Active Research Grants

PI: Erin Adams, Department of Biochemistry and Molecular Biology

myCHOICE

Dates: 09/01/2014 – 08/31/2019
Grant #: FP057824
Funder: NIH
Description: Three quarters of University of Chicago biomedical PhDs and PhD postdoctoral research trainees do not enter a tenure-track faculty appointment in the 5-10 years post PhD. Still, our training programs have given them little preparation for careers other than those of their mentors. Recognizing that this narrow focus has not served many of our students and postdocs well, we have begun a program to broaden exposure, education, and experiences for these students. This program – CHicago Options-In-Careers Empowerment, or myCHOICE – empowers trainees to select career directions in a more informed and successful way. BEST funding will accelerate the development of myCHOICE offerings at three levels of participation intensity – EXPLORATION, EDUCATION, and EXPERIENCE – and across the full range of careers in which trainees could leverage their strong science backgrounds. We will evaluate the effectiveness of myCHOICE by testing the hypothesis that more extensive participation in myCHOICE predicts greater trainee career choice empowerment and satisfaction with a chosen career. Using the results to optimize myCHOICE offerings, we will also explore whether myCHOICE leads to an improved correlation between the FASEB myIDP Career Fit assessment at training exit and actual career selection. Finally, we will establish a bidirectional dissemination mechanism to share information about myCHOICE within and outside the University,  to learn about other BEST programs, and to incorporate best practices from these programs into myCHOICE. This myCHOICE proposal enjoys extremely strong institutional support and will be continued beyond the funding period if it is successful.

Learn more about this program here

PI: Vineet Arora, Department of Medicine (General Internal Medicine)

Identifying Messages to PROmote Value & Education of (IMPROVE) Generic Prescribing

Dates: 9/1/2015 – 8/31/2018
Funder: FDA
Description: Understanding prescriber barriers and facilitators to prescribing generic drugs is critical to improving ‘generic efficiency’ for a particular class of drugs, or the percentage of drugs in a class prescribed that are generic. Unfortunately, many clinicians may hold negative perceptions about generic medications. More than one-quarter of physicians in one survey would NOT use generics as first-line medications for themselves or for their family. Currently, pharmaceutical representatives are the most common information source about market availability of generic medications. This underscores the need for developing and testing powerful evidence based messages that can counteract existing marketing strategies that promote prescribing costlier brand name drugs. While educational interventions to improve generic prescribing have been attempted none are based on principles of adult learning theory or use stakeholder input to inform the messaging and learning strategy to achieve practice change. Our goal is to develop messaging and interventions to promote generic prescribing of antidepressants, oral contraceptives, and cholesterol lowering agents for busy time-crunched primary care clinicians, specifically nurse practitioners (NPs) and primary care physicians (PCPs).

Mentoring Patient-Oriented Research: Sleep & Activity During/After Hospital Stay

Dates: 4/1/2017 – 3/31/2022
Grant #: FP064027
Funder: NIH
Description: This grant provides structured mentorship to pre-doctoral and post-doctoral trainees who are working on understanding and improving sleep health for patients who are transitioning from the hospital to home. This will be accomplished through a projects that aim to (1) understand the long-term consequences of sleep deprivation in the hospital; and (2) test whether educating and empowering patients about sleep loss in the hospital is associated with improved sleep and health after discharge.

SIESTA (Sleep for Inpatients: Educating Staff to Act)

Dates: 09/01/2014 – 08/31/2018
Grant #: FP050785
Funder: NIH
Description: Although sleep is imperative to biological functions and of critical importance in the recovery process from acute illness, hospitalization is far from restful. Less than half of Medicare patients who are hospitalized nationwide state that their room was kept quiet at night. To address these concerns and improve sleep in US hospitals, we aim to develop the SIESTA (Sleep for Inpatients: Empowering Staff to Act) program as an educational intervention designed to prepare hospital staff to assist patients in obtaining better sleep in hospitals and to recognize the importance of screening for sleep disorders. The major educational goals of this proposal is to develop and validate an educational program (SIESTA) which aims to train and motivate medical professionals (medical students, residents, and hospitalists) and hospital staff (hospital administrators, nursing staff, and environmental services) to provide better sleep for hospitalized patients.

Learn more about this program here.

