In its fifth round of funding, the Center for Health Research is pleased to award four new small research grants.
In its first round of funding, the Center for Health Research Center and CITRIS are pleased to award three Health Information Technology (HIT) Grants.
How does the demographic heterogeneity (e.g. differences in organizational tenure) within a health care organization influence the degree to which departments embrace and implement a strategic initiative to improve patient satisfaction? Health care organizations, like other organizations, are becoming increasingly diverse, and therefore, studying the effects of demographic heterogeneity within a health care setting is important. At the same time, health care organizations are expected to continually change and are presently adopting a number of change initiatives related to access to care and overall quality of service. Therefore, understanding how demographic heterogeneity affects the adoption of change readiness norms and a department’s ability to address change initiatives is of increasing importance to the health care industry. In this study, Jennifer Chatman (Business; chatman@haas.berkeley.edu) and her research team will explore the antecedents to change readiness norms, specifically, whether demographic heterogeneity within a department will influence the content and strength of norms, and thus the department’s ability to embrace change. For example, greater demographic heterogeneity may be associated with more openness to change, while greater homogeneity may stifle such norms. The research study will help us to better understand and assess how demographic heterogeneity influences change readiness and its consequences in health care organizations. It will also contribute to the currently thriving literature on organizational demography.
Mexico has a rapidly growing overweight and obesity problem in children and adults that transcends socioeconomic status and reflects a trend in Latin America that is reaching epidemic proportions. A very high proportion of children are also overweight or obese. There are many potential reasons for the strikingly high prevalence of overweight and obesity in Mexico, some of which relate to changing dietary patterns and energy expenditure. Rapid changes have occurred over the past two decades in economic development and market globalization. There is also evidence that cultural factors also contribute, including parent/child interaction and food-related behavior. Despite rapidly accumulating knowledge on several factors related to obesity, the scientific community has been largely unsuccessful in reversing the global obesity epidemic. Sylvia Guendelman (Public Health, sylviag@berkeley.edu) and her research team will explore the factors related to obesity in a population of Mexican children, with the eventual goal to develop targeted interventions and follow-up these children longitudinally. In particular, they will explore several possible factors and pathways contributing to obesity in children, such as parenting styles, family environment, economic factors, environmental stress, in addition to food consumption and exercise.
Medical researchers have performed over a million randomized controlled trials. Not coincidentally, life expectancy has increased phenomenally in recent decades. There have recently been several eloquent calls for more use of randomized trials and other rigorous evaluations of the impacts of development programs. Nevertheless, such evaluations remain rare. This rarity is a global tragedy. Poor nations, donor nations, and others spend billions of dollars trying to improve the lives of the world’s poor. Ignorance of what policies are effective has led to enormous lost opportunities. The problems are far too severe to continue well-meaning programs that are not based on rigorous evidence of what works. David Levine (Business, Levine@haas.berkeley.edu) will research the many obstacles to rigorous evaluation of project impacts. He will then propose potential policies to address the bulk of them. The opportunity to build learning into development projects presents an opportunity for all stakeholders, ranging from community-based organizations and other NGOs to donor nations, multilateral banks, foundations, and governments. This essay will be used as the basis for briefings of policy-makers in USAID, the World Bank, the regional multilateral bank (e.g., Inter-American Development Bank), the U.S. Treasury, State Department, and other donor and policy agencies. A related version of the essay will be directed at private foundations and large donors, while a third version will target NGOs.
Intergenerational correlations in socio-economic status and health capture an important dimension of inequality. However, while the literature on inter-generational correlations in economic status and health has made important strides in measurement, less is known about the mechanisms underlying the transfer of economic status between generations. These correlations could reflect nature or nurture, or the interaction of the two. In this project, Enrico Moretti (Economics, moretti@econ.berkeley.edu) will examine inter-generational correlations in birth weight, a key indicator of the health of newborns that has been linked to future educational attainment and earnings. Preliminary findings indicate that there is a strong inter-generational correlation in the birth weight of mother and child, and that children of low birth weight mothers are more likely to be low birth weight themselves. A second, and arguably more important question will be the extent to which this correlation reflects social factors that may be susceptible to rapid change (maternal income, maternal education, etc.) rather than factors such as genetics or the mother’s childhood family background which change only slowly over time. Arguably, this is a more important question for policy than the vexing and perhaps specious question of whether outcomes are predominantly due to nature or nurture.
Impoverished regions such as Sub-Saharan Africa are increasingly being overwhelmed by a shortage of trained physicians in their fight to provide effective health care . In this project, Eric Brewer (Computer Science, brewer@cs.berkeley.edu) and his team will develop applications for cell phones to enable medical data collection and decision support systems for non-physician healthcare workers, both at clinics and in the field, as a cost-effective means to reduce the workload of specially trained but scarce physicians. The data collected will be made available for real time analysis for more effective health policy decisions. While they will initially focus on applications to manage Anti-Retroviral Treatment (ART) for HIV patients, over time they expect to develop applications for a wide range of problems such as diabetes which are customarily seen by non-physical health workers as a means to improve quality of care being provided across the entire healthcare network.
The telecom research community has devoted substantial attention to developing powerful technologies that eliminate many of the barriers to effective knowledge sharing within and between organizations. In the wireless healthcare sector, communication systems are used to provide healthcare when distance separates the participants. These developments could revolutionize medical care and decrease health inequities. For example, rural patients may gain access to specialized services outside of their communities, and fewer errors may arise in hospitals as information sharing across departments becomes instantaneous. However, many advanced technologies have been less widely adopted and less effectively utilized than their potential seems to merit. Several barriers to wireless technology adoption exist, and even once a technology is adopted there is no guarantee that it will prove effective at enhancing quality, lowering error rates, or decreasing costs. Karlene Roberts, (Business, Organizational Behavior, karlene@haas.berkeley.edu) and her research team will seek to address the lack of rigorous research on telehealth technology through qualitative research on the adoption and implementation of wireless telehealth projects at several hospital systems.
Information and computer technology to provide assisted living and remote health care monitoring can improve the quality of life and extend the ability to live at home for elderly and other citizens by facilitating better home based rehabilitation and health monitoring and support to emerging mobile lifestyles providing independent living. In this project, Shankar Sastry (EECS, Sastry@eecs.berkeley.edu) and his research team will work to create a suite of applications and devices that provide for a modular, integrated, scalable system of integrated services. The integrated solutions created will provide the necessary connection to intelligent wireless sensor networks and pervasive home technologies which together are the enabling technological environment for real long term health monitoring and in general for supporting elder citizens in living the way they choose. Thus the new technology will have substantial social impact as well. It will make possible real home health care applications due to ubiquitous and on demand capability of measurement. The power to provide an on demand, direct link between a doctor and patient’s physiological measurement would greatly enhance their quality of life.
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