Current Projects
Development and Evaluation of an Intervention for Intimate Partner Violence in the Context of Nurse Home Visits (Funded by the CDC/National Center for Injury Prevention and Control for 2007-2012)
Co-PI's: Harriet MacMillan, MD; Jeffrey Coben, MD; David Olds, PhD
The overall goal of this project is to develop and evaluate an intervention to improve quality of life and reduce intimate partner violence (IPV) among low-income women during pregnancy and in the first two years postpartum. This five-year project is still underway, but considerable progress has been achieved. The intervention has been developed, pilot tested, and found to be acceptable to both nurses and clients in the NFP. The evaluation is ongoing. Originally proposed as a 10-site cluster randomized controlled trial, we have been able to expand the trial to include 15 sites within the Nurse Family Partnership program.
Factors Affecting Teachers Adoption of Youth at Work Talking Safety Curriculum (Funded by the CDC/National Institute for Occupational Safety and Health for 2011-2013)
PI: Kimberly Rauscher, ScD
This diffusion research study is an investigation of the barriers and facilitators faced by high school teachers in adopting and sustaining a youth-oriented occupational safety and health (OSH) curriculum. Over 200,000 teens are injured on the job annually, and one dies every five days from a work injury. Having safety training can help prevent these injuries, yet studies consistently show that many teens do not receive such training from their employers. NIOSH scholars have called for increased efforts at integrating OSH information into high school curricula, suggesting it is an effective way to transfer knowledge and raise OSH awareness among youth. A review of the OSH dissemination/translation literature provides little or no evidence on how best to do this. The proposed study aims to fill this gap. The NIOSH sponsored curriculum, Youth @ Work: Talking Safety (Talking Safety), is the most current and thorough program available in the United States to provide youth with the fundamental skills and knowledge they need to help keep themselves safe at work. While efforts to incorporate OSH topics into high school curricula are ongoing, there are no published data available on the success or sustainability of these efforts. With the ever increasing and often conflicting demands placed on teachers, the viability of their implementing an OSH curriculum in their classrooms, in a sustainable way and with fidelity, remains a question. Through telephone interviews with a sample of 338 high school teachers trained in the Talking Safety curriculum, we will achieve the following specific aims: 1) determine whether teachers trained in Talking Safety have adopted the curriculum (i.e., have ever used it in their classrooms) and if so, describe their level of sustainability (i.e. continued use) and fidelity to the curriculum activities and materials; 2) describe the barriers faced by teachers in adopting the curriculum, sustaining its use, and doing so with fidelity, and their suggested strategies for overcoming these barriers; and 3) identify the individual-, classroom-, and institutional-level factors associated with teachers’ initial adoption, sustained adoption, and fidelity to the curriculum activities and materials.
Burden of Injury in West Virginia (Funded by the West Virginia Bureau for Public Health for 2011-2012)
PI: Jeffrey Coben, MD
The West Virginia Bureau of Public Health has contracted the West Virginia University Injury Control Research Center to create a report that documents the “Burden of Injury in West Virginia.” Proceeding in four phases, this report will describe the morbidity, mortality, and financial costs associated with intentional and unintentional injuries to the residents of West Virginia. Phase I involves the identification and assessment of available data sources to be used in preparing the report. The objectives in Phase I are to: 1) identify relevant data sources, assess their usefulness, and determine their availability for analysis; and 2) summarize identified data sources and collaborate with the Bureau in deciding which data sources will be used to gather the information necessary to complete the report. In Phase II, the ICRC will specify both the design and content of the report. In Phase III, the ICRC and subcontractors will conduct data analysis and interpretation, construct tables and graphs, as well as design the layout of and assemble the report. Finally, in Phase IV the ICRC will disseminate the report (in both hard copy and electronic form) using a distribution list developed in collaboration with the Bureau.
