CoHSTAR Fellows are matched with faculty mentors at one of our participating academic institutions. Fellowship trainees customize their training experiences by focusing their study in one of the three health services research foundational areas:
- Analysis of large data sets
- Rehabilitation outcomes measurement
- Implementation science and quality assurance
1. Brown University
CoHSTAR fellows at Brown University work within the Brown University Center for Gerontology and Healthcare Research. This Center and other key resources and opportunities available for CoHSTAR fellows are described below.
The Center for Gerontology and Healthcare Research is one of the research centers within Brown University’s School of Public Health with a nationally prominent research program that studies the diverse health and social service needs of older adults and those with chronic illnesses. This center maintains state-of-the-art “dry lab” research with extensive data management resources including the SAGE archive: a multi-state, multi-year administrative database linking 20 million nursing home residents’ Minimum Data Set (MDS) assessments with nursing home facility characteristics, home health patients’ Outcome and Assessment Information Set (OASIS) assessments, Medicare claims, and Area Resource File data sets. This innovative data infrastructure can also be linked with the Centers for Medicare & Medicaid Services (CMS) Virtual Research Data Center (VRDC) workbench to provide close to “real-time” data for the planning and conducting studies.
The Q&I Center is a unique center based at Brown University that partners with healthcare providers, healthcare systems, and other innovators to identify promising interventions and seek grant funding to rigorously test them. The Q&I Center is affiliated with the American Health Care Association/National Centers for Assisted Living (AHCA/NCAL) and BAYADA Home Health. The Q&I Center facilitates recruitment of research sites from within the AHCA/NCAL network, assists investigators in implementing embedded pragmatic cluster-randomized trials (ePCTs), and uses the Center for Gerontology and Healthcare Research’s robust administrative data to evaluate between-group differences in outcomes over time.
NIA Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) is an approximately $54 million, five-year grant from the National Institute on Aging (NIA) that funds a nationwide effort to improve healthcare and quality of life for people living with Alzheimer’s disease and related dementias, as well as their caregivers. The overarching objective of this grant is to build on the model of the NIH Collaboratory to establish the National Institute on Aging (NIA) AD/ADRD Research Collaboratory. IMPACT will fund and provide expert assistance for up to 40 pilot trials that will test non-drug, care-based interventions for people living with dementia. The 40 pilot projects will be embedded in real-world healthcare systems and generate the necessary data to inform larger, definitive trials supported with federal funding. IMPACT will also develop best practices for implementing and evaluating interventions for Alzheimer’s and dementia care and share them with the research community at large.
The Center for Evidence Synthesis in Health (CESH) and The Brown Evidence-based Practice Center (EPC) are housed at Brown University. The EPIC is one of only 11 centers in North America that have been designated by AHRQ to perform Comparative Effectiveness Reviews, Technology Assessments, prioritizations of Future Research Needs, and other projects based on evidence-based medicine methodologies informed by stakeholder engagement processes. CESH faculty have published over 100 methodological articles on systematic reviews and meta-analyses, more than 200 applied systematic reviews, and over 80 evidence-reports and technology assessments in AHRQ’s EPC program. Within the center, EPC faculty have pioneered innovative methods and developed software tools for conducting evidence reviews and disseminating their findings. They have also contributed to setting community standards as evidenced in the influence of their work on definitive Institute of Medicine reports on evidence-based medicine and guidelines development and their role in leading one of the Patient Centered Outcomes Research (PCOR) methods study teams.
Advance Clinical and Translational Research (Advance-CTR) serves as a central hub to support and educate clinical and translational researchers in Rhode Island. Advance-CTR, supported by an IDeA-CTR program award from the National Institute of General Medical Science, works to support researchers by developing the infrastructure and resources investigators need to conduct clinical and translational research in Rhode Island. CoHSTAR Postdoctoral fellows at Brown will have access to Advance-CTR resources. Advance-CTR consists of two Award Cores and three Service Cores. The Award Cores are The Pilot Projects Program and the Professional Development Core, and the Service Cores include Clinical Research Design, Epidemiology and Biostatistics, Biomedical Informatics and Cyberinfrastructure Enhancement, and Clinical Research Resources and Facilities. The Mentored Research Awards aim to recruit and train an outstanding group of health scientists who will receive 75% protected research time to conduct clinical and translational research projects.
The Brown Center for Biomedical Informatics (BCBI) serves as the Biomedical Informatics and Cyberinfrastructure Enhancement Core of Advance-CTR. It offers the following resources and services: 1) facilitates requesting, accessing, and using data from health data partners and other data sources 2) helps identify options and solutions for storing and managing data from health data partners or other data sources, 3) assists in use or development of computational tools for processing (including de-identifying) and analyzing data from diverse sources, 4) assists with natural Language Processing, visualization and expertise with bioinformatics tools such as Ingenuity Pathway Analysis (IPA), 5) supports archiving, sharing, and disseminating research products using best practices and available, 6) provides guidance in available software to support project needs and facilitate installation of software in research computing environments such as URSA Stronghold, 7) provides programming support for custom development for creation and analysis of custom datasets or databases or web applications, 8) offers guidance for projects requiring informatics and data science expertise, with a focus on support for developing extramural or pilot project applications, and 9) provides training sessions related to offered services as well as other informatics and data science topics to complement existing full-semester and short immersion courses.
University of Pittsburgh Resources
CoHSTAR fellows at the University of Pittsburgh work within the School of Health and Rehabilitation Sciences (SHRS). SHRS and other key resources are described below.
