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  • January 18, 2022

    By MedStar Team

    Structural racism is one of the most pressing issues facing healthcare today.  Unfortunately, academic medicine historically exacerbating the exploitation of vulnerable communities to achieve educational and research goals, especially in Black, Indigenous, and People of Color (BIPOC) communities. For example, many traditional research practices among marginalized communities highlight and, in most cases, magnify inequities in care. These can include:   

    • Community members are under informed about research methods and strategies. 

    • Researchers prioritize extraction of information from communities rather than community ownership of information.

    • Researchers accrue funding, prestige, and publications (in which academics’ voices predominate over the narrative perspective of community members) without similar accrual to participating communities.  

    • Researchers’ understanding of questions to be answered may lack cultural context because of their incomplete comprehension of community conditions.  

    The relationship between research institutions and many BIPOC communities is estranged and needs mending to dismantle racial disparities and inequitable research practices. As the area’s largest healthcare provider, MedStar Health is committed to do the work needed to address these issues in everything we do in order to advance health equity for everyone we serve.

    “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

    (March 25, 1966 speech to the Medical Committee for Human Rights)

     

    Advancing Health Equity in Early Childhood and Family Mental Health Research

    MedStar Health investigators Arrealia Gavins, Celene E. Domitrovich, Christina Morris, Jessica X. Ouyang, and Matthew G. Biel recently published research emphasizing the need to co-learn and to co-develop research with community members themselves to prioritize benefits for both participants and researchers. “Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health” was published in the Journal of the American Academy of Child & Adolescent Psychiatry. This work was done through the Early Childhood Innovation Network (ECIN),  a community-based partnership between two academic medical centers (MedStar Georgetown University Hospital & Children’s National Health System) and several community-based organizations in Washington, DC that strives to provide support to families through caregiver and child mental health services, family peer support, child social and emotional learning, initiatives to address social determinants of physical and mental health for families, and place-based support to families within select communities.  

    In this study, researchers found that to begin to undo the inherent inequities within academic medical research, particularly in studies involving children and caregivers, investigators need to consider how best to build equitable, long-term partnerships with communities through Community-Engaged Research (CEnR) or more specifically, Community-Based Participatory Research (CBPR). CBPR offers an alternative to traditional non-participatory research with a collaborative, strengths-based orientation that equitably involves researchers, community members and other stakeholders in all phases of research while embracing their unique expertise. 

    Recently documented increasing rates of depression, anxiety, and suicide in BIPOC youth, compounded by the disproportionate impact of the COVID-19 pandemic on BIPOC communities, has heightened the urgency for progress in community-based research.

    The research team started to utilize CBPR practices to advance antiracism in their clinical research work in child and family health along with working with BIPOC communities. This approach to integrate CBPR practices into the development, implementation, and evaluation of community-based interventions seeks to support early childhood mental health in primarily Black communities in Washington, DC. 

    Making an Impact: Insights & Lessons Learned from CBPR

    Through this work of the EICN, the research team found five valuable lessons from applying CBRP principles to research collaborations in community settings. 

    Intervention Practices

    Lessons Learned and Applied

    ECIN launched a group-based mindfulness parenting program to explore how to support the emotional health of parents at a Head Start early education center with the intention to reduce caregiver stress and enhance caregiver-child relationships.

     

    Lesson 1: Invest the time to build trusting relationships

    Providers set up several discussion groups with community partners and medical center-based researchers to review proposed assessment tools to be used with children and families receiving psychotherapy services.

    Lesson 2: Involve community partners in the development of the intervention theory of change and measurement strategy

     

    Clinical staff organized peer specialists to provide support to families with young children through 3 evidence-based strategies: enhancing parents’ knowledge about caregiving with young children;optimizingparent use of existing resources; and increasing parents’ access to social supports.

     

    Lesson 3: Create interventions in partnership with community members

    Clinical staff providedearly childhood mental health consultation (ECMHC) in preschool classrooms to enhance educators’capacitiesto support early childhood development and to recognize early signs of mental health concerns

    Lesson 4: Interpret findings in partnership with community members

    ECIN membersparticipatedin formal antiracism training with external experts to incorporate antiracism principles into ECIN’s operations and into the culture of the Network. ECIN formed a Racial Equity Community of Practice (RECOP), that supports 8 intervention teams in developing practices that advance racial equity goals.

