Tag Archives: translational research

Karene Booker

Would  rewards or penalties work better for encouraging people to buy healthy food?  Will involving a person's family or faith-based social network improve an obesity intervention? How can state-of-the-art technologies be leveraged to measure people's exposure to stressors reliably and effectively, to help researchers study the links between stress exposure and health outcomes?

These are but a few of the questions that Elaine Wethington is tackling with her colleagues. She is playing a central role in three new prestigious grants which bring together accomplished interdisciplinary teams of scientists from economics, psychology, sociology, nutrition, marketing, epidemiology, and statistics. Wethington is a medical sociologist who is an Associate Professor in the Departments of Human Development and of Sociology. She is an expert in the study of stress and health and in translational research methods. Her major research interests are in the areas of stress and the protective mechanisms of social networks. She is co-director of the new Translational Research Institute on Pain in Later Life (funded by the National Institute on Aging and directed by Dr. Cary Reid of the Weill Division of Geriatrics), as well as the director of its Pilot Studies program.

A five-year, $6 million dollar grant will fund the Cornell Center for Behavioral Intervention Development to Prevent Obesity, a collaboration between Cornell University in Ithaca and the Weill Cornell Medical College. The goal of the new Center will be to translate basic behavioral and social science discoveries into effective behavioral interventions that reduce obesity and obesity related diseases in Black and Latino communities. The team will focus on behavior changes, not dieting - testing personalized strategies aimed at reducing weight and increasing physical activity in a way people can maintain over time.

In this project, Wethington will contribute her expertise to developing and designing the interventions, analyzing the results of participant interviews, and examining the impact of stressor exposure on the success of interventions. Dr. Mary Charlson, professor of integrative medicine at Weill leads the project. Other team members include Carol Devine, Division of Nutritional Sciences; Brian Wansink, Department of Applied Economics and Management; Martin Wells, Statistical Sciences; and Drs. Carla Boutin Foster, Erica Phillips-Cesar, Walid Michelen, and Bala Kanna from Weill Cornell. Harlem and South Bronx community health clinics affiliated with the Weill health system are participating as full partners in the development studies.

Another new study will team up researchers from the College of Human Ecology and the College of Agriculture and Life Sciences to explore strategies for influencing eating behavior. The work is supported by a nearly $1 million grant from the National Institutes of Health, funded by the American Recovery and Reinvestment Act. The research team will study how how shoppers respond to having easy to understand nutritional information available and to food pricing. Answers to these questions will shed light on the potential effectiveness of pricing policies designed to curb America’s appetite for “junk food.” Brian Wansink, Professor of Applied Economics and Management, leads the project. Wethington will focus on analyzing findings, as well as on developing the sampling, recruitment, and retention efforts for the study.  Other team members include John Cawley, Policy Analysis and Management; Jeffery Sobal from the Division of Nutritional Sciences; and David Just, William Schulze and Harry Kaiser from the Department of Applied Economics and Management.

In an existing 4-year grant from the National Institute for Drug Abuse, Wethington is collaborating with researchers from the University of Pittsburgh and Carnegie-Mellon University to develop valid, reliable, yet cost-effective instruments to measure chronic stress exposure in field studies. The instruments include hand-held devices for assessing chronic stress exposure and a web-based retrospective interview to assess stress exposure over a one-year period.  These instruments are being developed to support research on how stress affects health outcomes and how such effects are influenced by genetic factors. In this study, Wethington's contribution is focused on developing the web-based retrospective interview.  The team is led by Prof. Thomas Kamarck of the University of Pittsburgh Psychology department; team members include Drs. Barbara Anderson and Saul Shiffman at the University of Pittsburgh, and Drs. Daniel Sieworek and Asim Smailagic at Carnegie-Mellon.

These and other recent grants demonstrate the interest funders have in research that spans disciplines and translates basic behavioral and social science discoveries into effective behavioral interventions.

"The National Institute of Health recognizes that the 'team approach', involving established experts from multiple disciplines, has proven effective for tackling tough problems in health care and delivery, such as health disparities" states Wethington. "For some issues, such as reliable measurement of stressor exposure, social and psychological scientists are being encouraged to collaborate with computer scientists and engineers are developing health promotion and tracking devices. Social scientists who measure and study population health are being encouraged to collaborate with community health workers, health clinics, and frontline service agencies."

Effective collaboration strategies are the keys to success.Wethington adds: "No one discipline has the answer to every question. This is an exciting and rewarding time to be a health researcher.  You feel like you may be making a long-lasting contribution to the well-being of the population, while also benefiting from learning new things yourself."