The School of Health and Rehabilitation Sciences (SHRS) comprises 28 programs in rehabilitation and health disciplines, which span six departments: Communication Science & Disorders; Health Information Management; Occupational Therapy, Physical Therapy, Rehabilitation Science & Technology; and Sports Medicine & Nutrition. SHRS faculty have over $21.2 million in research funding from the Department of Health and Human Services, the Department of Defense, the Department of Veterans Affairs, the National Institutes of Health, the National Science Foundation, the Patient-Centered Outcomes Research Institute, the Pennsylvania Department of Labor and Industry, the United States Agency for International Development, multiple foundations, and other sponsors.
The University of Pittsburgh CTSI provides specialized resources, education, and expertise to support a wide range of clinical and translational research. The CTSI is organized into 12 Core divisions: Biomedical Modeling, Biostatistics, Epidemiology & Research Design, Community Engagement, Participant & Clinical Interactions, Biomedical Informatics, Innovation, Pilot Funding, Recruitment Innovation, Regulatory Knowledge & Support, Engaging Special Populations, Team Science & Workforce Development, and Trial Innovation.
The Physical Therapy Clinical and Translational Research Center (PT-CTRC) provides consistent, high quality physical-performance testing and rehabilitation intervention services to clinical and translational researchers. CoHSTAR fellows at University of Pittsburgh will have the opportunity to utilize the PT-CTRC or consult on methodological issues in implementation of specific performance testing and training procedures.
The Department of Physical Medicine and Rehabilitation’s mission is to maximize the health, function, and well-being of the people and populations they serve by providing the highest quality rehabilitative medical care, conducting highly relevant, cutting-edge research, and training the next generation of clinicians and researchers. The Department is nationally recognized for Rehabilitation Excellence with their physiatrists consistently listed as Top Doctors in Pittsburgh Magazine, national designation as a Center of Excellence in care for both TBI and SCI, and for being among the top five PM&R departments in funding from the NIH for rehabilitation research. Faculty from the PM&R Department will serve as potential mentors for CoHSTAR Fellows.
Boston University Environment
CoHSTAR fellows at Boston University work with faculty members from the School of Public Health, Health Law Policy, and Management (SPH-HLPM). SPH-HLPM and other key resources are described below.
The School of Public Health, Health Law Policy, and Management (SPH-HLPM) is a national leader in training healthcare policymakers and managers, helping students to develop the expertise and tools needed to meet the challenges facing today’s healthcare system. SPH-HLPM offers rigorous, competency-based educational programs that include the country’s largest concentration of health law faculty and courses. Multidisciplinary faculty specialize in engaging teaching methods, active learning, and a wide variety of innovative research projects, including: analyzing current Medicare and Medicaid policy, studying drug policy and regulation, and evaluating racial and ethnic variations in patient care. SPH-HLPM faculty members are widely published experts in health law, bioethics, human rights, policy, health services, and economics and implementation science, and address real-world problems by serving as members of state, national, and international committees and task forces. Beginning in 2020, the SPH-HLPM will offer a new Master of Science program in Translational and Implementation Science.
Sargent College comprises four academic departments: Occupational Therapy; Speech, Language, and Hearing Sciences; Physical Therapy and Athletic Training; and Health Sciences. The college’s 35 research labs and centers are supported by more than $16M in external funds annually. Sargent’s clinical services include the Boston University Physical Therapy Center, the Ryan Center, a full-service commercial clinic; the Center for Neurorehabilitation; the Sargent Choice Nutrition Center; the BU Speech-Language Clinic; the Aphasia Resource Center; and the Center for Psychiatric Rehabilitation. Research laboratories include more than 10,000 square feet, including wet labs (i.e., for the study of muscle biology, systems neuroscience, vascular biology, and aging), kinesiology and motion capture labs (neuromotor recovery, human adaptation, coordination dynamics, applied imaging, motor development), computational and imaging labs (speech, language and communication neuroscience), and human behavioral labs (autism, motivation and participation, severe mental illness, typical development, cerebral palsy). In addition, Sargent College faculty and student researchers collaborate throughout BU, Boston and beyond. Areas of particular focus include biomedical engineering, rehabilitation engineering, neuroscience and neuroimaging, physical and rehabilitation medicine, child development, linguistics, computational modeling, data sciences, mHealth/telemedicine and community health.
The Clinical and Translational Science Institute (BU CTSI) was funded through an NIH-funded clinical and translational science award to build on existing strengths to create an environment linking faculty members, trainees, and university programs. The institute acts as a bridge between disciplines to facilitate interactions by incorporating multiple key programs that support the university-wide commitment to a home for translational research. The ultimate goal is to accelerate the translation of innovations in medical science in order to improve maintenance of health and diagnosis and treatment of disease and share these innovations with other University-based Clinical and Translational Science Awards (CTSAs). The BU CTSI environment also supports the bi-directional development and translation of ideas that begin in the clinic to the BU scientific community and back to identify new ways to improve health and the delivery of healthcare services. Moreover, the Institute significantly enhances existing partnerships with Boston’s community health centers, transforming the conduct of clinical and translational research by infusing it with community-based perspectives and needs.
The Center for Implementation and Improvement Science (CIIS) is a methodological hub for the scientific evaluation of efforts to improve healthcare delivery. Combining Implementation and Improvement Sciences allows CIIS to assist in the development and rigorous evaluation of endeavors that seek to improve the quality of healthcare, particularly related to care for the underserved. CoHSTAR Fellows at BU can participate in the resources of CIIS, including a regular, 4-part skill building educational sessions covering a range of implementation and improvement sciences topics; and a 7-part skill building series on Transforming Implementation and Improvement Into Science.