The Johns Hopkins
School of Nursing has received a $2.5 million federal
research grant — the largest in the school's history
— to implement a team-based health care delivery
system to manage the total cardiovascular health of 500
high-risk patients. Headed by Jerilyn K. Allen, associate
dean for research, the five-year study will incorporate
successful prevention strategies from three earlier
research studies, addressing a wide variety of patient risk
factors.
"The reality is that very few patients have isolated
risk factors, and we need to take a more comprehensive
approach to prevent the progression of cardiovascular
diseases," Allen said. "We're bringing together the best of
three models of care to improve outcomes in urban clinics
and underserved populations."
The new team-based project, funded by the National
Heart, Lung and Blood Institute at the National Institutes
of Health, will draw on SoN Dean Martha N. Hill's research
on blood pressure in young African-Americans, Fred
Brancati's work for the
Bloomberg School of Public Health in managing diabetes
and Allen's own research on cholesterol management.
The centerpiece of the research program is the use of
a three-person team — comprising a physician, a nurse
practitioner and a community health worker — to
manage the health care of the study participants, who will
be recruited from clinics operated by Baltimore Medical
System, a nonprofit community health center system that
provides care to 35,000 medically underserved people in
Baltimore's poorest areas. BMS patients and health
providers are to serve on a steering committee that will
guide the research program.
"They will be true partners as we work together to
shape the intervention so that it will be sustainable when
the project is complete," Allen said.
Half the study patients will receive care from the
three-person team, and half will receive a more traditional
form of treatment. In addition to comparing health outcomes
for the two groups, Allen will compare the
cost-effectiveness of each type of treatment, as cost is a
key factor in implementing the project on a broader scale.
"One of our goals is to communicate to other stakeholders
how this model can be effective and cost-effective," Allen
said. "We would hope that it would have potential to result
in decreasing cardiovascular disease mortality and health
disparities if applied across other primary care
settings."
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