Clinical and Public Health Research
Investigating Regional Issues and Increasing Community Awareness.
CMU College of Medicine clinical and faculty researchers are pursuing projects with the potential to significantly contribute to new discoveries to advance clinical care. This work is focused on finding better treatments for a variety of common chronic illnesses and challenging issues that affect many people in Michigan.
Some of the key areas our researchers are working on include:
Women and Infant Health
The Michigan Archive for Research in Child Health (MARCH) study is a population-based cohort, sampled to represent pregnant women in Michigan, which serves a dual purpose – as a source of information on the needs, concerns and health problems of pregnant women in our state – and as a resource for examining the underlying causes of childhood illnesses. For many environmental exposures – toxic, nutritional, inflammatory – the most sensitive period of risk for child health is pregnancy and the perinatal period. These exposures are best ascertained from maternal self-report, biological specimens and objective environmental data collected during pregnancy and immediately after birth.
Opioid abuse is an enormous problem in Central and Northern Michigan, and the College of Medicine is working on a number of ways to address this problem. Faculty are actively working to incorporate medication-assisted treatment into the curriculum, and developing and testing new models of inter-professional education to more effectively train health care personnel in the proper management of opioid prescriptions. A student-led group is involved with a community education and outcomes project to determine if better education of the public leads to less opioid abuse. On the basic science side, a faculty investigator is studying the mechanism and outcomes of the opioid-induced “loss of sigh reflex” in patients taking opioids.
Minority Population End-of-life Decisions
Elderly minority populations are at high risk for not arranging end-of-life care and have the lowest rate of completion of advanced directives. This research is seeks to reduce the disparity of service currently experienced at the end-of-life by offering a better educated medical community and providing patients appropriate communication regarding these difficult choices. The ultimate goal is to ensure that minorities and high-risk older adults are better educated on end-of-life choices and to increase the number of completed advanced directives in this patient population.
Public health research
Public health projects are about more than just conducting research – they're about providing a service to the community. The College supports a number of small, regionally relevant public health research projects that are faculty-led and provide students with opportunities for community engagement and training in research. These projects align with our focus on increasing community awareness, preparing physicians who excel in providing evidence-based care and serving medically underserved populations.
Disparities in Diabetic-induced Chronic Conditions in Michigan
A research group has received NIH funding to mine big data to understand and more effectively treat people with diabetes in underserved areas of health care to determine why well-known co-morbidities of diabetes are more common in these populations.
Healthcare Barriers for People with Disabilities: The Community and Physician's Perceptivces
It has been found that many physicians who treat patients with disabilities felt as if they were inadequately trained in treating patients with disabilities. Further, physicians noted they were less likely to examine their patients with disabilities or would only do partial examinations due to the difficulty of transferring patients onto an examining table, amount of time needed for those patients to dress and undress, along with the possible need for assistance, and lack of adequate equipment to assist with transportation.
This study Aims to identify and understand the various barriers and disparities that people with disabilities experience in rural and semi-urban areas in Michigan when trying to access healthcare and receive healthcare services. We also seek to understand the challenges that physicians face while treating their patients with intellectual disabilities in order to inform stakeholders and improve the healthcare system for this patient population.
Overcoming Barriers in HPV Vaccination and Increasing Vaccination Rates in Rural Michigan
Human Papillomavirus (HPV)is the most prevalent sexually transmitted disease in the United States, and its prevention directly reduces the incidence of several types of cancer. Despite measures to increase HPV vaccination rates since its approval in 2007, Michigan’s HPV vaccination rates are below the national averages.
The Primary Aims of this project are to A) Assess the knowledge gaps and socio-economic barriers that contribute to the low HPV vaccination rates in Michigan as well as to understand the barriers that participants face in receiving the HPV vaccination such as lack of education about the vaccine, lack of access to the vaccine, expense of the vaccine, multiple administration appointments of the vaccine, and any other barriers that may exist. B) To provide education addressing the gaps of knowledge about the HPV vaccine through a multi-media approach including an informational video and handout. These will include information about HPV supported by the CDC, CMU Health physician recommendation, and any other applicable sources. The Secondary Aim of this project is to increase the vaccination rate by providing the participants with information in a brochure about where they can get vaccinated. This will include working with the on-site clinic to offer the vaccine to those participants who request it and other locations who may offer the vaccine for free.
Community Mental Health Awareness Project
Approximately 1,475,000 adult Michigan residents experience mental illness, with approximately 57.3% not receiving treatment (MHS Administration). Among barriers to mental health care, stigma is emerging as an important, community level, modifiable barrier (Clements 2014). The Primary Aim of the project is to assess community knowledge and attitudes concerning mental illness, educate subjects, and evaluate the impact of education. We hypothesize that initial levels of stigma will decrease via education of the adult population.
Aortic Stenosis Community Awareness Project
Aortic stenosis is prevalent in all communities including rural areas. Some individuals do not present with symptoms that are easily detectable and can go undiagnosed for years. The primary Aim of this project is to assess whether the elderly population is knowledgeable about aortic stenosis and its progression, as well as physicians' perceptions of their patients' level of knowledge. Additionally, we hope to educate the elderly population on the signs and symptoms associated with this disease in an aim to help diagnosis and improve preventative care.
Homeless Persons' Experience in Healthcare: Insight and Inroads to Better Treatment
People experiencing homelessness have higher rates of chronic illness, chronic injury, infectious disease, mental illness, and substance use disorders (JAMA, O'Connell, 2016; HCUP, Sun, 2017). Comparing chronically homeless to their housed counterparts, these health disparities result in a 25-year decrease in life expectancy (National Coalition for the Homeless, 2009).
The aim of this project is to better understand how homeless people experience the healthcare system as well as medication access barriers and current unmet needs in order to design interventions to better serve this population.