TEACH STRIVES: Spreading Teen-Research Inspired Videos to Engage Schoolmates

Grant #: FP053921
Funder: NIH
Description: Studies suggest that messages that have the potential to change people’s attitudes and behaviors often originate from a trusted peer. This is especially true in teens, who value the opinion of and seek to emulate their peers. While peer pressure is often cast as a negative phenomenon among teens, the use of positive peer pressure to change behavior among teens is gaining in popularity. Positive peer pressure has been used in many youth-to-youth messaging campaigns related to difficult to change behaviors such as alcohol and drug abuse or safe sex. Drawing upon these theories for motivating and engaging teens, this proposal aims to test the effectiveness of a novel peer-to-peer social media marketing campaign to spread video vignettes created by teens to inspire other teens to consider careers in clinical research.

Learn more about this program here.

PI: Kathleen Cagney, Department of Sociology

Health Services Research Training Grant

Dates: 07/01/2013 – 06/30/2023 
Grant #: FP037911
Funder: AHRQ
Description: The University of Chicago is requesting continued support from the Agency for Healthcare Research and Quality (hereafter, AHRQ) for the National Research Service Award (hereafter, NRSA) program entitled the Health Services Research Training Program. The Health Services Research Training Program will provide two to three years of support to outstanding candidates from predoctoral programs from both the University of Chicago and Northwestern University, leading to careers in health services research. The University of Chicago has been an ideal site in which to provide broad-based training in health services due to the extraordinary strength of its faculty in health services research and in the social science, biomedical, and statistical disciplines upon which health services research draws. The high caliber of students at the University of Chicago has been a notable strength of the ongoing and proposed programs. These students will now be able to draw on mentors from Northwestern University and trainees from there can interact with faculty at the University of Chicago. The support of AHRQ and the availability of NRSAs for students in the past fourteen years have helped the institution to expand upon the existing, successful research and training programs in health services by making the University more attractive to students with such interests, as well as attracting even more of this institution’s talented and promising students into the field. We expect that the renewal of the predoctoral program will continue to strengthen training in health services research at the University. Learn more about this program here.

PI: Robert Gibbons, Department of Public Health Sciences

A New Statistical Paradigm for Measuring Psychopathology Dimensions in Youth

Dates: 12/01/15 – 11/30/20
Funder: NIH
Description: We propose to develop and implement a multi-component clinical practice toolkit for diabetes management in older people (PERSONAL-DM) that will include 1) physician, clinical staff, and patient education, 2) decision support for goal setting, 3) targeted telephonic care management, and 4) regular audit feedback to physicians. Improving diabetes care in older people is a vital public health issue given the large and growing proportion of patients who are older, the vulnerability of many frail older patients living with diabetes, and the substantial costs associated with caring for these patients.

PI: Elbert Huang, Department of Medicine (General Internal Medicine)

Preferences, Management & Outcomes of the Oldest Patients with Diabetes

Dates: 12/01/15 – 11/30/20
Funder: NIH
Description: We propose to develop and implement a multi-component clinical practice toolkit for diabetes management in older people (PERSONAL-DM) that will include 1) physician, clinical staff, and patient education, 2) decision support for goal setting, 3) targeted telephonic care management, and 4) regular audit feedback to physicians. Improving diabetes care in older people is a vital public health issue given the large and growing proportion of patients who are older, the vulnerability of many frail older patients living with diabetes, and the substantial costs associated with caring for these patients.

PI: David Meltzer, Department of Medicine (Hospital Medicine)

A Randomized Controlled Trial of the Effects of Oral Health on Systemic Health, Oral Health & Health Care Among Older Adults

Funder: The George Richmond Foundation
Description: Despite the recognition and growing evidence that oral health influences systemic health, there is insufficient knowledge about the extent to which oral health care improves systemic health and may reduce health care costs.  Recent studies suggest that these effects may be large, but the observational design, size and/or duration of these studies has prevented them from clearly establishing and quantifying causal effects of oral health care on systemic health and health care costs. The need for such data is especially important for older adults, who often have substantial oral health challenges and lack dental insurance, resulting in important deficits in care. Given the high prevalence of oral health conditions and associated chronic diseases in older adults and the interest of many leaders in oral health and medicine in the better integration of oral and systemic care, data on the effects of improving access to integrated oral and general health care for older adults has great potential to influence policy and practice. We propose a randomized controlled trial that will study both systemic and oral health outcomes, and health care costs over 5 years for 1060 older adults without recent dental coverage and preventive dental care who are randomly assigned either to 1) an intervention group that is offered core preventive and restorative services free of charge or 2) a control group that is not offered such services free of charge. Our proposed random assignment, sample size, and 5-year study duration will allow us to assess and quantify causal effects of access to oral and systemic health care on outcomes and costs, addressing the key limitations of existing evidence. We hypothesize that patients in the intervention group will have fewer negative systemic outcomes (e.g., self-rated health status, conditions associated with poor oral health such as diabetes, cardiovascular conditions and others), oral health outcomes (e.g., tooth loss, periodontal disease, or worsening systemic health), and lower costs for oral and systemic health care than patients in the control group.

