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Our Call For Applications is now available. For more information and access to the online application visit www.rwjf.org/cfp/ia. |
Section InfoWith the passage of comprehensive health reform, the United States must redouble efforts to address our most vexing health policy issues. The need for innovative, cross-cutting health policy research is more urgent than ever. The Robert Wood Johnson Foundation (RWJF) recently announced the selection of this year's recipients of the RWJF Investigator Awards in Health Policy Research - scholars who will tackle some of America's most difficult health concerns and inform policy on these issues. The winning scholars, affiliated with major institutions across the country, will receive awards of up to $335,000 to support 8 innovative and cutting-edge research projects.
This prestigious and highly competitive funding program attracts investigators from a wide range of fields including medicine, nursing, public health, economics, sociology, political science, psychology, history, law, ethics, journalism, communications, public and social policy, and others. A national advisory committee of distinguished experts from fields similar to those of the investigators reviews applications and makes funding recommendations to the Foundation.
RWJF created the Investigator Awards in Health Policy Research program to support talented researchers throughout the stages of their careers whose cross-cutting and bold new ideas promise to contribute meaningfully to improving U.S. health policy. Funded projects produce enduring insights and sophisticated analyses of pressing problems, potential solutions for improving health and health care, and evidence that can inform policymakers, the media, and the public. Since 1992, the Foundation has supported 175 projects involving 224 investigators.
"Through the Investigators' program, the Foundation invests in ideas and individuals - investments that pay off long after the research grants have ended," said Lori Melichar, Ph.D., economist and senior program officer in Research and Evaluation at RWJF. "The books and articles resulting from Investigators' research contribute to the public discourse in health policy. The program also provides the Investigators with opportunities to join the debate on health policy issues, and influence how policymakers think about the challenges of providing and financing health care and improving the health of the nation."
For details of the 2011 Investigator Awards click "Show Awards" below.
Show Awards
| Collaboration through Avatars: Disability and Community in Virtual Worlds of Second Life Award Year: 2011 Show AbstractOne of the greatest challenges in United States public health is the growing number of people with disabilities, now numbering over 50 million. While there is a broad awareness about the usefulness of online mutual help groups, it is less well-known that individuals with disabilities have started to self-organize in grassroots initiatives in online virtual worlds, such as that of Second Life (SL). These immersive three-dimensional virtual worlds provide distinctively innovative modes of cyber communication for people with disabilities through the shared co-presence of avatars, which are embodied representations of selves.
This project aims to provide in-depth analysis of self-organized disability-related mutual help groups in various virtual worlds. By studying these innovative associational activities, the project is exploring future directions to increasing the potential of people with disabilities through the creative merger of technology and human capital. With this aim, Dr. Ikegami will be conducting a thorough ethnographic study and sociological analysis of various targeted mutual help groups in virtual worlds. | |
| Regional Variations in End of Life Care and Costs: Cultures of Medicine or Structures of Caregiving? Award Year: 2011 Show AbstractAmericans facing serious illness receive different care, at different costs, and with different outcomes based on where they live. Since the 1970s researchers from a number of groups, most notably John Wennberg, Elliott Fisher and David Goodman at the Dartmouth Institute for Health Policy & Clinical Practice, have made a compelling case that the use of medical services and procedures varies widely from community to community for reasons not fully accountable by medical need, not clearly related to evidence or medical outcomes, and likely substantially influenced by supply. Carla C. Keirns, M.D., Ph.D., draws on her clinical experience and her scholarship in her Investigator Award Project, Regional Variations in End of Life Care and Costs: Cultures of Medicine or Structures of Caregiving? Exploring how individuals and families