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Public health program gets $10m boost

The National Institute on Aging has awarded a team of Brown researchers over $10 million to study long-term care for the elderly nationwide, a windfall of rare magnitude for the University's burgeoning public health program.

The team, headed by Vincent Mor, professor of medical science and chair of the Department of Community Health, will compile a national database of information on nursing home practices and long-term care policies and conduct four studies using the information over the next five years.

Using the information they compile, researchers will study what factors influence when the elderly are hospitalized, how hospice care is administered for terminally ill nursing home residents, how physicians operate in nursing homes and the causes and effects of racial segregation in nursing home populations.

The research team - a multidisciplinary group organized by faculty in the University's Center for Gerontology and Health Care Research - will integrate data from a range of existing and original sources, including Medicare billing records, basic information that nursing homes are required by law to collect, a survey of state policies and a questionnaire that will be administered to a representative sample of over 2,000 nursing homes nationwide.

Beyond the research funded by the grant, members of the team said, the database should provide a wellspring of information that could spawn a great deal of future research.

Terrie "Fox" Wetle, associate dean of medicine for public health and public policy and a lead investigator on one of the studies the grant is funding, said the study "will provide the impetus for major improvements in the quality of care."

"Finding ways to both efficiently measure quality of care and then improve it is a central goal to our work," she added.

The grant is also a significant boon for the University. In a given year, the University is likely to receive about $40 million in grants from the National Institutes of Health, of which the NIA is a part. Most of those grants do not substantially exceed $1 million, Wetle said.

The University has expanded its public health efforts in recent years, centralizing them in new property at 121 South Main St. with the ultimate aim of creating a separate school of public health by 2010.

Receiving a grant of such magnitude from the NIA will help the public health program continue to grow and attract researchers, and it also represents "recognition that the University has the capacity" to undertake such a complex project, Wetle said.

"A $10 million grant is a big deal," Wetle said. "It's an act of trust. That's a lot of money, even for the federal government."

"The University is, of course, happy about it because it brings in resources to the University," she added. "But it also brings in ... recognition of the high quality of work that's done in the program."

The grant the NIA awarded Mor's team is a coveted "program project" grant, which assures funding for a major research effort comprised of multiple interrelated threads of inquiry. The NIA only awards two or three such grants annually, and the application process is rigorous, said John Haaga, deputy director of the NIA's Behavioral and Social Research Program.

To receive a "program project" grant, researchers must convince independent reviewers not just that their research will have a significant impact on public health, but also that they have the track record necessary to pull off such a complex undertaking, Haaga said.

Brown's proposal, which Mor's team began working on three years ago, fit the bill, he said.

Haaga said that in his experience such grants benefited universities in many ways.

"It's long-term, pretty stable funding," Haaga said. "It should help in both building and keeping a really good team of people at Brown working on long-term care issues."

Program project grants often spur new ideas for research and may be renewed beyond the original five-year term, he added. When applying for further funding, such grants give researchers "a lot of experience to point to."

Research team member Andrew Foster, professor of economics and chair of the department, said the cross-disciplinary quality of the research team will lend strength to the study. He intends to contribute expertise by modeling labor market forces and economic theory to the project, helping its findings stand up to economic and not just public health scrutiny.

Foster said the grant speaks to Brown's reputation in the public health field and the quality of research that has already been done, and he agreed that it will likely spark more research - both on College Hill and elsewhere - in the future.

This effort, he said, "will make Brown one of the key places that people look over the next four or five years" for research on long-term care.

Foster credits Mor's reputation and abilities in spearheading the effort with helping Brown land the grant, citing his "charisma" and "ability to talk to people in a lot of different fields."

Mor is out of the country this week and directed inquiries about the grant to other members of the research team.


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