Appalachian Training Program in Occupational Health and Safety (Funded by the CDC/National Institute for Occupational Safety and Health for 2010-2015)
PI: Christopher Martin, MD
Appalachia is arguably one of the most underserved regions in the country with an unacceptably high burden of occupational disease and injuries. This training program in occupational health and safety provides support to 1) the Occupational Medicine Residency, 2) the Occupational Safety and Health Engineering, and 3) Industrial Hygiene training programs at WVU. These training programs produce skilled professionals who understand workplaces, diagnose and treat injured workers, focus upon use of engineering to measure and identify hazards, understand failure modes and effects to engineer out such hazards, and are prepared for, and dedicated to, the public health aspects of mitigation and prevention in the region. In addition to having the only Occupational Medicine Residency and one of only three Occupational Safety and Industrial Hygiene programs in the entire Appalachian region, the presence of NIOSH’s largest facility in the country on our campus is a unique asset. NIOSH personnel are actively engaged in the efforts of all three training programs.
Does Graduated Drivers Licensing Produce Safer Teen Drivers? (Funded by the CDC/National Center for Injury Prevention and Control for 2010-2012)
PI: Motao Zhu, PhD
This comprehensive evaluation of Graduated Drivers Licensing (GDL) at the national level is expected to provide the strong scientific evidence needed to assess whether GDL does, in fact, produce safer drivers, and the extent to which GDL affects transport choices. Given that GDL influences nearly all adolescents and their families nationwide, the results of this study will be an important factor in informing policy decisions regarding whether GDL should be continued in its current form or substantially modified for safer driving as opposed to limiting driving. The objective of this research is to examine the impact of GDL on multiple outcome variables, including driving behaviors, alternative transportation, crash rate (per mile driven) and non-driver injuries (per person-year) among teenagers aged 15-17 years, and crash rate among 18 year olds. Using data from the National Household Travel Survey, which provides estimates on driving and transportation behaviors, as well as the Fatality Analysis Reporting System and Police Accident Reports, which identify fatal and injury crashes, we will: 1) identify changes in driving behaviors and crash rate among 15-17 year olds due to GDL implementation; 2) identify how GDL affects the use of alternative means of transportation (public transport, walking, bicycling, being driven by others) by teenagers aged 15-17 years, as well as how GDL affects deaths and injuries among 15-17 year olds who are vehicle passengers, pedestrians, and bicyclists; and 3) assess changes in driving behaviors and crash rate among 18 year olds due to GDL implementation.
Screening, Motivational Assessment, Referral & Treatment in Emergency Departments (Funded by the NIH/National Institute on Drug Abuse, Clinical Trials Network for 2010-2012)
PI's: Owen Lander, MD and Stephen Davis, MS, MPA
This study contrasts substance use and substance-related outcomes among patients exhibiting problematic drug use during an emergency department (ED) visit who are randomly assigned to one of three treatment conditions: 1) minimal screening only (MSO); 2) screening, assessment, and referral to treatment (if indicated) (SAR); and 3) screening, assessment, and referral plus a brief intervention (BI) with two phone follow-up booster sessions (BI-B). Individuals presenting in the ED displaying problematic drug use on screening are randomized in 1:1:1 ratio to MSO vs. SAR vs. BI-B. Randomization occurs after screening, and those randomized to MSO do not receive further assessment until follow up. The other two groups receive baseline assessment, and assignment to SAR vs. BI-B is not revealed until after the baseline assessment is complete. Those in the SAR group then receive referral if indicated, and those assigned to the BI-B group receive a brief intervention consisting of motivational enhancement therapy (MET) adapted for use in the ED, followed by referral if indicated. The BI-B group also receives two booster telephone calls, ideally within one week of the ED visit. Face-to-face follow up assessments of all three groups are conducted at 3 months, 6 months, and 12 months post-enrollment. A total of 1,285 patients with probable drug abuse or dependence (approximately 429 per group) seeking medical treatment in the ED, recruited from 6 EDs, will be enrolled.
Investigating the Longitudinal Consequences of Adverse Medical Events Among Older Adults (Funded by the NIH/National Institute on Aging for 2010-2012)
PI: Mary Carter, PhD
A paucity of information exists about the scope and impact of adverse medical events, especially among older adults. Moreover, because previous research has focused primarily on acute care settings, little is known about the pattern of adverse medical events across healthcare settings. In response, the overall goals of this project are to: 1) conduct a nationally representative, longitudinal investigation of the incidence of adverse medical events among older adults; and 2) examine the subsequent patterns of health, healthcare service use, and costs over several years duration. Our specific aims are to: 1) examine the incidence and patterns of adverse medical events among older adults across settings and over time; 2) examine the consequences of adverse medical events on subsequent healthcare service use over time; 3) explore transitions in health and functioning levels over time; and 4) estimate the direct and indirect healthcare costs associated with adverse medical events over several years of study. We are drawing upon multiple years of the Medicare Current Beneficiary Survey, a nationally representative, longitudinal panel of Medicare beneficiaries, to build an analytical data file, capable of tracking adverse medical events across medical settings and over time, for five separate cohorts of Medicare beneficiaries.
