2006 — 2010 |
Dreer, Laura E |
K23Activity Code Description: To provide support for the career development of investigators who have made a commitment of focus their research endeavors on patient-oriented research. This mechanism provides support for a 3 year minimum up to 5 year period of supervised study and research for clinically trained professionals who have the potential to develop into productive, clinical investigators. |
Problem Solving Training and Low Vision Rehabilitation @ University of Alabama At Birmingham
[unreadable] DESCRIPTION (provided by applicant): This application proposes a training plan to develop Laura E. Dreer, Ph.D. into an independent patient oriented researcher specializing in the psychological factors involved in low vision and its rehabilitation. Dr. Dreer is a licensed clinical psychologist with subspecialty training in rehabilitation psychology and neuropsychology and prior research experience involving the application of evidence-based psychoeducational interventions for persons with chronic conditions and functional impairments. This training program will consist of mentored research, advanced coursework leading to a Masters in Science in Public Health in Epidemiology, and multi-disciplinary didactics including courses in vision science. Mentored research will be conducted under the direction of a mentorship committee composed of Dr. Cynthia Owsley, Professor of Ophthalmology, and Director of the UAB Clinical Unit, Dr. Timothy R. Elliott, Professor of Psychology, and Dr. Gerald McGwin, Jr., Director of Epidemiology and Biostatistical Services in the Clinical Research Unit. Consultants expert in the delivery of low vision rehabilitation will participate in the training plan: Dr. Dawn DeCarlo, Director of UAB Center for Low Vision Rehabilitation; Dr. Lylas G. Mogk, Director of the Visual Rehabilitation Center of Michigan of the Henry Ford Health System; and Marry Warren, M.S., OTR/L, Director of the UAB Graduate Certificate in Low Vision Rehabilitation Program. This research will be conducted using the client resources of the UAB Center for Low Vision Rehabilitation. The current research literature on the psychosocial factors that influence adjustment following irreversible vision loss have been considerably understudied, despite the fact that adjustment to functional impairment and disability has been linked to health related outcomes in a variety of chronic health conditions. Empirical research clearly shows that problem solving training (a "psychoeducational" intervention) effectively decreases distress and enhances the health and well-being of persons with serious chronic conditions. Thus, the current project aims to extend the application of this useful intervention to adult persons with low vision and their unique problems. The efficacy of the problem solving training intervention on depression and other health-related outcomes (emotional distress, vision-targeted health-related quality of life) will be examined in the research component of this K23 training program through the conduct of a randomized intervention evaluation. [unreadable] [unreadable] [unreadable]
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2015 — 2019 |
Dreer, Laura E |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Enhancing Glaucoma Medication Adherence Among African Americans @ University of Alabama At Birmingham
? DESCRIPTION (provided by applicant): Glaucoma is the leading cause of irreversible blindness among African Americans (AA) who are more than three times more likely to develop glaucoma when compared to Caucasians. Changes associated with the progression of glaucoma can have a serious negative impact on an individual's quality of life, independence, and everyday functioning. Accumulating research indicates that pressure-reducing eye drops can significantly delay or prevent the onset of disease; however, such preventative efforts have been found to be limited due to problems with poor medication adherence. Lacking are available health promotion interventions that minimize this important health disparity. Thus, in our research program, we demonstrated this health disparity for glaucoma medication adherence (Dreer et al., 2012). Next, we conducted several follow-up studies in order to develop a culturally relevant and informed, health promotion-based intervention to improve glaucoma medication adherence among AA's. As part of the intervention development process, we conducted several focus groups with AA glaucoma patients to elicit the salient barriers and facilitators related to glaucoma medication adherence, and then formed a community-based participatory research team comprised of AA's with glaucoma (Dreer et al., 2013). The resulting intervention was based on a multi-component empowerment framework that includes glaucoma education, motivational interviewing, and problem-solving training to improve glaucoma medication adherence. We recently pilot tested the feasibility and preliminary efficacy of the intervention among AA's. Findings revealed significant improvements in objective medication adherence (Dreer et al., under review). Therefore, we now propose to further evaluate the efficacy of this intervention for improving glaucoma medication adherence among AA patients in a large-scale randomized clinical trial (RCT). The patient population for the RCT will consist of 240 adult AA's with glaucoma and who are aged = 21 years who seek services at the University of Alabama at Birmingham's Glaucoma Clinic within the Department of Ophthalmology. The RCT will have two treatment arms; patients will be randomized following eligibility determination and written informed consent. The usual care only arm will consist of the standard medical care for glaucoma (medicine, laser trabeculoplasty, conventional surgery, or a combination of any of these). The second arm will consist of usual care as just described plus the culturally relevant, health promotion-based intervention. The primary outcome (objective glaucoma medication adherence) and secondary outcomes will be assessed at baseline before intervention initiation and at 3, 7, and 12-month in-clinic follow-up visits by a research interviewer masked to subjects' randomization. The practical question to be addressed is does a culturally relevant, health promotion-based intervention improve glaucoma medication adherence among a high-risk segment of the population? Information from this project will be particularly useful for AA's with glaucoma, their families, and eye care providers.
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