Clinical and Translational Science Institute invests in four pilot projects

Penn State Clinical and Translational Science Institute awarded funding to four projects with topics addressing at-risk populations or instituting prevention programs in health care as part of its Bridges to Translation Pilot Grant Program.

Bridges to Translation invests in novel research ideas to promote collaboration across Penn State to collect information to lead to external funding and future research. The competitive process awarded principal investigators Britney Wardecker, PhD, and Jes Matsick, PhD, Dennis Scanlon, PhD, and Selena Ortiz, PhD, Megan Mendez Miller, DO, and William Calo, PhD.

“We received many strong proposals this year, especially related to rural and at-risk populations,” Lawrence Sinoway, MD, director of the institute, said. “The four funded projects represent diverse research topics across translational research. We look forward to seeing where these projects lead toward improving health.”

Penn State Clinical and Translational Science Institute provides tools, services and education to make health research more efficient and promote collaboration at Penn State. To learn about the institute’s resources, visit ctsi.psu.edu or request a consultation by completing a service request form.

The funded projects are:

Assessing person-centered care for LGBTQ older adults

Britney Wardecker, PhD, is studying person-centered care for LGBTQ older adults. A person-centered approach empowers individuals to actively participate in their care and incorporates aspects of their daily lives that are most important.

“Our project aims to develop and validate items for care and living preferences that reflect the needs of people with various sexual and gender identities, Wardecker said. “This pilot grant is important to our team because our proposal could lead to a tool to reduces LGBTQ health disparities. Honoring people’s individuality in their care is associated with better health outcomes.”

Wardecker will use the pilot study data to develop a proposal for a larger study to build upon the National Institutes of Health’s designation of LGBTQ people as a health disparity population and its priorities for aging, person-centered care and quality of life.

“We will evaluate the association between our newly designed items for care and living preferences with various sexual and gender identities and aging processes among LGBTQ older adults,” Wardecker said. “For instance, can characteristics associated with mental decline, like loneliness and lack of autonomy – risk factors found to be higher among LGBTQ adults than non-LGBTQ adults—be improved among LGBTQ people when preferences are honored?”

Wardecker is an assistant professor at Penn State College of Nursing. She is collaborating with Jes Matsick, PhD, co-principal investigator and assistant professor of psychology and women’s, gender, and sexuality studies; Rabbi Steelman, co-investigator, staff chaplain, and founder and director of the LGBT+ Initiatives and Task Force at Abramson Senior Care; and Kimberly Van Haitsma, PhD, co-investigator, professor of nursing, and director of the Program for Person-Centered Living Systems of Care at Penn State.

Increasing colorectal screening

Megan Mendez Miller, DO, is studying the use of annual stool-based testing for those at risk of not getting a colorectal screening.

“Patients with health disparities including lack of insurance coverage, health care access or transportation, as well as racial minorities and those of lower socioeconomic status are known to have less incidence of colorectal cancer screening combined with a higher incidence of colorectal cancers,” Miller said.

In this study, Miller will partner with federally qualified health centers and free clinics to pilot a colorectal cancer screening initiative using a stool-based test called a FIT test. Medical students will help patients navigate the health care system to receive a colonoscopy when the FIT results determine one is needed.

“As a family physician passionate about preventive health, especially related to vulnerable populations, I see this as a way for our academic health center to further build bridges and serve the highest needs in our local communities,” Miller said. “In utilizing medical students in leadership roles and patient navigation, we are exploring the power behind medical student navigation for vulnerable populations as well as in professional identity formation of future health care providers.”

The pilot data will show the effectiveness of such an approach in increasing colorectal screenings, which Millers hopes will lead to larger future studies.

“In addition, by showing feasibility and reproducibility of our program, we can disseminate our pilot data to inform academic medical centers, medical schools, federally qualified health centers and free clinics on how to have partnerships to achieve optimal health care of vulnerable communities,” Miller said.

Miller, assistant professor of family and community medicine, is collaborating with the departments of family and community medicine, gastroenterology and public health sciences; Hershey Endoscopy Center; and several clinics, including Hamilton Health, Beacon Clinic and Lebanon Free Clinic.

Scaling implementation of a prevention program

Dennis Scanlon, PhD, Selena Ortiz, PhD, and team are researching how to identify, implement and move evidence-based findings to scale rapidly. The pilot study builds on a current research project that implements the Centers for Disease Control and Prevention’s diabetes prevention program at Penn State Health’s State College medical clinic. The pilot study will help the team develop processes to implement the prevention program throughout Penn State Health system.

“This pilot grant is important to implement evidence-based practice in a major health system within our state,” Scanlon said. “What we learn from this implementation process will potentially inform other evidence-based programs in other clinical areas.”

The team will formally study and develop processes to spread the prevention program across the Penn State Health system outside of State College. While the study’s clinical focus is on diabetes prevention, the broader focus is to understand how to accelerate implementing and scaling evidence-based interventions throughout a health system.

Scanlon, a distinguished professor of health policy and administration, and Ortiz, an assistant professor of health policy and administration, are collaborating with junior and senior investigators and clinicians.

“The investigative team brings a strong balance of health economics, community engagement, and clinical expertise,” Ortiz said. “This collaborative aspect lends the expertise needed to explore other areas of clinical need.”

Assessing diseases of despair through a helpline

William Calo, PhD, is studying the use of a helpline to assess callers for diseases of despair and refer them to appropriate services.

“Many individuals in Southwestern PA contact the United Way’s PA 2-1-1 Southwest helpline for information or referrals to help meet basic needs,” Calo said. “Those social and economic stressors have been linked with behaviors causing diseases of despair, including suicide, drug overdose and alcohol-induced liver disease. This pilot project will use the opportunity this helpline provides for the implementation of a community-to-clinic referral approach. Callers are risk assessed for diseases of despair and referred to care in their communities.”

The diseases of despair are diagnoses related to social and economic conditions in communities. Princeton economists Anne Case and Angus Deaton proposed the concept in 2015. Case and Deaton’s research observed a decline in life expectancy of middle-aged white men and women between 1999 and 2015 – the first such decline since the flu pandemic of 1918. They theorized that this decline is associated with the social and economic downturn in rural communities and small towns. These changes include loss of industry, falling wages, lower marriage rates, increasing barriers to higher education, increased one-parent homes and a loss of social infrastructure. The topic is a focus of Penn State Clinical and Translational Science Institute.

“The causes of diseases of despair are countless and unique to every affected person. However, these diseases are directly related to communities’ underlying social and economic factors,” Calo said.

Calo will use the pilot’s data to support a future large-scale trial to compare the effectiveness of community-to-clinic referral methods on promoting engagement with health care.

“This information could significantly advance the knowledge and efficacy of referral interventions like the one we are testing,” Calo said. “Additionally, this project will provide new information about how community-clinical linkages are implemented in real-world settings.”

Calo, an assistant professor of public health sciences, is collaborating with Deepa Sekhar, MD, associate professor of pediatrics; PA 2-1-1 Southwest helpline led by its director and community leader, Michele Sandoe; and Jordan Lewis and Victoria Bosman from the Department of Drugs and Alcohol Programs.

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