The candidate is a minority clinician-scientist who is committed to a career as an independently-funded investigator who can design, conduct, and disseminate interventions that will improve patient outcomes by increasing access to evidence-based rehabilitation services for minority and rural populations. The short-term objectives are to provide didactics, career development activities, and a period of intensive mentoring with formative, pilot research that will culminate in the ability to undertake randomized, controlled trials of innovative interventions for post-stroke survivors. Training activities include (1) coursework leading to an MPH for core competencies in epidemiology and biostatistics with a minor in ethics;electives have been selected to augment the candidate's current skill in secondary data analysis, (2) selected reading and practical with mentors and advisors in the areas of community-based participatory research, health disparities, stroke, and telemedicine, (3) a mentored research study that will provide pilot data for a multi-site R01 to improve inpatient management, discharge disposition, and recovery phase care by providing rehabilitation consults to stroke survivors in rural areas. Research Plan:
Specific aims are to (1) demonstrate the effect of early introduction to rehabilitation by comparing Phase I and Phase II participants'inpatient care and rate of discharge to various rehabilitation settings versus home with no services;(2) compare the rates of self-reported physical activity levels of Phase I and Phase II participants at 90 days;(3) identify the barriers to successful implementation of a Stroke Telemedicine Access Recovery (STAR) project. Phase I will observe the current stroke process of care and recovery at one rural, ethnically diverse hospital. Phase II will implement a multi-pronged intervention including telemedicine video-conferencing consult with a physiatrist (physician in Physical Medicine and Rehabilitation) to oversee recovery from 0 to 90 days post- stroke. Environment: UNC Chapel Hill has the Sheps Center for Health Services Research and is committed to eliminating health disparities, thus an ideal environment for this training program. The candidate has in-kind support from the Health Sciences Library, which also hosts the online Area Health Education Center training, and her mentors are successful investigators with the span of expertise required to foster success. The proposed work seeks to use innovative interventions including telemedicine video-conference technology as a tool to provide access to and deliver high quality stroke rehabilitation services. It utilizes health services research strategies to increase access to care and eliminate disparities.
| Gregory, Patricia C; Szanton, Sarah L; Xue, Qian-Li et al. (2011) Education predicts incidence of preclinical mobility disability in initially high-functioning older women. The Women's Health and Aging Study II. J Gerontol A Biol Sci Med Sci 66:577-81 |
| Gregory, Patricia C; Lam, Diana; Howell, Paul (2010) Osteoporosis treatment following hip fracture: how rates vary by service. South Med J 103:977-81 |
| Gregory, Patricia; Edwards, Lloyd; Faurot, Keturah et al. (2010) Patient preferences for stroke rehabilitation. Top Stroke Rehabil 17:394-400 |