    Lesson 5: Embed an antiracism focus in research structures and processes

     

    The research team found this community-based approach to be helpful in conducting research that will have a long-lasting impact on not only the community, but also on members of the research team. During a time where BIPOC families are experiencing the effect of COVID-related deaths and grief, unemployment, housing instability, and police violence; researchers have an opportunity to be engaged in the community and work to eliminate racial inequities within academic medicine and research. 

    Journal of the American Academy of Child & Adolescent Psychiatry, DOI: 10.1016/j.jaac.2021.06.018

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  • December 04, 2016

    By MedStar Health

    MedStar Health Research Institute (MHRI) was awarded membership to the second cohort of the Safe Healthcare, Epidemiology, and Prevention Research Development (SHEPheRD) Program funded by the Centers for Disease Control and Prevention (CDC). MHRI is one of a select group of organizational members of this cohort.

    SHEPheRD was developed as an indefinite delivery, indefinite quantity contract to provide CDC a mechanism to collaborate with healthcare systems, academic, and other research partners to perform research and quality improvement projects. Membership is divided into eight specific research areas, ranging from adverse event research protocol development to healthcare information technology development to advanced molecular epidemiology and microbial community analysis. Membership into specific area domains qualifies MHRI investigators to bid as the prime contractor on CDC-released task orders.

    MHRI was awarded membership into “Acute Inpatient Care Quality Improvement and Research Implementation Infrastructure”, as one of only four organizations. As part of this award, MHRI has partnered with Abt Associates, a research organization specializing in large-scale data collection, evaluation, and analysis of health problems, policies, and programs. This award also leveraged MedStar’s academic partnership with Georgetown University to access the expertise of the O’Neill Institute for National and Global Health Law in assessing legal and policy interventions as related to the impact of infection control interventions.

    In addition, MHRI is also a partner on the Abt Associates SHEPheRD award under “Healthcare-associated infection (HAI) and Other Adverse Healthcare Event Prevention Research Protocol Development and Implementation”. Membership under this specific domain allows Abt Associates to bid as the prime contractor on CDC-released task orders that will focus on successfully answering research questions posed by CDC, including study design, protocol development, database development, statistical support, background literature review, study implementation, and data management and analysis services. If interested, MHRI investigators could be investigators and collaborators under SHEPheRD proposals submitted by either MHRI or Abt Associates.

    Across the entire SHEPheRD program, including all domains, CDC will fund projects totaling up to $200M over five years. For more information, contact research@medstar.net.

  • December 04, 2016

    By MedStar Health

    Congratulations to all researchers who were published in November 2016. There were 99 peer-reviewed studies published in 51 journals that are part of the body of work completed by MedStar Health investigators, physicians, and associates. We look forward to seeing your future research.

    Selected research:

    1. Exercise Training for Persons with Alzheimer's Disease and Caregivers: A Review of Dyadic Exercise Interventions.
      Journal of Motor Behavior, November 2016. DOI: 1080/00222895.2016.1241739
      Lamotte G, Shah RC, Lazarov O, Corcos DM.
    2. Going Viral: Importance of Viral Pathogens in Nonventilated Hospital-Acquired Pneumonia.
      Chest, November 2016. doi: 1016/j.chest.2016.05.028
      Shorr AF, Zilberberg MD.
    3. Intestinal Transplant Inflammation: the Third Inflammatory Bowel Disease.
      Current Gastroenterology Reports, November 2016. DOI: 1007/s11894-016-0530-0
      Kroemer A, Cosentino C, Kaiser J, Matsumoto CS, Fishbein TM.
    4. Efficacy and Safety of LixiLan, a Titratable Fixed-Ratio Combination of Insulin Glargine Plus Lixisenatide in Type 2 Diabetes Inadequately Controlled on Basal Insulin and Metformin: The LixiLan-L Randomized Trial.
      Diabetes Care, November 2016. DOI: 2337/dc16-1495
      Aroda VR, Rosenstock J, Wysham C, Unger J, Bellido D, González-Gálvez G, Takami A, Guo H, Niemoeller E, Souhami E, Bergenstal RM; LixiLan-L Trial Investigators.
    5. Identifying visual search patterns in eye gaze data; gaining insights into physician visual workflow.
      Journal of the American Medical Informatics Association, November 2016. DOI: 1093/jamia/ocv196
      Fong A, Hoffman DJ, Zachary Hettinger A, Fairbanks RJ, Bisantz AM.

    View the full list of publications on PubMed.gov here.