navigate health care, Dr. Keirns studies source of regional variation in end of life care and costs not only in the local structures and cultures of medical practice, but also in patterns of housing, employment, and family structure that impact the choices available to patients at the end of life—particularly the feasibility home hospice care. This work draws from both a growing literature on decision-making, costs, and patterns of end-of-life care, and a deep and extensive literature on local cultures of medical practice from many disciplines. Drawing on her experience as a historian, sociologist, and health services researcher, as well as a practicing palliative care physician, she uses health utilization data, interviews and community studies to make sense of individual choices and regional patterns which are fundamental to understanding how to empower patients, improve care and reduce costs. | |
| The Impact of the Patient Protection and Affordable Care Act on Americans' Support for Health Care Reform and Policy Sustainability Award Year: 2011 Show AbstractThe sustainability of the Patient Protection and Affordable Care Act of 2010 (ACA) will depend not only on its economic, legal, and administrative feasibility or the stance of political elites but also on how the new law itself, as implementation unfolds, gradually influences citizens’ attitudes about health care reform and affects their support for future changes. Over the next several years, Americans’ lived experiences of the law and their observations of its impact on their families and communities may alter their attitudes about it, fostering greater support or opposition, and it may generate new constituencies that will mobilize on its behalf, or inadvertently, it may activate opponents. This project will examine how the ACA affects citizens’ attitudes about health care policy and their participation in the policy process before, during, and after the law’s major provisions are scheduled to go into effect. The analysis will consider how changes in political behavior are affected by the impact of the law’s provisions on particular groups of Americans, depending on age, income, and other factors, and also by the extent to which its effects are perceived, depending on the visibility of its components. If the law makes the public more supportive of expansions or of repeal, such effects will influence its sustainability and the contours of the next round of health care reform in the United States. The project feature a longitudinal study and in-depth, qualitative interviews with a smaller number of individuals. | |
| Intellectual Disability and the American Medical Welfare State Award Year: 2011 Show AbstractThis project explores the accomplishments and shortcomings of the American medical welfare state in assisting individuals and families affected by intellectual disabilities. To highlight the specific policy challenges posed by different disabilities, the project focuses on three common genetic conditions associated with intellectual disability: Phenylketonuria (PKU), Down syndrome, and fragile X syndrome. The project has two intertwined strands. The first addresses the social insurance structures required to provide income security and to support important services. Intellectual disability provides a novel lens through which one can see unexpected accomplishments and the shortcomings of the American welfare state. The second strand concerns service delivery and addresses how American medical care and social service systems are now unprepared to address central challenges in this area. Some systemic challenges reflect weaknesses in public financing structures while others reflect organizational shortcomings of medical, social service, and educational systems which are poorly matched with the specific challenges posed by intellectual disabilities. | |
| Gatekeepers at Life's End: Surrogate Decision Making in Intensive Care Award Year: 2011 Show AbstractThe end of life epitomizes a public health priority: “high burden, major impact, and a potential for preventing the suffering associated with illness.” Less apparent, life’s end – for a majority of Americans – is in the hands of others, gatekeepers who control their end-of-life medical care. Until now, the process by which treatment decisions were considered, made, and remade for those who lack decisional capacity had eluded rigorous empirical examination. As a result, we do not know why patient wishes are honored, thwarted, or transformed; why interventions to change the “American way of death” succeed or fail; or what structures, factors, or gatekeepers stand in the way of choosing alternative goals of care. In short, we lack the information necessary to shape effective policy regarding medical care at life’s end.
