This is a reapplication for the Geriatric Mental Health Academic Award that I received when I was Director of Geriatric Psychiatry at the Medical College of Virginia/Virginia Commonwealth University. The original award sought to expand my statistical and epidemiological research training and to pursue a research program examining aspects of aggressive behavior in dementia patients. The results from my initial study lead to a refinement of my research focus. Since medication management represents a primary treatment intervention for aggressive dementia patients, the present proposal will examine medication decision making by physicians using simulation models called """"""""contrastive vignette technique"""""""". This program of research has important health services' and educational applications since it is designed to uncover biases that alter physician decision making, and lead to ill-suited health care decisions by physicians. For example, if a physician harbors a bias that """"""""all male"""""""" dementia patients should be kept on a neuroleptic to keep them """"""""under control,"""""""" then that physician is making a clinical decision based on a biased """"""""rule of thumb"""""""" heuristic. The research program will be complimented by planned educational activities including: supplemental course work in statistics, computer programming and research methodology at the SAS Institute, ongoing research supervision by an assembled panel of experts, and an ongoing participation in the Epidemiological Research Seminar in the Department of Public Health Sciences at Bowman Gray School of Medicine.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Academic/Teacher Award (ATA) (K07)
Project #
2K07MH000787-02
Application #
3077786
Study Section
Life Course and Prevention Research Review Committee (LCR)
Project Start
1991-08-01
Project End
1995-07-31
Budget Start
1991-08-01
Budget End
1992-07-31
Support Year
2
Fiscal Year
1991
Total Cost
Indirect Cost
Name
Wake Forest University Health Sciences
Department
Type
Schools of Medicine
DUNS #
041418799
City
Winston-Salem
State
NC
Country
United States
Zip Code
27106
Smith, S L; Colenda, C C (1997) Mental health and health care utilization in geriatric primary care patients. Int J Psychiatry Med 27:23-32
Colenda, C C; Cohen, W; McCall, W V et al. (1997) Phototherapy for patients with Alzheimer disease with disturbed sleep patterns: results of a community-based pilot study. Alzheimer Dis Assoc Disord 11:175-8
Colenda, C C; McCall, W V (1996) A statistical model predicting the seizure threshold for right unilateral ECT in 106 patients. Convuls Ther 12:3-12
Colenda, C C; Rapp, S R; Leist, J C et al. (1996) Clinical variables influencing treatment decisions for agitated dementia patients: survey of physician judgments. J Am Geriatr Soc 44:1375-9
Smith, S L; Colenda, C C; Espeland, M A (1994) Factors determining the level of anxiety state in geriatric primary care patients in a community dwelling. Psychosomatics 35:50-8
Colenda, C C; Hamer, R M (1991) Antecedents and interventions for aggressive behavior of patients at a geropsychiatric state hospital. Hosp Community Psychiatry 42:287-92
Colenda, C C; Trinkle, D; Hamer, R M et al. (1991) Hospital utilization and readmission rates for geriatric and young adult patients with major depression: results from a historical cohort study. J Geriatr Psychiatry Neurol 4:166-72