Jan L. Wallander - US grants

stress; psychological adaptation; child with disability;

The candidate's immediate career goal is to develop a position so that in the next 3-5 years he can have a significant impact on the study of adaption to handicapping conditions in children and their families, especially as it pertains to mental retardation and physical disabilities. The essential long-term career goal is to direct international multidisciplinary teams in comprehensive longitudinal investigations of high risk populations of children, including those with handicapping conditions, to identify factors and processes controlling adaptation, based on well-developed theories combining individual difference and epidemiological as well as behavioral and biological perspectives and using state-of-the-art statistical techniques. An RCDA award will release significant time now devoted to clinical, training, and administrative responsibilities; facilitate accelerated productivity and improved quality of research; and allow enhancement and acquisition of knowledge, particularly in the crucial areas of epidemiology and advanced multivariate statistics. The applicant institution is an excellent environment in which to accomplish these goals with a progressive health sciences center; unique programs in epidemiology, biostatistics, and medical psychology; and the recent establishment of a mental retardation research center. The specific aims of the proposed research are to (a) evaluate change in adjustment and prevalence and incidence of maladjustment over 3 years in volunteer samples of 14 and 17 year olds with mild mental retardation; (b) evaluate and compare the contribution to their variation in adjustment and development of maladjustment from disability, intrapersonal, social- ecological, and psychosocial stress and coping factors; and (c) to evaluate the utility of an integrative comprehensive disability-stress-coping conceptual model in explaining adjustment and development of maladjustment in this population. A prospective longitudinal multivariate design will be used in studying two age groups (14 and 17) of up to 280 adolescents with mild MR, who will be followed over three yearly assessments. Adjustment will be measured over several domains (behavioral, social, and psychiatric symptomology) and maladjustment will be defined statistically on this basis.

DESCRIPTION (provided by applicant): Efficacy research demonstrates that written self-disclosure (WSD) improves physiology, health status, and health care utilization in healthy young people (> age 14) and in adults with one of two chronic diseases. Our team has further shown that WSD may reduce service utilization when implemented in adult primary health care as well as specialty health care for young people (> age 14) with a chronic disease. We now propose a pilot study to evaluate: (1) the effectiveness of WSD on health status of youth ages 12-18 with functional recurrent abdominal pain (RAP); (2) whether effectiveness of WSD is similar for younger (12-14) and older (15-18) youth with functional RAP; and (3) the feasibility and acceptability of WSD when extended to the pediatric health care setting. We will implement a RCT design to compare health status in 140 youths (ages 12-18) with functional RAP assigned either to standard medical care (SMC) or WSD provided in the health care setting in addition to SMC. Health status will be measured at Baseline and 3-and 6-months thereafter. Primary measures of health status are symptom severity and episode frequency, consistent with the definition of RAP. Secondary measures of health are functional health, psychological distress, health-related quality of life, and health care utilization. Total use and diagnostic tests will index health care utilization, collected for the 6-mos prior to and following Baseline. Mixed model ANOVA or MANOVA will be used to test directional hypotheses corresponding to the specific aims. Consistent with the indicated Program Announcement, this project translates a promising intervention to the clinical setting and provides preliminary effectiveness data that can support a future multi-center research grant application.

DESCRIPTION (provided by applicant): The goals of this Core are to support the administrative needs of the COE faculty, students and community partners, and to expand the capacity and competence of UC Merced in conducting health sciences research that addresses health disparities In the region. Conceptualization of the role of COE and Its organizational structure was developed jointly with faculty, COE leadership and campus leadership. Structure of the Administrative Core: It Is led by two co-PIs, Maria Pallavicini and Jan Wallander, guided by Internal (Chair- Pallavicini) and external (Chair- Roussos) advisory boards, with faculty leads for three components of the Research Training and Education Core (Chair-Wallander). The Research Training and Education Core components include: Undergraduate Health Disparities Research Training (Lead: Rudy Ortiz) Graduate Health Disparities Research Training (Lead: Andy LiWang) Health Disparities Undergraduate Curriculum (Lead: Jan Wallander) The Research Training/Education Core will feature three programs: (1) Undergraduate Health Disparities Research Training, (2) Graduate Health Disparities Research Training, and (3) Health Disparities Undergraduate Curriculum, each to be elaborated below.

DESCRIPTION (provided by applicant): Project Summary Nationwide, Latinos of all age groups disproportionately experience overweight and obesity morbidity and mortality. These disparities are exacerbated in communities with high rates of poverty and limited English proficiency. The eight-county region of the San Joaquin Valley (SJV) of California is such an area. SJV is represented by one of the highest concentrations of Latinos in the U.S., predominantly of Mexican descent. The region also has among the highest rates of undocumented, immigrant Latino populations which are largely under-represented in research and pose greater challenges in relationship with researchers. Established in 2005, the University of California, Merced (UC Merced) is the first-ever research university in the SJV and one of two Hispanic Serving Institutions in the 10-campus UC system. Since its inception UC Merced has had a strong, formal commitment to improve the well-being of SJV. Since 2006, UC Merced has grown an initiative for Community Engaged Scholarship that has contributed to multiple regional CBPR efforts with a focus on social justice and health equity. These efforts have not well reached the Latino communities in SJV nor have they addressed obesity disparities. The proposed collaboration between UC Merced, Central California Regional Obesity Prevention Program, and several regional community stakeholders will create a formal CBPR initiative to address obesity disparities among Latinos, with a focus on families and multigenerational households (common for Latinos in SJV). Traditional working partnerships, advisory boards, and conference and meeting methods will be blended with emerging CBPR approaches such as Open Space, World Cafes, Photovoice, and social media to establish a strong and sustainable network of action research that is culturally and linguistically appropriate Training and support will aim to improve the capacity of both community and academic partners to work synergistically to establish an action plan to use CBPR to address Latino obesity disparities. Advisory, planning, and action teams will be established with community-academic representatives and across community sectors (e.g.., faith, business, education) and generations. The project will produce sustainable community-academic relationships and infrastructure, and initial proposals for CBPR projects on Latino obesity/overweight disparities in the SJV.