African American Cardiovascular Pharmacogenetic CONsorTium (ACCOuNT): Discovery & Translation

Dates: 08/19/2016 – 05/31/2021
Funder: NIH
Description: Pharmacogenomics is aimed at identifying genetic variation (SNPs) that influence inter-individual differences in drug response and adverse events and has widespread clinical relevance. Its application promises to enable targeted drug administration, improve therapeutic outcome, and inform drug development. Pharmacogenomic insights have improved our understanding of the underlying pathways and mechanisms behind adverse drug reactions, which account for approximately 100,000 deaths per year in the US and markedly increase healthcare costs. The vast majority of pharmacogenomic association studies, which are the drivers of discovery in the field of precision medicine, have been conducted on exclusively European populations, thereby precluding the discovery of African American specific genetic biomarkers that affect drug phenotypes. Without scientific inquiry on the presence and association of these SNPs to drug response, our ability to deliver precision medicine to 1 in 7 Americans is severely hampered. To close this growing health disparity in African American precision medicine we formed ACCOuNT and are proposing a discovery project within cardiovascular pharmacogenomics. In our Discovery project, we hypothesize that through discovery efforts centered on African Americans, we will identify predictive biomarkers of cardiovascular drug response and disease susceptibility that can be investigated in translational outcome studies. We will test this hypothesis with the following aims: 1) Determine genetic predictors of drug response to thrombotic therapy using genome-wide association methodology, 2) Investigate the role of gene expression/splice variants and eQTLs on drug response phenotypes for elucidation of biological mechanisms and genetic regulation of these phenotypes, and 3) Create a publically available and searchable database to house the results of the genomic and transcriptomic studies in African Americans. Through the infrastructure of ACCOuNT we will conduct our discovery efforts with a patient-centered approach that incorporates the input of community partners, frontline physicians, and African American patients. We anticipate that these studies will reveal novel SNP associations and gene regulation pathways. Several potential research areas/questions may develop from this work. Our proposed genomics database will serve as needed resource within the pharmacogenomics scientific community, which currently lacks comprehensive genomics and transcriptomic information on African Americans. These new research avenues have the potential of feeding seamlessly into our translational project and pilot projects thus allowing us to leverage our Transdisciplinary Collaborative Center to move implementation of precision medicine in African Americans faster than previous efforts.

The Chicago Area Patient-Centered Outcomes Research Network (CAPriCORN)

Dates: 10/01/2015 – 09/30/2018
Funder: Chicago Community Trust Description: The Chicago Area Patient-Centered Outcomes Research Network (CAPriCORN) is an unprecedented partnership of research institutions, clinicians, patients and patient advocates. The CAPriCORN mission is to develop, test, and implement policies and programs that will improve health care quality, health outcomes, and health equity for the richly diverse populations of the metropolitan Chicago region and beyond. Within the Chicago metropolitan area, CAPriCORN seeks to address the needs of an estimated 9.5 million residents, including groups that experience significant health inequities partly due to variable access to high-quality care. Find out more about this program here.

Changing Long-Term Care in America: Policies, Markets, Strategy & Outcomes

Dates: 02/15/2014 – 01/31/2019
Grant #: FP050876
Funder: NIH Description: Using the Minimum Data Set and Medicare claim data from 1999 to 2016, we propose to characterize hospital decisions to staff the role of the attending physician and to examine the impact of those decisions on clinical outcome and health care utilizations.

CMS Practice Transformation Network

Dates: 05/01/2015 – 04/30/19
Funder: Centers for Medicare and Medicate Services
Description: The University of Chicago affiliated investigators will serve two roles for the Great Lakes Practice Transformation Network (GLPTN): 1. Provide quality improvement leadership to expand successful efforts aimed at reducing hospital admissions and comprehensive care to complex patients throughout the 3-state region 2. Recruit practitioners into the GLPTN. The University of Chicago expects to recruit 625 practitioners into the network. David 0. Meltzer, M.D., PhD will serve as a Ql expert for the project consortia. Learn more about this project here.

