Population Health and Health Services Research Scholars Program

Purpose

Core to the mission of the Center for Population Health Sciences and Health Equity are the priorities to prepare future clinicians, deliver high-quality and equitable care in a high-performing health system, and create and disseminate community-led population health research within our world class academic medical enterprise. In service of these priorities, the purpose of these pilot awards is to:

Support the research careers of GW SMHS junior and mid-career faculty with research interest in the areas of population health, health services research, and health equity
Support Goal 10 of the GW SMHS and MFA (Academic Medical Enterprise) Strategic Plan to “identify and build clinical and research programs to improve population health and health equity for the communities served by the GW academic medical enterprise”

Program Eligibility

GW full-time regular faculty with an appointment at a GW clinical affiliate will be eligible to participate in the Scholars Program. Specifically, this program aims to support junior faculty with less than five years of experience in academic medicine and mid-career faculty with more than five years of experience in academic medicine seeking to gain new experience in population and health services research.

Program Scope – Population Health and Health Services Research

This Program will support scholars conducting research in population health and health services. Population health research is defined as the application of scientific methods to determine 1) the underlying causes of health outcomes within a defined group of people and/or 2) the impact of health interventions on the health status of a defined group of people. Health services research is defined as the application of scientific methods using a team-based science model to examine and/or evaluate access to, utilization, cost, quality, delivery, efficiency, organization/operational structure, and/or outcomes of healthcare services for individuals or populations.

Eligible Populations

Research projects should focus on at least one of the following three populations:

Patients served by GW MFA;
Patients or residents who live in the primary service area of the Cedar Hill Regional Medical Center-GW Health (zip codes 20019, 20020, 20032, 20003, 20024, 20002);
Patients or residents of the regional DC/MD/VA community.

Applicants are encouraged to choose a subpopulation(s) as long as it/they belong to one or more of the above three categories. Examples of eligible subpopulations include but are not limited to: 1) patients who have received in-person or virtual care from a particular GW MFA provider/department regardless of residence; 2) persons who live in the Cedar Hill primary service area and have received care from GW MFA (meets the first 2 categories); or 3) persons living in communities within the DC/MD/VA region impacted by one of the six eligible focus areas of the program listed below.

Research projects that examine populations not included in these three categories, such as non-local patients in a particular EHR system such as Epic Cosmos or Cerner Real-World, Medicaid enrollees not specific to the three local Medicaid (DC, Maryland, and Virginia) programs, or health equity proposals with a national or global health policy focus will be deemed ineligible for this Program.

Eligible Focus Areas

GW academic medical enterprise faculty will be required to develop research proposals that are responsive to community need and address disparities in health and healthcare in patient populations. Further, the proposals should be focused in programmatic areas where GW SMHS faculty and staff are available to provide mentorship and support. The areas of focus include:

Cancer prevention and treatment services: Residents in the geographic service area of the Cedar Hill Regional Medical Center-GW Health experience the highest cancer rates in the District of Columbia, including cancer types for which preventative measures and early screening and diagnostic tools exist such as breast, cervical, colorectal, lung, and liver. Examination of the data suggests that a primary focus on cancer screening is not sufficient to eliminate disparities in cancer death rates. For example, breast cancer screening rates are similar (or higher in some years) in Wards 7 & 8 than other wards in DC; however, breast cancer death rates remain substantially higher in women living in Wards 7 & 8. The cancer prevention and treatment research grants should examine the barriers to equitable, high-quality cancer prevention and treatment services that would decrease inequities in access to care and cancer mortality. Potential topics include collaborative care models for navigation services with existing community-based clinical providers, gap analysis for diagnostic cancer services to inform cancer clinical program design, and design of an evaluation program to assess the impact of geographic access to cancer prevention and treatment services on patient outcomes.
Pregnancy-related care: Improving birth outcomes has been a focus of the District’s health system engaging healthcare and community providers in a number of key initiatives. As a result, DC has record low infant mortality rates across all ethnic and racial groups. Maternal complications of pregnancy, which had been the top cause of infant death for a decade, is now the third leading cause of infant deaths. Progress remains stagnant, however, in maternal morbidity and mortality. In 2019-2020, thirty percent (30%) of live births in DC occurred in women residing in Wards 7 & 8. Less than 60% of pregnant women in Wards 7 & 8 initiate prenatal care during the first trimester, and rates of severe maternal morbidity remain substantially higher in Black/African-American women when compared to other racial and ethnic groups in DC. The pregnancy-related care research grants should focus on topics including collaborative care models for teaming in maternity care, engagement of community-based clinical providers, transitions of care, social support and wraparound services including the role of doulas/perinatal support workers/home visitors.
Behavioral health service delivery: The need for behavioral health services by persons of all age groups including children and seniors continues to increase. While the District’s health planning agencies are responsible for ensuring an adequate number of behavioral healthcare facilities and services to meet the demand of the population, GW can work with partners to ensure that the services offered within its health system are delivered effectively and in a culturally appropriate and acceptable manner leveraging current best practices. The behavioral health research grants should focus on topics including engagement of non-specialist in behavioral health service delivery, community models for behavioral health service delivery, teaming in behavioral health service delivery, and healthcare worker well-being and support.
Food as Medicine: Residents in Wards 7 & 8 experience a disproportionate burden of chronic diseases such as diabetes, hypertension, cardiovascular disease, and renal disease. The incidence and management of these chronic health conditions has been linked to diet and food access. The food as medicine research grants should focus on topics including implementation of clinical models for assessing food security, effective models for clinical linkages to community support services for food access and nutrition education, and collaborative models for culturally appropriate and acceptable nutrition education.
Hospital-based violence intervention programs: Community safety is one of the key drivers of health and is linked to health inequities. Residents in Wards 7 & 8 have expressed support for Cedar Hill Regional Medical Center-GW Health as a community hospital and the current plan for the care of patients experiencing intentional injury. The District of Columbia Hospital Based Violence Intervention Program has operated at multiple hospitals in the DC area including GWUH and United Medical Center. The hospital-based violence intervention research grants should focus on topics including effective models for clinical linkages to community support services for victims of intentional injury, collaborative models for care coordination among clinical and social support service providers, and use of credible messengers/paraprofessionals for violence interruption in the acute care setting.
Telehealth and Digital Health: Equitable access to healthcare remains a priority focus area for health systems planning agencies and organizations in the District of Columbia and national capital region. Barriers to telehealth as a modality decreased during the recent public health emergency allowing for greater adoption and acceptance by providers and patients. The implementation of telehealth programs in various settings creates the opportunity for GW to increase access to healthcare services prior to the opening of Cedar Hill Regional Medical Center-GW Health. Further, the use of digital health tools and wearable devices continues to increase in popularity for the management of chronic health conditions as well as the detection of abnormalities during normal events such as pregnancy, exercise, etc. The effectiveness of these tools and related applications can be impacted by the digital health literacy of the end user. Telehealth and digital health research grants should focus on 1) facilitating strategic partnerships to increase the adoption of telehealth in community settings such as places of worship, libraries, and private residences of complex-care patients to increase access to primary, specialty, and/or urgent care services at GW, 2) facilitating strategic partnerships to increase the adoption of telehealth in FQHCs/community health centers to increase access to specialty care at GW, or 3) improving the digital health literacy of patients.