Centre for Research Development in Gender, Mental Health and Violence Across the Lifespan (Performed under contract from McMasters University; funding from the Canadian Institutes for Health Research)
Co-PI: Jeffrey Coben, MD
With funding support from the Canadian Institutes of Health Research's Institute for Gender and Health as a new Centre for Research Development, the Preventing Violence Across the Lifespan (PreVAiL) Research Network is an international research collaboration of over 50 researchers and partners from Canada, the United States, the United Kingdom, Asia, Europe and Australia including representatives from the World Health Organization and NCIPC’s Division of Violence Prevention. The goal of this initiative is to bring together researchers and decision-makers to produce and share knowledge that will help children, women and men exposed to child maltreatment and intimate partner violence (IPV). The three main objectives of PreVAiL are to: 1) increase knowledge about the links between mental health impairment, gender and exposure to child maltreatment and IPV, both in Canada and internationally; 2) develop interventions to prevent or reduce child maltreatment, IPV and related mental health problems; and 3) develop and use proven methods of knowledge translation and exchange to ensure that our research findings reach those who make decisions in these areas. PreVAiL has implemented an entire program of research activities, networking, pilot projects, and new investigator mentoring, which are described in greater detail at http://www.prevailresearch.ca.
Occupational Health Literacy, Socioeconomic Status & Work-related Injury to Teens (Funded by the CDC/National Institute for Occupational Safety and Health for 2009-2012)
PI: Kimberly Rauscher, ScD
This study examines the relationship between health literacy as it applies to the workplace, i.e., “occupational health literacy,” and work-related injury (WRI), which affects nearly 230,000 U.S. adolescents under 18 every year. Since general health literacy is known to be associated with a variety of health outcomes and with socioeconomic status (SES), occupational health literacy is likely to be related to occupational health outcomes and to SES as well, yet no previous studies have explored this hypothesis. In this study, occupational health literacy is examined as both a determinant of WRI prevalence and as a mediating factor in the known association between SES and adolescent WRI. Specific aims are to determine: 1) if low occupational health literacy is associated with higher WRI prevalence among youth; 2) if youth of lower SES have lower occupational health literacy; and 3) if low occupational health literacy among low SES youth mediates the association between low SES and elevated WRI prevalence. We will achieve these aims by taking advantage of a unique dataset containing information on 2,315 adolescent workers of varying levels of SES in five cities across the US. These data include WRI prevalence, several measures of SES and an array of variables used to measure occupational health literacy (e.g., access to health and safety information and demonstrated health and safety knowledge and skills).
Young Worker Fatalities and Violations of Labor and Safety Regulations: Moving Toward a Solution (Funded by the CDC/National Institute for Occupational Safety and Health for 2008-2012)
PI: Kimberly Rauscher, ScD
Evidence shows that nonfatal injuries can occur when youth are illegally employed, yet little research has looked at the relationship between fatal injuries among young workers and violations of labor and safety regulations. Understanding this problem and generating strategies for improvements are the goals of this study. To achieve them, the study uses a mixed-methods approach which involves taking the findings into the field and engaging with stakeholders (i.e., enforcement officials) to affect change at the local level. The first aim of the study is to understand the extent to which violations of child labor laws and/or health and safety standards are related to adolescent occupational fatalities. The second aim is to explore how the current enforcement environment might have an impact on this relationship by examining the extent and nature of investigations carried out by federal and NC regulatory agencies on identified young worker fatalities. The last aim is to identify current challenges in enforcement and develop strategies to overcome these challenges and improve the protection of young workers by engaging with a range of local stakeholders through focus groups, in-depth interviews, and a multi-organizational capstone meeting.