  • December 04, 2016

    By MedStar Health

    Edited Jan. 5, 2017: Due to unforeseen circumstances not within our control, Research Grand Rounds on January 6, 2017 has been CANCELLED. We hope to reschedule Dr. Aviles-Santa for a later date and look forward to seeing you at the February Research Grand Rounds.

    Research Grand Rounds are sponsored by MHRI and Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) and bring together the MedStar Health community for a learning experience focusing on a different topic each month.

    The Research Grand Rounds are open to all members of the research team, from principal investigators to clinical and research coordinators and trainees. Topics covered in the Research Grand Rounds can range from community-focused research to best practices with the intention of increasing collaboration within the research community both within and outside of MedStar Health.

    The Hispanic Community Health Study/Study of Latinos: Building the Project, Baseline findings, and Future Research Opportunities

    Presented by M. Larissa Avilés-Santa, MD, MPH, Division of Cardiovascular Sciences, NHLBI

    January 6, 2017

    12 Noon to 1 PM – Presentation                                             

    1 PM to 1:30 PM – Lunch

    MedStar Washington Hospital Center, 6th Floor, CTEC Theater

    110 Irving Street, NW, Washington, D.C., 20010

     

    View the listing of the FY17 Grand Rounds.

  • December 01, 2016

    By MedStar Health

    An estimated 13% of people with HIV don't know they have the virus, leaving it to cause severe damage that could be avoided with treatment.
  • November 29, 2016

    By MedStar Health

    Many Americans with chronic acid reflux swear by proton pump inhibitors. But are these common over-the-counter medications safe for long-term use?
  • November 29, 2016

    By MedStar Health

    Nearly 50,000 Americans are diagnosed with cancer of the pancreas each year. In the vast majority of these cases — approximately 95 percent — patients have one specific type of cancer: adenocarcinoma of the pancreas.

    The remaining 5 percent of pancreatic cancer patients have different treatment options and prognoses.

    A Brutal Disease

    As with any cancer, when one of the body's mechanisms for controlling the growth of abnormal cells breaks down, those atypical cells begin to divide rapidly and form one or more tumors.

    After a person develops a pancreatic tumor, many of the cancer cells can spread outside this organ. Some of those tumor cells will travel to other body parts via the bloodstream or lymphatic system. Most often, they go to the liver, lungs and abdominal cavity.

    Pancreatic cancer is particularly deadly because of the pancreas' location ― in the middle of the abdomen and close to vital organs. Also, tumors that develop in the pancreas typically do not cause symptoms until they have grown to cause symptoms in the area of the pancreas, or have even spread to other parts of the body. As a result, doctors often find and diagnose pancreatic cancer when it has already reached a more advanced stage than other cancers.

    In fact, about 60 percent of the time, a patient's pancreatic cancer has already spread by the time he or she receives a diagnosis. In another 20 to 25 percent of cases, the cancer hasn't yet spread at the time of diagnosis, but is inoperable.

    Even when pancreatic cancers are detected at early stages, they tend to be extremely aggressive. In fact, more than 70 percent of pancreatic cancers that are successfully operated on still lead to death.

    Treatment Options

    Pancreatic cancer treatment involves a multidisciplinary effort. A surgeon, medical oncologist, radiation oncologist, and others work together to determine which actions and therapies should have the most desirable outcomes.

    Only 10 to 20 percent of pancreatic cancer patients are diagnosed with an operable cancer, the only type of pancreatic cancer that can be cured. Inoperable cancers can be controlled or treated, but not cured. Sometimes, an inoperable cancer treated with radiation therapy or chemotherapy can be rendered operable.

    When a patient has an incurable form of pancreatic cancer, chemotherapy is usually helpful.

    Without chemotherapy, the symptoms of cancer can be devastating. These include severe pain, chronic fatigue and extreme weight loss. Chemotherapy can stabilize and even shrink tumors, weakening their physical impact and causing patients to feel better. Plus, chemotherapy regimens have become more effective in recent years, and their side effects are generally short-term and cyclical, allowing a patient to maintain a relatively high quality of life despite being on chemotherapy

    New Research, New Hope

    Research into pancreatic cancer is going strong. Medical experts are exploring a wide range of drugs and therapies and dozens of clinical trials are underway.

    If you get a pancreatic cancer diagnosis, a second opinion is vital, and it's important to see oncologists and specialists with extensive experience. In addition, try to go to a medical facility that offers innovative pancreatic cancer treatment options. With personalized, cutting-edge care, you should be able to fight the cancer, and maintain as high a quality of life as possible, for as long as possible.