Research
The University of Rochester Department of Family Medicine rates #10 in the USA in federally funded research. Research in the Department of Family Medicine focuses on improving communication between patients and health professionals, and reducing disparities in health and health care. Specific areas of research include:
- Patient navigation to reduce disparities in cancer care
- Patient activation to improve recognition and treatment of depression in primary care
- Promoting physical exercise in minority populations
- Improving patient-physician communication about risk and uncertainty
- Web-based approaches to suicide prevention for gay and lesbian adolescents
- Improving patient-clinician communication and healthcare for deaf patients and families who communicate with American Sign Language (ASL)
- Promoting mindfulness and self-monitoring in clinical practice
- Peer review to improve quality of care and professionalsim
- Healthcare needs of refugees
Our research programs, directed by Dr. Ronald Epstein, are housed in a 5,000 square foot building at 1381 South Avenue in Rochester. We emphasize a collaborative approach to research, including a variety of disciplines and areas of expertise, including psychology, family systems, epidemiology, qualitative methods, psychometrics, and analysis of large claims databases.
Communication in Health Care Settings – Ronald M. Epstein, MD
Dr Epstein directs the The Rochester Center to Improve Communication in Health Care, founded in 2003 to consolidate research relating to communication between clinicians and patients and among health care professionals, to address the needs of vulnerable and marginalized populations.
- Dr. Epstein’s research focuses on the relationship between patient-centered communication and health care costs, the influence of direct-to-consumer advertising on the patient-physician relationship and physician prescribing patterns, and communication research theory and methodology. Funding has been through the Agency For Healthcare Research And Quality, National Institute Of Mental Health, National Cancer Institute, and the Robert Wood Johnson Foundation. In addition, his educational research has been funded through foundation grants.
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Disparities in Health and Health Care – Kevin Fiscella, MD, MPH
- Dr. Fiscella’s research focuses on factors that promote and eliminate disparities in health care, including access to care, prejudice and bias, health insurance status, trust, and communication. His major grants have been funded by the Agency For Healthcare Research And Quality; Centers for Disease Control and Prevention; National Heart, Lung and Blood Institute; National Cancer Institute (NCI); and the Robert Wood Johnson Foundation. In 2005, Dr Fiscella was the recipient of a substantial five year grant from the NCI to improve access to cancer diagnosis and follow-up for disadvantaged populations; in 2007, he received a large grant from the American Cancer Society to assess the impact of reminders, recall, and outreach on disparities in cancer screening, and a grant from the National Heart, Lung and Blood Institute to access the added benefit of the incorporation of social risk into coronary heart disease risk assessment. He is also exploring the impact of interactive media on informed decision making in colorectal screening of underserved patients through a subcontract with the University of California at Davis on Dr. Anthony Jerant's grant from the NCI.
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Health Care for Marginalized Populations – Steven Barnett, MD; Jennifer K. Carroll, MD, MPH; Vincent M. B. Silenzio, MD, MPH
- Dr. Barnett has devoted his career to health promotion and healthcare with deaf people and their families, with a focus on working with people and familes who primarily communicate with American Sign Language (ASL). He is Associate Director of the Center for Disease Control (CDC) funded Rochester Prevention Research Center: National Center for Deaf Health (NCDHR). NCDHR 's mission is health promotion and disease prevention with deaf and hard-of-hearing people and their families through community-based participatory research (CBPR). NCDHR's initial five-years (2004-2009) focused on collecting baseline health data by adapting a CDC telephone survey for use in ASL on a touchscreen computer-kiosk. During the second cycle (2009-2014), NCDHR will focus on developing and evaluating linguistically accessible and culturally appropriate healthy weight interventions. Dr Barnett also received an AHRQ K08 Mentored Research Career Development Award (2006-2011). That research studies the healthcare experiences of deaf adult ASL-users by first adapting AHRQ's CAHPS®(Consumer Assessment of Healthcare providers and Systems) ambulatory surveys for use in ASL.
- Dr. Carroll has also focused on refugee health, including issues of political asylum, torture, and the role and status of women in refugee communities, and was the recipient of a grant from the Agency for Healthcare Research and Quality to continue her research on refugee health issues. Major refugee populations in Rochester include those from Sub-Saharan Africa and Southeast Asia. She was the recipient of an NIH Loan Repayment Award, and completed the highly competitive Grant Generating Project sponsored by the American Academy of Family Practice.
- Dr. Silenzio focuses on suicide prevention research among gay, lesbian, and bisexual, adolescents using Internet-based approaches. He has a 3-year T32 NRSA Research Fellowship in Suicide Prevention Research from the National Institute of Mental Health, and works closely with the Psychiatry Department's Center for Study and Prevention of Suicide. Dr. Silenzio has focused on health care for the lesbian, gay, bisexual and transgendered (LGBT) population with emphasis on HIV risk behaviors and the effects of violence directed at LGBT individuals upon mental health, particularly with regard to suicide. He has received a New Investigator Award from the National Institute of Mental Health, and has expertise in qualitative and quantitative methodology.
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Cancer: Prevention, Patient-Centered Communication, Patient Navigation - Drs. Carroll, Epstein and Fiscella
- Dr. Carroll's work focuses on the role of exercise in the prevention of cancer, and, as a trainee on the UR Cancer Center's Cancer Control grant funded by the National Cancer Institute, was the Principal Investigator on three studies designed to explore various issues related to physical education counseling, including underserved communities. She is now exploring the same areas of interest as a K Award recipient from the National Cancer Institute.
- Dr. Epstein and Dr. Richard L Street of the Baylor College of Medicine were commissioned by the NCI to prepare a monograph entitled "Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering;" this has been published by the NCI.
- Dr. Fiscella's grant from the NCI, entitled "Randomized Control Trial of Primary Care-based Patient Navigation-Activation," is designed to evaluate the impact of patient navigation on both cancer related quality of care and on disparities in cancer-related care. He is further exploring the area of Patient Navigation with Jennifer Carroll, Site Principal Investigator, on a subcontract with Boston Medical Center funded by the Avon Foundation that is intended to develop a measure to directly observe and quantify the tasks of patient navigators and the networks they employ to conduct their work.
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Risk Perception/Patient Communication-Robert E. Gramling, MD, DSc
- Dr. Gramling holds two NIH independent research awards investigating the 1) impact of cardiovascular disease (CVD) risk perception on long-term CVD outcomes and 2) whether raising awareness of heritable CVD risk improves long-term outcomes among individuals with a strong family history.
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Statistics - Paul Winters, MS
- Paul Winters, MS offer psychometric and statistical support to faculty both within and outside the department.
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