SUMR 2018 Attends AHRQ National Research Service Awards Conference

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SUMR 2018 Attends AHRQ National Research Service Awards Conference

Undergrad Scholars Engage With Some of Health Care's Most Important and Controversial Issues
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The 24nd annual National Research Service Award (NRSA) Conference took place in tandem with the 2018 AcademyHealth Annual Research Meeting at the Sheraton Seattle Hotel and the adjacent Washington State Convention Center. NRSA is part of the Agency for Healthcare Research and Quality (AHRQ) program that provides training, grants and other supports to undergraduate, predoctoral and postdoctoral trainees and fellows in the health services research field. This year's event was attended by 23 Summer Undergraduate Minority Research (SUMR) scholars from the University of Pennsylvania program co-sponsored by the Leonard Davis Institute of Health Economics (LDI) and the Wharton School Health Care Management Department. The day-long gathering included 35 podium presentations and a poster session with 55 entries. Above, opening the proceedings was Francis Chesley, MD, Director of the (AHRQ) Office of Extramural Research, Education and Priority Populations.
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EISENBERG MENTORSHIP AWARD

Noting that training the next generation of health services researchers was one of AHRQ's highest priorities, Chesley (above, left) announced the winner of the John M. Eisenberg Excellence in Mentorship Award: Jane Holl, MD, MPH, Director of the Institute for Public Health and Medicine at Northwestern University. The opening plenary panel (above, right) moderated by Steve Shortell, PhD, Professor and Dean Emeritus at the Berkeley School of Public Health, featured five NRSA trainee research presentations on some of health services research's most important and controversial issues.
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PENN/LDI SUMR SCHOLARS

Mixed in the audience with 160 other postdoctoral students, program directors and health services research faculty members, the LDI SUMR Scholars got an up-close and personal sense of NRSA's grant program that funds trainee research projects. Above, left are SUMR Scholars Joanna Ferguson, Manuel Alcalá and Christine Olagun-Samuel, all of Penn. Listening intently above, right, are LDI SUMR Scholars Nahnsan Guseh of Syracuse University, Risha Sheni of Cornell and Grace Nie of Penn.
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CANCER DRUG PRICE VARIATIONS

In the first plenary trainee presentation, NRSA trainee Aaron Mitchell (above), MD, MPH, of the University of North Carolina explained his study that found cancer patients were charged higher prices when treated in private practices compared to when they were treated in academic medical centers. Under the Medicare Part B rules, private practice oncologists can purchase cancer drugs directly from the manufacturer and mark them up for resale to patients.
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RACIAL DISPARITIES IN NURSING HOME RESTRAINTS

NRSA trainee and Brown University first year doctoral student in Health Services, Policy and Practice Shekinah Fashaw (above, left) explained to SUMR Scholar Janiece Strange (above, right) and the rest of the audience her study on racial disparities in the use of physical and chemical restraints in Medicaid-reliant nursing homes. One finding was that facilities with higher than average numbers of African-American residents used a higher proportion of chemical restraints. "Chemical" restraints are antipsychotic drugs used in an off-label manner to quiet nursing home patients' agitation, aggression and other behaviors deemed problematic. Interestingly, a higher number of African-Americans in a facility population was also found to be associated with a lower than average use of physical restraints, like bed rails, mittens and tightly-tucked sheets.
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HIGH USE OF LOW-VALUE IMAGING

Brandeis University NRSA trainee and nurse practitioner Monica O'Reilly-Jacob, PhD, MS (above, left), detailed her study of low-value imaging tests ordered for Medicare Part B patients by four different groups of clinicians: generalists, specialists, nurse practitioners and physician assistants. She found that despite professional guidelines to the contrary, low-value imaging was ordered for 34.5% of all such patients across all groups of clinicians. The highest use was among orthopedic specialists, whose orders for low-value imaging were 35.1% higher than those of generalist physicians. Listening to the real-world findings were (above, right) LDI SUMR Scholars Grace Nie of Penn, Tolu Omole of Arizona State University, Risha Sheni of Cornell, and William Jackson of the University of Kentucky.
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'BAD ACTORS' IN OPIOID USE TREATMENT

A survey of government officials, insurers and providers in eight states unexpectedly found a growing concern about "bad actors" moving in to take unscrupulous advantage of the increasing flows of federal funding available to opioid use disorder treatment providers. In his presentation, NRSA trainee Cliff Bersamira, MA (above, left) a doctoral candidate at the University of Chicago School of Social Service Administration, said the research team discovered state officials were worried that growing numbers of former "pill mill" providers are switching strategies to become "negligent Buprenorphine prescribers." Listening in the audience (above, right) was LDI SUMR Scholar Ayomide Ojebuoboh of Boston University.
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BETTER SELF MANAGEMENT OF CHRONIC CONDITIONS

NRSA trainee Jessica Bing Ying Poon (above, left), a doctoral candidate in the Center for Healthcare Organization and Innovation Research (CHOIR) Group at UC Berkeley, is studying the dynamics of "patient-centered care." Along with "shared decision making" and "patient activation," that is one of the new buzzwords in the wake of the Affordable Care Act's implementation that are still not exactly defined or operationally fully understood. Part of her study is aimed at determining whether patient activation or shared decison making is the most effective aspect of the new clinician-patient engagement model. In an analysis of 1,276 college-educated female diabetes and/or cardiovascular disease patients over 65 who were covered by commercial insurance, she found that patient activation has a four times stronger impact on shared decision making than shared decision making has on patient activation. That result suggests that in order to optimize patient-centered care encounters, health care providers should focus on providing support for self management through patient education measures and personalized coaching. Above, right, during the Q&A period, LDI SUMR Scholar Grace Nie asks a question of Poon about language barriers for non-English-speaking immigrants in the patient-centered care model.