Comprehensive Care, Community, & Culture Program

Dates: 08/07/18- 08/06/19 
Funder: AmeriCorps 
Grant #:FP063133
Description: The Comprehensive Care Physician (CCP) Program at the University of Chicago proposes to have 10 AmeriCorps members who will: 1) recruit Medicare patients of diverse ages who are at increased risk of hospitalization for a program designed to serve their medical and social needs, 2) assess patients for unmet social needs, 3) directly serve these patients through this program, and 4) help evaluate the effects of the program in the South Side of Chicago and adjacent Thornton Township. At the end of the first program year, the AmeriCorps members will be responsible for improving patient experience in the health system and health outcomes, lowering hospitalization rates and resolving unmet social needs for this population. In addition, the AmeriCorps members will leverage 30 volunteers who will be engaged in recruiting participants, helping to address participants’ unmet medical and social needs, and collecting and analyzing outcomes data. This program will focus on the CNCS focus area of Healthy Futures and Encore Programs.

Hospital Medicine Collaborative Group (CRG)

Grant #:FP065595
Funder: Patient-Centered Outcomes Research Institute
Description: The overall goals of this program are to develop research projects and programs which take advantage of the central role of hospitalists and hospital medicine researchers in delivery of care in US hospitals. During the course of this project, we will develop a set of research priorities, refine our oversight structures and engagement strategies, and produce products which will frame research proposals using and enhancements for PCORNet data models. Find out more about this program here.

Longitudinal Effects of Integrated Inpatient/Outpatient Care for Patients at Increased Risk of Hospitalization

Dates: 7/01/2013 – 04/30/2019 
Funder: The Donaghue Foundation
Description: Health care costs and adverse health outcomes are concentrated in a small fraction of the population at increased risk of hospitalization. Hospitalized patients often experience discontinuities between inpatient and outpatient care that increase costs and impair outcomes. This has been especially true as hospitalists have increasingly provided hospital care instead of traditional primary care physicians, who no longer typically have enough patients in the hospital to make it economically viable for them to see hospitalized patients. With funding from the Center for Medicare and Medicaid Innovation since 2012, we have recruited 2,000 patients for a randomized trial to test whether Medicare patients at increased risk of hospitalization experience better outcomes if they can receive inpatient and outpatient care from the same physician. We make this possible by having a group of comprehensive care physicians (CCPs) who care for a small panel of patients at increased risk of hospitalization so that they have enough patients in the hospital each morning to justify their daily presence there while having a small enough panel of patients that they can provide them with primary care despite only having clinic in the afternoons. Our preliminary results suggest substantially improved care experience, outcomes, and costs with CCP care over 18-months, but require longer follow-up. The goal of the requested support is to perform long-term followup to assess whether outcomes improve and total resource use declines over 4 years if patients receive inpatient and outpatient care from a CCP compared to different inpatient and outpatient physicians.

MD-PhD Program in Medicine, the Social Sciences, and Aging

Funder: NIH
Description: Our proposed MD/PhD Program in Medicine, the Social Sciences, and Aging, seeks not just to innovate in strategies to recruit candidates but to improve upon the training received by most past MD/PhD trainees in the social sciences by incorporating the best of both disciplinary and interdisciplinary study to prepare scholars to work even more successfully at the crucial interface of medicine, the social sciences, and aging. We propose this because we believe that while depth in a traditional social science discipline is critical to ensure that trainees bring the newest ideas and greatest disciplinary rigor to their work, traditional academic disciplines do not provide adequate breadth of training in either aging or health services research to fully enable the translation between innovative ideas in the social sciences and improvements in health.