Further Resources

Wethington, E., Breckman, R., Meador, R., Lachs, M. S., Carrington Reid, M., Sabir, M. & Pillemer, K. (2007).  The CITRA Pilot Studies Program:  Mentoring Translational Research.  The Gerontologist, 47, 845-50.

Wethington, E. & Pillemer, K.  (2007).  Translating Basic Research into Community Practice:  The Cornell Institute for Translational Research on Aging (CITRA). Forum on Public Policy Online, Winter 2007.

Human Development Outreach & Extension

Human Development Today e-News

The Cornell Institute for Translational Research on Aging (CITRA) is pleased to announce continued funding of its Roybal Center. The new center will be called the Translational Research Institute on Pain in Later Life (TRIPLL), and will focus on improving the prevention and management of pain in later life. Cornell University and its medical college are joined by new partners including Columbia University’s Mailman School of Public Health, Memorial Sloan Kettering Cancer Center, the Hospital for Special Surgery and the Visiting Nurse Service of New York. Dr. Cary Reid will serve as Director and Dr. Karl Pillemer will serve as co-principal investigator. Dr Elaine Wethington, also co-principal investigator, will oversee the Pilot Study core component of the grant.

The focus on pain management in later life is particularly appropriate given that as many as 30 to 40 percent of older adults experience persistent pain, which can be a costly and frequently disabling disorder in later life. Effective solutions to the problem of later-life pain require moving basic behavioral and social science and medical research findings more rapidly into programs, practices, and policies targeting older adults. This Center will continue to take advantage of its research-ready senior center and agency network, based in the diverse multicultural environment of New York City. It will build on its earlier success in applying theoretical and empirical findings in the area of social integration and isolation, to understand barriers to diffusion of successful pain management programs, particularly self-management programs and strategies.

The mission of the center is to 1) translate the findings of basic behavioral and social science research into treatments, intervention programs, and policies that improve the health and well-being of older adults who suffer from or are at increased risk for pain, 2) promote translation of evidence-based practices, treatments, and interventions across
diverse venues to improve management of pain, 3) develop and test innovative methods, tools, and strategies that facilitate successful translation of evidence into practice and finally, 4) develop and maintain an effective infrastructure for conducting translational research on aging and pain.

For Further Information

Please email Karl Pillemer, kap6@cornell.edu, or Cary Reid, mcr2004@med.cornell.edu, if you have any questions or would like additional information about TRIPLL. A new website is in preparation and will be available shortly.

Human Development Outreach & Extension

Rhoda Meador

When older people fall, experience chronic pain, or become socially isolated, a cascade of health problems tend to follow. Cornell University researchers have developed an innovative method, the research-to-practice consensus workshop, to bring researchers and practitioners together to share their knowledge and perspectives and to agree on research priorities, practice recommendations and how to disseminate recommendations.

The consensus workshop model was developed by researchers at the Cornell Institute for Translational Research on Aging (CITRA), which is a part of the Bronfenbrenner Life Course Center at Cornell. CITRA is a unique collaboration of social science, clinical research, and education, encompassing researchers from Cornell's Ithaca campus; research clinicians at the Division of Geriatrics and Gerontology at the Weill Medical College of Cornell in Manhattan. The CITRA approach to research involves researchers, educators, and community participants in joint decisions regarding every step of the research process. CITRA is funded by the National Institute on Aging.

“We developed this model to get evidence-based practices into the field and to put researchers and practitioners on equal footing. This helps create research that has the practice community in mind, but is still scientifically rigorous,” said Karl Pillemer, co-director of the (CITRA) and professor of human development at Cornell, who helped develop the model. “Now, CITRA can take a pressing problem for older people and ask researchers and practitioners together how to best approach it.”

So far, CITRA has sponsored six consensus workshops: The first workshop focused on falls prevention; subsequent workshops have addressed social isolation, chronic pain, elder abuse, care transitions and the application of hospitality research to aging services. In the case of the falls prevention consensus workshop, “The group agreed, for example, that the interventions most likely to be effective are group activities that include discussion, self-help, exercise and interpersonal skills training activities,” said Pillemer. “They also recommended working to strengthen naturally occurring networks among older adults living in the same neighborhood.”

