This application in response to SIP13-072, Expanding Information about Dementia and Co-occurring Chronic Conditions among Older Adults, will provide critical information to clinicians, policy makers and researchers to establish/refine guidelines and target interventions to improve quality of care for older adults with cognitive impairment (CI) and multiple chronic conditions (MCC). It will address major research gaps in public health practice information previously identified through SIP 10-037 and other potential priority areas of the Healthy Aging Program in the CDC's National Center for Chronic Disease Prevention and Health Program, Division of Population Health, viz., """"""""multiple chronic conditions"""""""", """"""""provision of clinical preventive services"""""""" and """"""""service utilization outcomes-hospitalizations."""""""" Component One consists of a secondary analysis of the combined Health and Retirement Study/Medicare administrative data database to measure the impact of CI and MCC on receipt of necessary and preventive care and ambulatory-care-sensitive hospitalizations. It will address several specific limitations of earlier studies on health services use by persons with CI and MCC: focus on over- or under-use rather than quality of care; focus on single chronic conditions rather than MCC;simplistic conceptualization and operationalization of MCC;failure to examine the impact of NPC on other service utilization;and inability to examine level of CI. Component Two consists of the use of an expert-panel guided literature review and public policy agenda development strategy proposing collaboration with selected Healthy Aging Research Network Centers having particular expertise in/focus on CI, the BioBehavioral Heart Health (B2H2) Collaboration, the International Research Community on Multimorbidity, and CDC Project Scientists. Component One Aims: In a nationally representative sample of adults age 65 and older:
Aim 1 : To provide baseline descriptive statistics and ensure that Aims 2 and 3 follow SMART principles, measure the occurrence and co-occurrence of CI and MCC as: one-year period prevalence of CI (none, mild, moderate/severe) and chronic conditions using counts, published indices, intersection of comorbidities, geriatric syndromes and physical disability, and empirically derived clusters of comorbidities;
Aim 2 : In a cross- sectional analysis, compare the use of NPC and H-ACS in individuals with and without MCC (measured as indicated above) and/or with mild or moderate/severe CI;
Aim 3 : Test a model to examine whether receipt of inadequate NPC mediates the relationship between MCC and/or CI and higher likelihood of H-ACS. Component Two Aims Aim 1: Conduct a guided literature review to update findings from SIP 10-037 regarding gaps in knowledge about MCC in older adults;
Aim 2 : Assemble and engage a 5-8 member expert panel to develop, vet and disseminate a public health agenda for the Healthy Aging Research Network.

Public Health Relevance

The proposed project addresses unmet public health needs by documenting the current patterns of care received by older adults with cognitive impairment (CI) and multiple chronic conditions (MCC) to identify subgroups at high risk for inadequate care and unnecessary hospitalizations, and suggest appropriate interventions and guidelines. A public health agenda specific to individuals with or at risk for the co-occurrence of CI and MCC will be developed and disseminated.

Agency
National Institute of Health (NIH)
Institute
National Center for Chronic Disease Prev and Health Promo (NCCDPHP)
Type
Health Promotion and Disease Prevention Research Centers (U48)
Project #
3U48DP001930-05S1
Application #
8642411
Study Section
Special Emphasis Panel (ZDP1-EEO (7E))
Project Start
2009-09-30
Project End
2014-09-29
Budget Start
2013-09-30
Budget End
2014-09-29
Support Year
5
Fiscal Year
2013
Total Cost
$304,513
Indirect Cost
$110,556
Name
Case Western Reserve University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Trapl, Erika S; Koopman Gonzalez, Sarah J; Fryer, Craig S (2018) Adolescent dual-product users: Acquisition and situational use of cigarettes and cigars. Drug Alcohol Depend 188:356-363
Trapl, Erika S; Koopman Gonzalez, Sarah J; Cofie, Leslie et al. (2018) Cigar Product Modification Among High School Youth. Nicotine Tob Res 20:370-376
Trapl, Erika S; Koopman Gonzalez, Sarah J (2018) Attitudes and Risk Perceptions Toward Smoking Among Adolescents Who Modify Cigar Products. Ethn Dis 28:135-144
Sajatovic, Martha; Tatsuoka, Curtis; Welter, Elisabeth et al. (2017) Correlates of quality of life among individuals with epilepsy enrolled in self-management research: From the US Centers for Disease Control and Prevention Managing Epilepsy Well Network. Epilepsy Behav 69:177-180
Antognoli, Elizabeth L; Seeholzer, Eileen L; Gullett, Heidi et al. (2017) Primary Care Resident Training for Obesity, Nutrition, and Physical Activity Counseling: A Mixed-Methods Study. Health Promot Pract 18:672-680
Freedman, Darcy A; Flocke, Susan; Shon, En-Jung et al. (2017) Farmers' Market Use Patterns Among Supplemental Nutrition Assistance Program Recipients With High Access to Farmers' Markets. J Nutr Educ Behav 49:397-404.e1
Trapl, Erika S; Pike, Stephanie N; Borawski, Elaine et al. (2017) Food Melt in Consumer Food Environments in Low-income Urban Neighborhoods. Am J Health Behav 41:710-718
Koopman Gonzalez, Sarah J; Cofie, Leslie E; Trapl, Erika S (2017) ""I just use it for weed"": The modification of little cigars and cigarillos by young adult African American male users. J Ethn Subst Abuse 16:66-79
Sahoo, Satya S; Zhang, Guo-Qiang; Bamps, Yvan et al. (2016) Managing information well: Toward an ontology-driven informatics platform for data sharing and secondary use in epilepsy self-management research centers. Health Informatics J 22:548-61
Jewett-Tennant, Jeri; Collins, Cyleste; Matloub, Jacqueline et al. (2016) Partnership Among Peers: Lessons Learned From the Development of a Community Organization-Academic Research Training Program. Prog Community Health Partnersh 10:461-470

Showing the most recent 10 out of 22 publications