Glenn V. Ostir, Ph.D. - US grants

DESCRIPTION (provided by applicant): Our proposed study addresses the RFA entitled "Research on Mind-Body Interactions and Health" (RFA #OD-03-008). Specifically, we address the National Institute on Aging interests in the study of "the impact of optimism, happiness, or a positive attitude on well being and health; and social functioning and health." We will do this by initiating a longitudinal study to examine how positive emotion (e.g., joy, gratitude, love, contentment) and social networks independently and interactively contribute to recovery of functional status after stroke within two underserved groups--African Americans and Hispanics. Findings will be compared with a sample of whites with stroke. Specific Aims of the proposed research are to: 1. Examine recovery of functional status (motor and cognitive function), for white, African American and Hispanic persons with stroke discharged from rehabilitation facilities; 2. Examine the contributions of positive emotion and social networks on recovery of functional status (motor and cognitive function), for white, African American, and Hispanic persons with stroke discharged from rehabilitation facilities; and 3. Examine the interaction between positive emotion and social networks on recovery of functional status (motor and cognitive function) for white, African American, and Hispanic persons with stroke discharged from rehabilitation facilities. Persons with stroke will be recruited from 20 rehabilitation facilities across the U.S. Specific rehabilitation facilities will be targeted to assure a sample of 400 whites, 400 African Americans, and 400 Hispanics. Data will be collected by the IT Health Track at four time points: at admission and discharge from rehabilitation facility, and 80-180 days and 365-425 days after discharge. This work is important as it begins to identify and examine factors that may contribute to a narrowing of the health disparities that currently exist between underserved minority groups (i.e., African Americans and Hispanics) and whites. This is consistent with NIH/NIA's strategic plan to "advance aging research closer to the ultimate objectives of reducing and eliminating health disparities among older racial and ethnic minorities." The work is also important as it has the potential to "contribute important insights into why some do well and others do poorly in the face of persistent challenges."

DESCRIPTION (provided by applicant): I completed MY Ph.D. in 2000 from the Graduate Program in Preventive Medicine and Community Health at the University of Texas Medical Branch (UTMB). His dissertation was titled, "Emotional well-being and subsequent health, functional ability and mortality in older non-Hispanic whites, blacks, and Mexican Americans." After completing his Ph.D., he served as a guest researcher at the National Institute on Aging (NIA), Laboratory of Epidemiology, Demography, and Biometry in Bethesda, Maryland. While at the NIA he was an investigator on the Women's Health and Aging Study and the Hebrew Home Study of Impairments and Exercise. He has been assistant professor in the Division of Geriatrics at UTMB since July 2001, with joint faculty responsibilities in Rehabilitation Sciences. Career Goals. My long-term career goal is to develop an independently funded research program in the area of rehabilitation outcomes. He is particularly interested in how concepts such as quality of life are related to recovery of functional performance in persons with disability and chronic disease. His immediate and specific career objectives to achieve this goal are to 1) Develop an understanding of quality of life including satisfaction and participation as described in the medical rehabilitation and disability literature; 2) Establish a working knowledge of conceptual frameworks used to guide research in rehabilitation with a focus on the WHO ICF disablement model and the IOM's Enabling-Disabling Process; 3) Acquire expertise in data management; 4) Develop skills and expertise in item response theory (Rasch analysis) and use this knowledge to examine quality of life measures in injury, disability and chronic disease; 5) Publish research articles in high impact peer reviewed journals; 6) Present research outcomes at national interdisciplinary conferences; 7) Obtain grant funding (i.e., RO1 funding) as a principal investigator to conduct research in the areas of disability, recovery and quality of life; and 8) Develop a comprehensive understanding of issues associated with scientific integrity and the responsible conduct of research involving humans. Research Plan. The Research Plan includes examination of quality of life variables (satisfaction and participation) using a national database of rehabilitation outcomes. The Specific Aims include examining the psychometric characteristics of patient satisfaction and participation and the relationship between change in functional status and these variables.