Examples of Research Questions for Scholars Program

Examples of research questions that are appropriate for the purpose and scope of this Program are listed below. These are intended as examples only; however, applicants can use these examples in the development of a research proposal. Each example includes multiple questions of varying scope that can either be answered in sequential phases within the initial 12-month project period or across a 24-month project period if renewed. Multiple questions are not required, but applicants are encouraged to think through potential phases of inquiry to help describe the project’s significance and to develop a strong research proposal.

Click here for examples of in-scope and out-of-scope questions.

Example 1 - Phase 1: Are there differences in time to treatment after a breast cancer diagnosis at MFA by patient zip code (or patient or provider characteristics)? Phase 2: Can XX intervention improve time to treatment for Y population?
Example 2 - Phase 1: Are MFA patients with a diagnosis of XX (i.e. conditions or disorders) at risk for food insecurity? Phase 2: Can clinical linkages to community-based services and supports address food insecurity in patients with social risk/social need? Phase 3: Does addressing social risk/need impact patient health outcomes related to XX conditions/disorders?
Example 3 - Phase 1: How can an academic health system and community-based organizations successfully partner to design and implement an HVIP in a community hospital setting? Phase 2: Conduct a formative evaluation to answer the following: how are HVIP services at a community hospital coordinated with other local hospitals and stakeholders? What program factors are facilitators or barriers to effective coordination?
Example 4 - Phase 1: Are there differences in adherence to follow-up care for post-acute stroke patients who receive primary care at GW MFA compared to patients without a primary care provider at GW MFA? Phase 2 (if Phase 1 determines that MFA PCP status matters): Can implementation of neurology telehealth services improve post-acute stroke follow-up care?

The following types of research questions do not meet the purpose and scope of the Scholars Program and would likely not be recommended for funding, including but not limited to questions about non-regional, national or global trends:

What has been the effect of Medicaid expansion on national breast cancer screening rates?
How have follow-up rates after telehealth and office visits changed in the past three years across the country?
Are there nationwide differences in cancer screening rates between patients with Medicare advantage and traditional Medicare?

For additional guidance developing a research question, please visit the Clinical & Translational Research workshop resource page and scroll down to the “Framing your Research Question” presentation.

For video trainings on the fundamentals of research and study design, please visit The Center for Faculty Excellence Education Research Modules.

Expected Deliverable(s)

One or more of the following deliverables is expected upon project completion:

Clinical practice guideline
Community-based program development and intervention
Extramural funding application submission
GW MFA clinical system transformation
Manuscript for peer-reviewed journal

Scholars Program Requirements

Program requirements will include participation in identified seminars, courses, etc. offered by the Center for Faculty Excellence and the Office of Research Workforce Development.

In addition, scholars will be required to have a team of mentors for their projects and the team-based science model will be supported by staff (data research scientist, program associates, clinical quality improvement specialist) in the Center for Population Health Sciences and Health Equity. Program leadership will assist scholars in identifying mentors with similar research interest and/or experience in population health and health services research.

Lastly, all awardees will be required to submit an attestation from their department chair that their time will be protected (approximately 0.1 FTE or 10%) for this Program. More information will be provided upon award.

Scholars Program Application and Review

The electronic application for the Scholars Program is available here. Applications are due by 11:59pm EST on April 29, 2024. We strongly encourage applicants to draft and save application responses in a separate word processor as progress will not be saved in the electronic application form.

If you would like to request technical assistance with formulating a research question or proposing a research design, please contact pop_partners@gwu.edu by April 22, 2024.

The application will be reviewed by a panel of GW faculty with experience and expertise in population health, health services, health equity research, and faculty development.