Susan Shapiro draws on unprecedented observational research in two intensive care units, analyzing more than 1,000 encounters between health care providers and friends, family, and significant others representing patients who lack decisional capacity. The research was conducted day after day, as these end-of-life trajectories took shape and changed course. In a book and multiple articles, Shapiro will examine how surrogates make medical decisions on behalf of patients unable to speak for themselves, the factors that influence the process, the outcome of decision-making, and how these gatekeepers enable or preclude one end-of-life trajectory over another. Shapiro will also address the role of law, advance directives, and regulation in surrogate decision making and how surrogates illuminate fundamental questions about trust and fiduciary responsibility. | |
| Reengineering the Value Chain of Pharmaceutical Innovation Award Year: 2011 Show AbstractPharmaceutical innovation has been the engine behind an industry, where U.S. companies account for nearly 40% of global pharmaceutical production. Yet R&D productivity has declined, and innovation has faltered over the past decade and a half. During that same period, the estimated cost of bringing a new drug to market has ballooned to $800 million, updated more recently to $1.3 billion. With an economic recession and a patent cliff faced by many large pharmaceutical firms, financial capital available to help reverse this trend will only be scarcer. This project analyzes the sharing of the 3Rs of pharmaceutical innovation - resources, risks and rewards - studying how these factors work (or do not work), to reengineer the value chain of pharmaceutical innovation. The specific aims of the project are to: 1) identify and investigate how best to structure collective approaches to sharing resources that may help reduce the risk of pharmaceutical R&D; 2) study approaches to sharing risks for pharmaceutical R&D across public and private sectors; and 3) develop models for sharing rewards, both to ensure sufficient incentive to bring products to market and to provide fair returns on public investment. This project seeks to identify and evaluate promising, crossover approaches among neglected tropical diseases, rare diseases, antibiotics, and other therapeutic areas of public health significance that might enhance U.S. pharmaceutical innovation. | |
| Marriage, Gender and Health in Lesbian, Gay and Heterosexual Couples Award Year: 2011 Show AbstractMarried heterosexuals enjoy greater health and longevity than the unmarried, and the importance of marriage for health increases as people age. However, since same sex couples cannot legally marry in most parts of the United States, we know very little about the health implications of marriage for aging gay and lesbian couples. Dr. Umberson examines how committed relationships affect health-related behavior and health care, and how those processes vary across gay, lesbian, and heterosexual unions. By comparing cohabiting and married couples, Dr. Umberson also explores how legal marriage differs from cohabitation in shaping relationship and health dynamics. This project will inform health policy involving when and how marriage and cohabitation influence health-related behavior, and how partner dynamics around health care at home and in formal health care settings vary for different union types. Policy strategies that result in more health-promoting behavior, more effective partner participation in health care, and more efficient use of health care systems have the potential to reduce health care costs, while improving the health and well-being of individuals and couples. | |
| Translating Research Into Health Benefits: Returning Research Results & Incidental Findings Award Year: 2011 Show AbstractTremendous debate surrounds the question of whether researchers have a duty to offer research participants incidental findings (IFs) or individual research results (IRRs) of potential health importance that are discovered in the course of conducting the research. When neuroscience researchers obtain an MRI scan of the brain, they risk stumbling upon a brain tumor or other IF of potential life-and-death significance. When researchers collect genetic data, they may discover unexpected findings ranging from chromosomal abnormalities to gene variants predicting a catastrophic reaction to common medications. There is no agreement on how to handle these findings and whether to offer them back to individual research participants and affected subpopulations. In the past, most researchers have declined to return individual findings, on the grounds that investigators are engaged in research, not clinical care. Yet an increasing number of researchers have become uncomfortable with this tradition of silence, and emerging data suggest that many people want and even expect to receive notice of clinically important research findings. A major controversy has thus arisen over return of IFs and IRRs. The question of whether researchers should return these research findings to individual participants for clinical benefit challenges the traditional line drawn between research and clinical care, a line historically fundamental to the structure of research practice, health law, and bioethics. Reconsidering how we draw that line by contemplating return of incidental findings and research results has enormous health policy implications. At stake is how we conduct human subjects research, its relationship to clinical care, and whether we can harvest the potential health benefits to individuals flowing from research without unduly burdening that research effort. Susan M. Wolf, J.D., who has led NIH-funded work on these issues, will use multiple research methods to generate a groundbreaking book, as well as journal articles on the public health, public policy, legal, and ethical implications. This project promises to shape public policy and research practice by asking what researchers owe individual research participants and how research findings can translate appropriately into clinical care. |
Tel: 1-617-353-9220, ext. 1 | Fax: 1-617-353-9227 | Email: rwjfihp@bu.edu