[unreadable] DESCRIPTION (provided by applicant): The proposed study addresses the NIA pilot research grant program PAR-03-056-#12-calling for preliminary studies examining "factors moderating the rate of age-related changes and risk for adverse events with increasing age." The program announcement is particularly interested in "factors contributing to exceptional healthy aging in humans." We propose: to examine "exceptional healthy aging' through an examination of the trajectory of the syndrome of frailty in a sample of older, initially non-frail, Mexican Americans; and to examine whether positive affect is associated with the delay in onset and progression of frailty for this population. This work is important for 3 reasons. First, the syndrome of frailty has not been studied in older Mexican American populations. Second, this work begins to examine factors that may contribute to a narrowing of health disparities that currently exist between underserved minority groups. Third, the committee on future directions for Behavioral Social Sciences Research at the National Institutes of Health recently recommended that new resources be made available for advancing knowledge on aspects of positive health including mechanisms underlying the health benefits resulting from positive psychological influences. Specific Aims of the proposed research are: 1. Examine the trajectory of the syndrome of frailty using operationally defined criteria, 2. Examine interaction effects for positive affect and age, gender, marital status, and socioeconomic status on the trajectory of the syndrome of frailty, and 3. Examine the mediating effect of positive affect on associations for co-morbidity, cognition, and social support on the trajectory of the syndrome of frailty in a sample of older, initially non-frail Mexican Americans over a 7 year period. Data is from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (HEPESE), and this data represents 85% of the older Mexican American population in the U.S. Findings from this R03 application will generate data for an R01 application examining cross-national differences and similarities in healthy aging for older Hispanics in the U.S., Mexico, and Latin America. [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): Our proposed study addresses the Program Announcement entitled "Research on Mind-Body Interactions and Health" (PA-07-046). Specifically, we address the National Institute on Aging (NIA) interest in exploring associations between psychological well-being and functional ability in older adults hospitalized for acute illness. The Specific Aims of the proposed application are to: 1. Examine change in functional status during hospitalization and up to one-year post hospital discharge. Functional status will be assessed by a battery of measures (a 4 meter walk, a test of grip strength, knee extensor strength and seven activities of daily living (ADLs)) at 5 time points: within 24 hours of hospital admission and discharge, and 1, 6 and 12 months post discharge. 2. Examine direct and indirect associations between psychological well-being and functional status during hospitalization and up to one-year post hospital discharge. Psychological well-being, assessed by a 6- domain psychological well-being instrument and a positive affect summary scale, will be used to examine patterns of association with functional status over the 5 time points outlined in aim 1. 3. Examine whether psychological well-being modifies ethnic health disparities associated with functional status during hospitalization and up to one-year post hospital discharge. This aim will allow us to examine how ethnic group (non-Hispanic whites, non-Hispanic blacks and Hispanics) interacts with psychological well-being to influence functional status over the 5 time points outlined in aim 1. To explore our aims, we plan to follow up an ethnically diverse sample of 800 older patients (non-Hispanic whites, non-Hispanic blacks and Hispanics) admitted to the Acute Care for Elders (ACE) unit at the University of Texas Medical Branch. Older adults enrolled in the study will be assessed at five time points: within 24 hours of hospital admission, within 24 hours of hospital discharge and 1, 6 and 12 months post discharge. The five time points will allow us not only to examine overall patterns of effect between functional status and psychological well-being but it will also allow us to examine patterns of effect over distinct time periods including hospitalization and post discharge. The three post discharge follow up interviews will further allow us to examine and explain associations between functional status and psychological well-being in relation to short (1 month) and longer term (6 and 12 month) recovery patterns. A central goal of the current application is to examine whether psychological well-being can influence the risk for functional status decline associated with hospitalization in an ethnically diverse older patient population. [unreadable] [unreadable] [unreadable]

Since 2000, our Core has developed comprehensive subject recruitment, tracking and retention capabilities across multiple studies and research designs, ranging from biological mechanisms of muscle metabolism to health outcomes of physical function and disability. The proposed CR-RC1 will continue to provide these services as required by new and on-going investigations. In the first year of funding the CR-RC1 will provide new support for two Developmental studies (see Section b.2.4.), four Pilot studies (see PESC), three RCDC scholars, and continue to support ten externally funded projects (see Section d). Below, we outline the strengths of our CR-RC1 beginning with administration and personnel. This is followed by a discussion on the role of the Core within the structure of our OAIC and services and/or activities provided. We next discuss progress made by the Core since 2000, in building infrastructure and in supporting OAIC investigators. Finally, we highlight externally supported research.