"The workshops begin with a cutting-edge, non-technical summary of the scientific literature on the problem. Based on this document, several dozen selected academicians and practitioners come together to work toward a consensus.  “The model provides a non-threatening environment for researcher-practitioner dialogue to take place,” said Elaine Wethington, professor of human development at Cornell. “We think that the model provides a learning opportunity for researchers to become more aware of the real-world problems practitioners face and for practitioners to become more aware of research. It also provides an environment where both groups can develop innovative ideas for intervention programs because researchers and practitioners possess valuable insights, which are often complementary.”

CITRA Research-to-Practice Consensus Workshop Model

The concept of a research-to-practice consensus workshop emerged, in the course of the CITRA partnership, from discussions of ways to bridge the gap between research and practice. The research-to-practice consensus workshop was designed to achieve several specific goals. First, it addressed the need for meaningful dialogue between researchers and practitioners. Opportunities for equal-status contact between researchers and practitioners in which serious research issues can be openly discussed are few (Minkler & Wallerstein, 2003). The consensus workshop model provides a venue for such dialogue.

Second, scientists’ agendas frequently do not reflect the real-world concerns of eventual end-users of research (Stokes, 1997). A primary goal of the consensus workshop model was to identify discrepancies between interventions recommended by research and the actual experience of community-based practitioners. CITRA researchers and community partners jointly assumed that practitioners would be able to shed light on why some programs do not achieve expected results, and could provide important contextual information useful for the design of future intervention research projects.

Third, Kitson, Harvey and McCormack (1998) suggest that effective movement of research evidence into practice requires researchers’ attention to the environment in which the research is to be placed and to the method of facilitating the knowledge transfer, rather than simply assuming that the rigor of the evidence is sufficient justification for adoption. By encouraging practitioners to critique existing research and to place it in actual contexts where older persons are served, the consensus workshop aims to capture practitioner interest and to encourage discussion about the implications for practice.

To achieve the goal of facilitating meaningful dialogue between researchers and practitioners, CITRA modified an existing model popular in the scientific community. Many government agencies and scientific organizations organize “consensus conferences” or workshops (Black, Murphy, Lamping, McKee, Sanderson, Askham & Marteau, 1999; Ferguson, 1993; Goven, 2003).

The major steps involved in conducting the consensus workshop are:  1) Selecting a topic that is both an important problem and one on which there is scientific evidence; 2) Selecting a group of scientific experts on the topic; 3) Preparing a preliminary report that summarizes available research findings; 4) Convening meetings of the scientific panel involving presentations and discussion of the report; and 5) Preparing a final consensus report.

Further Resources

Visit the CITRA website for complete reports from each of the consensus workshops. The website also features a downloadable manual that users can use to conduct their own consensus workshop.

The CITRA Research-Practice Consensus-Workshop Model: Exploring a New Method of Research Translation in Aging

Taking Community Action Against Pain: Translating Research on Chronic Pain among Older Adults

Elder Mistreatment Consensus Recommendations

Social Isolation: Strategies for Connecting and Engaging Older People

Applying Hospitality Research to the Delivery of Aging Services

Transitions of Care for Frail Elders

References

Black, N., Murphy, M., Lamping, D., McKee M., Sanderson, C., Askham, J., Marteau, T. (1999). Consensus development methods: a review of best practice in creating clinical guidelines. Journal of Health Services Research Policy, 4, 236-48.

Ferguson JH. (1993). NIH consensus conferences: dissemination and impact. Annals of New York Academy of Sciences, 180-98; discussion 198-9.

Goven, J. (2003). Deploying the consensus conference in New Zealand: democracy and de-problematization. Public Understand. Sci. 12, 423–440.

Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence based practice: a conceptual framework. Quality in Health Care, 7, 149–158.

Minkler, M., Wallerstein, N.(2003). Community-Based Participatory Research for Health. San Francisco, CA: Jossey-Bass.

Sabir, M., Breckman, R., Meador, R., Wethington, E., Reid, M.C., & Pillemer, K. (2006). The CITRA Research-Practice Consensus-Workshop Model: Exploring a New Method of Research Translation in Aging. The Gerontologist, 46, 833-839.

Sabir, M., Wethington, E., Breckman, R., Meador, R., Reid, M.C., and Pillemer, K. (2009). A Community-Based Participatory Critique of Social Isolation Intervention Research for Community-Dwelling Older Adults. Journal of Applied Gerontology, 28, 218-234.

Cornell researchers have identified a need for older adult research subjects and have consistently reported challenges in recruiting subjects in an efficient and productive manner. In response, Cornell Institute for Translational Research on Aging (CITRA) has maintained a vigorous program to address the challenges of subject recruitment for translational research projects by forging successful relationships with community agencies and organizations in the New York City area. The NYC senior centers have come to constitute a very large respondent pool that has led to many successful community-research partnerships.

