Research
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.
Research in the Department of Family Medicine has four main areas of focus and expertise:
- Communication in Health Care Settings
- Disparities in Health and Health Care
- Health Care for Marginalized Populations
- Cancer: Prevention, Patient-Centered Communication, Patient Navigation
Communication in Health Care Settings – Ronald M. Epstein, MD and Stephen J. Lurie, MD, PhD
- The Rochester Center to Improve Communication in Health Care was founded in 2003 to consolidate research in a variety of areas relating to communication between physicians and patients, among health care professionals, and media influences on the patient-physician relationship. We have a particular interest in 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 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.
- Dr. Stephen J. Lurie, MD, PhD focuses on measurement of communication skills as well as on educational research on peer assessments, social networks and teamwork.
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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 National Cancer Institute (NCI); Agency For Healthcare Research And Quality (AHRQ); National Heart, Lung and Blood Institute; National Institute of Mental Health; and the Robert Wood Johnson Foundation. In 2005, Dr Fiscella was the recipient of a $3.2 million, five year grant from the NCI to improve access to cancer diagnosis and follow-up for disadvantaged populations; in 2007, he received a $1.1 million grant from the American Cancer Society to to assess the impact or reminders, recall, and outreach on disparities in colorectal cancer screening, and an $820,000 grant from the NIH/National Heart, Lung and Blood Institute to demonstrate that the incorporation of social risk into global risk assessment and preventive treatment guidelines offers potential for reducing disparities in coronary heart disease.
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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 care for deaf people and their families, including issues of access, communication and patient knowledge. He is co-principal investigator on a large Centers for Disease Control prevention grant focusing on the community of deaf American Sign Language users ($3.5 million over five years), and received a K-08 award from AHRQ in 2006. Rochester has the highest per capita deaf population in the USA. It has approximately three times the density of deaf people than other cities in New York State, with an estimated 10,000–15,000 Rochesterians who communicate in American Sign Language (ASL). Nationally, more than 4.9 million people cannot hear or understand speech, and approximately 28 million people have some degree of hearing loss.
- 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.
- 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 will be published as a book in October 2007 by the NCI. He is also the Principal Site Investigator on a grant from the Avon Foundation to the Boston Medical Center entitled "Measuring What Navigators Do: Task and Social Network Analysis" 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.
- 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.
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Psychometrics -
- Kathleen D. Holt, PhD and Sean Meldrum, MS offer psychometric and statistical support to faculty both within and outside the department.
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