Principal Investigator: Christopher Callahan, MD
Co-Principal Investigator: Daniel Clark, PhD
Title: Translation Research on Chronic Disease Self-Management
Web address: http://medicine.iupui.edu/IUCAR/roybal/
The Indiana University Edward R. Roybal Center conducts research on improving support and education for self-management among older adults. Our thematic focus stems from our experience in designing and studying models of care for physically and socioeconomically vulnerable older adults. Our research recognizes the fundamental role of generalist physicians in providing care to older adults and the fundamental role of patient self-management in achieving excellent outcomes. Over the brief history of the IU Roybal Center, we have developed the capacity to apply and integrate the fundamentals of the behavioral and social sciences into clinical medicine. Thus, one of our key strengths is the ability to put knowledge into practice and thereby change clinical care.
To move knowledge into practice, we have developed a clinical laboratory to efficiently test ideas that hold promise for improving self-management education and support in real-world clinical settings. Below we provide examples of our work.
Health Aging Brain Center
The HABC is an outpatient center providing both a research laboratory and clinical services for cognition. The model for the Center is based on the findings of an innovative care model that included collaboration between multi-disciplinary care teams, family caregivers, and patients for the care of dementia. In a randomized controlled trial by IU-Roybal faculty, that model showed significant reduction in both patient and caregiver behavioral and psychological symptoms without increasing the use of antipsychotics or sedative-hypnotics. This trial indicated that patient and caregiver engagement with provider teams can improve chronic illness care and reduce symptoms in the cognitive domain. Created by multiple partners, including the IU-Roybal, the Center facilitates patient and caregiver engagement in both clinical care and research. Since 2008, the HABC has evaluated over 900 new patients and their caregivers and has garnered the interest of care organizations inside and outside the U.S.
HealthyMe is a primary care-based lifestyle weight management program developed with and for lower health literacy adults and their providers. IU-Roybal faculty carried out focus groups with patients and providers and designed the user-inspired program that was funded with a $2.7 million grant from the Richard M. Fairbanks Foundation. The program has provided free lifestyle counseling and support services to over 5,000 obese English and Spanish-speaking adults in Wishard/Eskenazi Health’s seven community health centers in Indianapolis, Indiana.
Self-Management Support at Home
Lifestyle self-management adoption and maintenance requires frequent communication between patients and providers and ongoing social support. Both are a challenge for primary care to provide. IU-Roybal has created self-management education and support programs that older adults can access from their living rooms using multiparty video-conference. We have shown that older adults with no computer experience can participate and benefit from these programs. IU-Roybal support has led to the creation and piloting of weight loss, exercise, and caregiver support programs. Projects in collaboration with primary care, community service agencies, and industry are at various stages of trial and implementation.
Indiana University Center for Aging Research
The IU-Roybal is based in the Indiana University Center for Aging Research (IU-CAR). Established in in 1997, the Center is led by founding director and IU-Roybal PI Christopher Callahan, MD. Sixteen other faculty M.D. and Ph.D. researchers conduct research under IU-CAR’s umbrella. The primary research themes of the Center are primary care of geriatric syndromes, health promotion, and the management of chronic conditions among older adults across the continuum of care. In particular, our research has focused in the areas of the aging brain (Alzheimer’s disease, dementia, depression, delirium, and stroke) and new models of health care delivery for older adults (care management,, information technology, and self-management).