The potential impact of the IDS-1 and IDS-2 stroke interventions and disability among Americans is enormous, and large-scale trials will be needed to test methods designed to maximize independence. The implementation of these trials will require information regarding the generalizability of findings and the potential personal and societal effects of those interventions. RRC-A is designed both to meet the needs of current UM-OAIC projects and to lay the groundwork for future trials.
The specific aims of RRC-A are: 1. Support centralized recruitment and evaluation of factors affecting recruitment. 2. Implement interview-based measures of outcomes, including basic and instrumental activities of daily living, quality of life, and caregiver burden, as well as potential modifiers of that outcome, including comorbidities, mood, cognitive function, social support, and exercise perception. 3.Develop an innovative approach to modeling the potential health care cost savings of interventions that lead to changes in functional status. There is a compelling rationale for including these services in a core rather than in individual projects. Centralized recruitment of stroke patients for both IDS studies is more efficient, allows study of the determinants of recruitment, and can provide strategic consultation regarding recruitment to other studies of chronic disease in older Americans. Centralized performance of interview-based measures will facilitate training, quality control, standardization, and precision of measurements. The inclusion of a health-services component in this core makes this expertise available not only to the IDS studies, but also to R01 -funded studies of exercise interventions in peripheral vascular disease and hip fracture patients. The RRC-A will also contribute actively to training young geriatrics and gerontology investigators in epidemiology and health-services research, and will provide resources for the conduct of junior-faculty and pilot studies.
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