In October, 2007, CITRA launched a small, yet fruitful, initiative to extend the older adult respondent pool concept to Tompkins County, NY. The project leaders began this effort by recruiting adults from Tompkins County, age 60 or older. Subjects were recruited by telephone, leading to an initial pool of 200 potential subjects. Telephone recruitments are currently being conducted to double the size of the pool. In addition to recruiting subjects, staff collected basic information from respondents including previous research study experience, availability, mobility, and demographics including race, age, education, income, occupation, marital status, and language.

Researchers at Cornell interested in recruiting older respondents into their studies have access to this pool by applying to CITRA. In the first six months of operation, three researchers at Cornell-Ithaca have applied and received samples from the CITRA Older Adult Research Subject Pool for use in their individual research projects. They have reported rates of participation as high as 95%. The availability of a subject pool is a major incentive to new researchers to attempt translational research studies. Project leaders have submitted an abstract for a scientific presentation on the subject pool and anticipate publishing at least one article on this model.

CITRA is one of ten Edward R. Roybal Centers on Applied Gerontology nationwide. CITRA promotes evidence-based practice, systematic dissemination of information, and intervention studies involving the aging population. CITRA's on-line resources include downloadable publications on translating research to practice, research-community partnerships, conference summaries, trusted websites for information on aging, and much more.

For Further Information contact Leslie Schultz, ls30@cornell.edu.

Karl Pillemer

Cary Reid, Associate Professor of Medicine at Weill Cornell Medical College, and Karl Pillemer, Professor of Human Development and Director of Cornell Institute for Translational Research on Aging (CITRA) were awarded a grant of $450,000 from the National Institute for Nursing Research. The project, entitled “Taking Community Action against Pain," will conduct a trial of non-pharmaceutical interventions for chronic pain in older persons.

Over the past several years, CITRA has been developing a program of applied research and extension/outreach on the problem of chronic pain in older adults. Chronic pain is a common and costly disorder. Effective, evidence-based treatments in the form of self-management programs have been developed for use in the community, but have been underutilized. Numerous barriers to program use likely exist at the individual, program, and cultural levels. The project will use a community based participatory research approach to identify these barriers, develop and pilot test methods to successfully address the barriers, and then disseminate tools and resources.

Partnering with three senior centers in New York City (each serving a distinct race/ethnicity group), the interdisciplinary team will seek to answer the following key questions: 1) What are the major barriers to adoption of and adherence to an evidence-based pain-reduction protocol by seniors with chronic pain? 2) How can the pain protocol be adapted using a community based participatory research approach to better meet the needs of seniors from three distinct race/ethnicity groups: African American, Hispanic American, and non-Hispanic White Americans? 3) What is the effectiveness of this approach on pain management compared to a conventional chronic pain program?

A number of other activities relating to translational research on chronic pain are underway in CITRA. In addition to Reid and Pillemer, leadership in this area comes from Elaine Wethington, Associate Professor of Human Development and Co-Director of CITRA, and Anthony Ong, Assistant Professor of Human Development.

For Further Information

Cary Reid, mcr2004@med.cornell.edu

Karl Pillemer, kap6@cornell.edu

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During the last decade of his life, Urie Bronfenbrenner became increasingly concerned about the potential role of growing levels of chaos as it contributed to developmental disarray in children. Gary Evans, Departments of Human Development and Design and Environmental Analysis, organized with Ted Wachs, Department of Psychological Sciences at University of Purdue, the First Biennial Bronfenbrenner Conference on the ecology of human development. The conference theme was Chaos and Children's Development. The conference took place October 25-27, 2007 at the Bronfenbrenner Life Course Center, Cornell University.

Multidisciplinary groups of scholars from as distant as Istanbul, Turkey and as proximate as down the hall within the College of Human Ecology came together for two and half days to examine what we currently know about the role of chaotic living conditions in children's development and to utilize Bronfenbrenner's Bioecological Model of Human Development to conceptualize bridges between existing areas of developmental scholarship and the concept of chaos. Another objective of the conference was to formulate a research agenda to help illuminate the potential importance of the concept of chaos both to scholars as well as practitioners interested in children's well being. Cornell faculty Gary Evans, Dan Lichter, John Eckenrode, and Elaine Wethington presented papers at the conference. An edited volume will be forthcoming.

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