Northwestern University - University of Chicago Health Services Research Postdoctoral Training Program

Dates: 07/01/2013 – 06/30/2023
Grant #: FP037911
Funder: AHRQ
Description: The University of Chicago is requesting continued support from the Agency for Healthcare Research and Quality (hereafter, AHRQ) for the National Research Service Award (hereafter, NRSA) program entitled the Health Services Research Training Program. The Health Services Research Training Program will provide two to three years of support to outstanding candidates from postdoctoral programs from both the University of Chicago and Northwestern University, leading to careers in health services research. The University of Chicago has been an ideal site in which to provide broad-based training in health services due to the extraordinary strength of its faculty in health services research and in the social science, biomedical, and statistical disciplines upon which health services research draws. The high caliber of students at the University of Chicago has been a notable strength of the ongoing and proposed programs. These students will now be able to draw on mentors from Northwestern University and trainees from there can interact with faculty at the University of Chicago. The support of AHRQ and the availability of NRSAs for students in the past fourteen years have helped the institution to expand upon the existing, successful research and training programs in health services by making the University more attractive to students with such interests, as well as attracting even more of this institution’s talented and promising students into the field. We expect that the renewal of the postdoctoral program will continue to strengthen training in health services research at the University. Learn more about this program here.

Program in Oral Health, Systemic Health, Well-Being & the Social Sciences

PI: David Meltzer & Kathleen Cagney
Dates: 01/01/2015 – 12/31/2017
Grant #: FP059778
Funder: George E. Richmond Foundation
Description: This project will promote the application of cutting-edge social science methods to address important problems in oral health by supporting research projects and trainees at multiple levels. Research projects will seek to have impact both through the importance of their findings and through their ability to train researchers who will have impact locally (in Chicago and at the University of Chicago), nationally, and internationally. Learn more about this program here.

Short Term Aging-related Research (STAR) Program

Dates: 05/01/2013 – 04/30/2023  
Grant #: FP036348
Funder: NIH
Description: This grant is a renewal of the grant that funds nine medical student stipends for research in aging-related fields as part of the Pritzker Summer Research Program. This funding is critical to the success of the Summer Research Program. Learn more about this program here.

The University of Chicago Patient-Centered Outcome Research K12 Training Program

Dates: 08/01/2014 – 07/31/2019
Grant #: FP050644
Funder: AHRQ
Description: Our proposal is in response to AHRQ Patient-Centered Outcomes Research Institutional Award (K12) RFA-HS-12-001. This opportunity is consistent with our successes following the award of an ARRA-funded KM1 training grant and will allow us to continue building a high value training program prepared to supply the nation with well-trained researchers in comparative effectiveness and patient-centered outcomes research. Learn more about this program here.

PI: Greg Ruhnke, Department of Medicine (Hospital Medicine)

Measuring the Impact of Accreditation on Diagnostic Accuracy & Health Outcomes in Echocardiography

Dates: 10/01/15 – 9/30/17
Funder: Intersocietal Accreditation Commission
Description: There has recently been a great deal of high-profile controversy about the cost and value of physician certification. Although such certification is distinct from imaging facility accreditation, there are certain analogies in the goal of these processes. As payers increasingly require accreditation, greater interest has arisen in demonstrating the effects of such accreditation on imaging quality and health. For example, the Medicare Improvements for Patients and Providers Act (MIPPA) created a requirement for accreditation of outpatient providers of advanced diagnostic imaging. We propose to create a framework for future rigorous research to demonstrate the impact of accreditation on diagnostic accuracy, maximizing the ability for causal inference, and estimate its cost-effectiveness. Since the Intersocietal Accreditation Commission (IAC) is the only organization that accredits echocardiography laboratories, this is a unique opportunity to observe quality across all facilities seeking accreditation at multiple points in time. This three-part proposal seeks to: (1) comprehensively review accreditation processes to identify observational and experimental research designs that would allow for a rigorous evaluation of its costs and benefits across heterogeneous imaging modalities; (2) using echocardiography as a case example, measure the change in quality of reports submitted to IAC after delayed accreditation and a period of accreditation, compared to those submitted at the initial accreditation application, and whether these differences vary by the characteristics of the imaging facility; (3) based on the information gained in project 2, create a cost-effectiveness model to estimate the value in both health and monetary terms of diagnostic error reductions associated with the accreditation process for echocardiography.

PI: Julian Solway, Department of Medicine (Molecular Medicine)

Re-engineering Translational Research at the University of Chicago (CER Core)

Dates: 09/17/2007 – 05/31/2017 Grant #: 2UL1TR000430-07 Funder: NIH/NCATS Description: This is a NCATS Clinical and Translational Science Award that broadly supports the infrastructure to perform clinical and translational research as well as research training at the University of Chicago.

