:  Gordon and Betty Moore Foundation
  • 12/1/2008-11/30/2011

This project aims to improve the transition from hospital back to the home for multilingual vulnerable elders, with the aim of reducing readmission rates to hospitals. Dr Sarkar is exploring effects on medication reconciliation processes during transition from hospital to home and to ambulatory clinic.

Coronary Artery Risk Development In Young Adults (CARDIA)

  • PI:  Steve Sidney, MD, MPH and Kirsten Bibbins-Domingo, MD, PhD, MAS (CVP co-investigator)
  • Funder: National Heart Lung and Blood Institute
    Kaiser Oakland Field Center
  • 10/1/08-9/30/13

This project will examine the development of cardiovascular risk in black and white young adults.

Randomized Controlled Trial Embedded in an Electronic Health Record

  • PIs:  James Kahn; CVP co-investigators: Dean Schillinger, Urmimala Sarkar and N Ratanawongsa
  • Funder:  Agency for Health Research Quality (AHRQ)
  • 10/1/08-8/31/11

This grant aims to extend and evaluate the effects of an electronic personal health record (ePHR) on HIV care in a public-health care setting.  CVP investigators are examining effects on physician-patient relationship, and patient safety regarding medication management.

CAN-DO Center Renewal Grant- Flouride Varnish (FV) Reach Study

  • PI:  Jane Weintraub, DDS, MHP and Dean Schillinger, MD, Margaret Handley, PhD MPH (CVP Co-Investigators)
  • Funder:  NIH
  • 10/1/08-8/30/13

This study will examine the effectiveness of a "real world" implementation of FV and related caregiver counseling programs with emphasis on overcoming barriers for children and caregivers in low income and minority families. We will learn how to implement an efficacious, low-cost, low-tech intervention; change clinical and social service agency practices to benefit the health of young children; and provide insights to reduce health disparities.  Knowledge would be generalizable to implementation/dissemination research for all low cost, low-tech health interventions systems-level health communication.

A Screening, Brief Intervention, Referral and Treatment (SBIRT) Medical Residency Program at San Francisco General Hospital

  • PI: Paula Lum and Neda Ratanawongsa (CVP co-investigator)
  • Funder: Substance Abuse and Mental Health Services Administration (SAMSHA) 9/30/08-9/29/13

The goal of this project is to 1) develop and implement a training system to teach residents skills to provide evidence-based SBIRT at an urban county hospital serving a culturally diverse population affected by and at high risk of alcohol and drug use disorders; and 2) disseminate SBIRT practices widely by training across hospital departments and in local and statewide medical communities.

Examining the Link between Diabetes Outcomes and Patient Experiences within Vulnerable Populations

  • PIs: Alicia Fernández, MD  and Hilary Seligman, MD (CVP co-investigator)                                 
  • Funder:  The Commonwealth Fund
  • 7/1/08-6/30/09

This project will expand the scope of an already funded study of diabetes patients at large safety net hospitals in San Francisco and Chicago to test the validity of a survey instrument that captures the care experiences of minority and low-income patients. The investigators aim to determine how socio-economically diverse insured and uninsured patients' diabetes outcomes are affected by care experiences, and what the risk factors are for having substandard experiences.

Development of a Patient-Centered, Literacy-Appropriate Self-Management Guide for Patients with Coronary Artery Disease (CAD)

  • PIs: Darren DeWalt (University of North Carolina) and Hilary Seligman (CVP co-investigator)
  • Funder:  American College of Physicians Foundation
  • 5/14/09-5/13/10

Drs. Seligman and DeWalt are developing a literacy-appropriate guide for teaching self-management skills to adults with coronary artery disease. The study consists of three phases: 1. providers who work with CAD patients will participate in individual interviews or small focus groups to provide information about how they help CAD patients to become better self-managers; 2. English and Spanish speaking patients with CAD will participate in focus groups to understand barriers to CAD self-management, perceptions of CAD difficulties, and strategies to overcome CAD difficulties; and 3: Patients with CAD will participate in cognitive interviews to improve the readability and effectiveness of the CAD guide under development.

Development of an Instrument to Measure Health Literacy

  • PI:  Lauren McCormack, DrPH,  Dean Schillinger, MD (CVP Co-Investigator)
  • Funder:  NCI/Research Triangle Institute
  • 10/01/07 – 7/31/10

To develop and validate a set of health literacy measures for chronic disease and cancer.

Health Literacy and Self-Management in Heart Failure

  • PI:  Michael Pignone, Dean Schillinger, MD (Site PI) and Kirsten Bibbins-Domingo, MD, PhD, MAS (co-investigator).
  • Funder:  NIH/National Heart Lung and Blood Institute (NHLBI)
  • 9/1/06 – 5/31/11

To conduct a multi-site randomized controlled trial of a diuretic self-management intervention among a sample of 660 English and Spanish speaking patients with heart failure and limited health literacy.