Departments of Preventive Medicine, Medicine
and Physical Medicine and Rehabilitation
What are your research interests?
My clinical research interests center on rehabilitative and preventive rheumatology. With colleagues from a number of departments and institutes at the Feinberg School, we pursue clinical epidemiologic and health services research focused on the outcomes of rehabilitation and orthopedic surgical treatments and physical activity interventions for people with arthritis. This research also involves looking at the factors that determine functional limitation and disability in clinical and community populations with arthritis.
What are some of your current research projects?
A number of our recently published studies involved identifying and altering modifiable factors associated with the incidence of functional limitation and disability in patients with arthritis. For example, we recently published findings from a study that utilized data from national survey of U.S. community-dwelling residents aged 60 or older where we identified “regular vigorous physical activity” as a major protective factor in preventing disability in those subjects reporting arthritis. This has led to our current R01-funded study which tests the efficacy and cost-effectiveness of a tailored intervention designed to increase the physical activity of patients with rheumatoid arthritis and knee osteoarthritis.
We are also interested in studying health and health care disparities pertaining to persons with arthritis. For instance, we recently published findings of a study exploring whether there are racial/ethnic disparities in arthritis-related hip and knee surgeries. That study looked at a national sample of African American, Hispanic, and white adults age 51 or older. The results showed that while African Americans under age 65 have similar age/gender adjusted rates of hip or knee arthritis surgeries, African Americans over 65 have significantly lower rates when compared with white patients of the same age. We concluded that national data documents lower rates of arthritis-related hip or knee surgery for older black versus white adults and that these differences occur in the Medicare-aged population.
Another recent study looked at racial and ethnic differences in the development of disability in older adults. We found that older African American adults and Hispanic adults interviewed in Spanish have higher risks for developing disability. Further, we concluded that this disparity was attenuated by health and socioeconomic differences, but not completely explained by these differences. We suggested that language- and culture-specific programs designed to increase physical activity and promote weight maintenance may reduce rates of disability in activities of daily living.
What is the ultimate goal of your research?
As revealed in the examples given, our research efforts ultimately seek to prevent arthritis-related functional limitation and disability. Our hope is that these studies lead to an effective health care system, public health, and public policy approaches that improve the health of people with arthritis across the full spectrum of age, gender, race, ethnicity, cultural background, and socioeconomic status.