PI: Linda Waite, Department of Sociology

Re-engineering Translational Research at the University of Chicago (CER Core)

Dates: 05/01/2016 – 04/30/2021
Funder: NIH
Description: This proposal requests support for specialized pre-doctoral and postdoctoral training in the Demography and Economics of Aging at the University of Chicago. Both trainees and trainers (i.e. mentors) are affiliated with the Center on Aging at NORC at the University of Chicago. Postdoctoral trainees are recruited from top graduate programs nation-wide, usually from outside the University of Chicago. Predoctoral trainees are recruited early in their graduate careers into a structured program of mentorship, coursework and research experience. PhD students in the departments of Economics, Sociology, Public Health Sciences and the Harris School of Public Policy Studies provide most trainees, with some coming from other departments and programs at the university. We select trainees for funding from this pool, using criteria of previous performance in the program, interest in and commitment to the demography and/or economics of aging, and availability of a suitable mentor. All PhD students with interests in the demography and/or economics of aging are invited to apply to the program; those receiving support from the University and those who are not eligible for NIH support for reasons of citizenship are admitted into the training program as “predoctoral affiliates” but receive no funding. All trainees, regardless of funding, follow the same program. All are matched to a mentor with whom they meet regularly and work closely. All enroll in a structured program of coursework, including the Demography Workshop and the Post-Mortem Seminar. All receive financial support from the University of Chicago and administrative support from NORC and the University of Chicago. All receive training in the Responsible Conduct of Research. Our record of trainee productivity and placement is excellent, as is the pool of trainees from which we select those for funding. We endeavor to recruit and retain trainees (and trainers) who are members of underrepresented minority groups and/or from disadvantaged backgrounds as well as students with disabilities. A new External Advisory Committee will assist the Executive Committee of the CDT with program design and evaluation. We request support for four pre-doctoral and two postdoctoral trainees per year over five years in a training program on the Demography and Economics of Aging.

PI: James Zhang and David Meltzer, Department of Medicine

A Novel Big Data Screening Tool to Identify and Reduce CRN

Funder: NIH
Description: Up to a third of older patients report cost-related medication non-adherence (CRN), adversely affecting patient outcomes and raising health care costs. Despite the institution of Medicare Part D, recent studies have suggested that the CRN rates in the sicker patients did not decease or even worsened. There is no known low-cost, automated tool to screen and identify patients with CRN. Neither copays nor income accurately predict non-adherence by themselves and these measures do not have the sensitivity or specificity to identify CRN. Common measures of non-adherence (e.g., medication possession ratio, gaps in filling of prescriptions) are not specific to non-adherence related to financial costs and thus suffer from low sensitivity and specificity because of other factors such as cultural preferences and side effects that are correlated with non-adherence. Universal approaches in which all patients are asked about the financial burdens of medications and CRN are costly and unlikely to be followed by providers. The overall aim of this proposal is to use data from the Health and Retirement Study (HRS), a nationally representative survey linked with Medicare claims data, to construct and assess the validity of a novel big-data screening tool by connecting information on the delays in filling prescriptions until their monthly SS income becomes available. We hypothesize that this novel automated indicator may be a useful and low-cost predictor of potential cost-related non-adherence (CRN). We think that this measure may be especially useful among persons for whom social security is a large fraction of their income and whose insurance leaves them with significant out-of-pocket medication costs, and those with high disease burden. The novel automated indicator of potential delay in filling prescriptions until social security check availability will be measured by comparing prescription fill dates from Medicare Part D data to the date each month that the individual’s social security check is available when a gap in refilling is present. We think that the automated CRN measure could be implemented in pharmacy claims data at almost no cost in order to identify patients at increased risk of CRN and target them for potential interventions. Such interventions could include sending reminders to physicians or clinic staff to ask high-risk patients if CRN is occurring and discuss potential solutions, such as generic or preferred-tier formulary substitutions, or manufacturers discount programs. High risk patients could also be sent mailings or other notices to encourage them to discuss any CRN issues with their providers. The proposed research is informed by our preliminary research on the prevalence of CRN, the patterns of CRN behaviors, and the association between ordering prescription with social security availability and self-reported CRN. This research will take place at the University of Chicago. We have a uniquely qualified research team with expertise in the Medicare program, clinical research, claims data analysis, and economic aspects of health and healthcare. Dissemination of the research results in the national professional conferences and professional journals are also planned. The research will be of value to clinician, health services researchers, health care organizations, and policy makers to target the patients at the high risk of CRN, reduce costs, and improve patient-centered outcomes.

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