Health challenges or inequities can be driving forces for change. This has led the NYC Partnership to award one-year pilot funds to address health challenges faced by communities receiving care in the public health care system in Queens, New York. This funding will enable teams at NYC Health + Hospitals (H+H)/Elmhurst, NYC Health + Hospitals/Queens and Mount Sinai to conduct collaborative research studies and care improvement projects that help address the communities’ health needs and affect change.
The NYC Partnership is a collaboration between the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, the Global Health Institute at NYC H+H/Elmhurst, and NYC H+H/Elmhurst and Queens.
The collaboration aims to engage in health care improvements, training, and research to address the needs of local Queens communities receiving care in the public health care system.
One mechanism to achieve this goal is the Pilot Project Awards, which encourage multidisciplinary and inter-institutional pilot projects. An 18-person Selection Committee composed of members from Mount Sinai, NYC H+H/Elmhurst and Queens reviewed and scored 19 applications, resulting in the funding of five projects for up to $25,000 each. The Committee selected these five projects:
Clinical and social implications that may exist by maintaining or removing race correction from pulmonary function testing in a racially diverse vulnerable population-Alfredo Astua, MD, and Ricardo Lopez, MD
There is a movement underway to remove race as a factor in many clinical algorithms as it can unfairly influence treatment options. Race correction equations used in pulmonary medicine may be preventing patients from receiving appropriate treatments as well as misclassifying the severity of disease. This project evaluates the effect of race correction, and its removal, from pulmonary function testing in the racially diverse communities served by NYC H+H/Elmhurst and Queens. Results will be correlated with social determinants of health and geospatial analysis of patients’ residence to understand associations of these social and structural factors on pulmonary diagnostics.
Alfredo Astua, MD
Ricardo Lopez, MD
Zachary L. Hickman, MD
NYC Health + Hospitals/Elmhurst Mild Traumatic Brain Injury and Concussion Program-Zachary L. Hickman, MD
As the only Level 1 trauma center in western Queens, NYC H+H/Elmhurst cares for approximately 800 patients with a traumatic brain injury (TBI) each year. The majority of these injuries are mild, including concussions. All patients with mild TBIs should be followed as outpatients by brain-injury specialists for the management of ongoing or prolonged symptoms related to their head trauma and for potential comorbid conditions (such as depression, anxiety, PTSD, or substance use disorders). If TBIs are untreated or under-treated, there are significant psychosocial and quality-of-life ramifications. Disparities in health care access and delivery are known to exist for patients after a TBI. This project will establish the first multidisciplinary Mild TBI/Concussion Program within the New York City public health system at NYC H+H/Elmhurst to reduce health care inequities in TBI diagnosis, treatment, and outcomes.
Perspectives of family caregivers and clinic staff on standardized caregiver needs assessment within an urban safety net primary care clinic for older adults-Harriet Mather, MD, MSc, and Hadeel Alkhairw, MD
Family caregiving is an urgent public health challenge due to the rapid increase in family caregivers and the impact on caregivers, care recipients, and the economy. Community-based caregiver support services are important for improving caregiver wellbeing, yet uptake of these services is low, with evidence of sociodemographic inequities. Systematic identification and needs assessment of family caregivers in primary care is a vital first step to promote uptake of support services. Through interviews with family caregivers of older adults attending the medical primary care clinic at NYC H+H/Elmhurst and focus groups with clinic staff, the study aims to understand the feasibility, acceptability, and preferences of caregiver needs assessment in primary care. This study will inform the co-design of a caregiver needs assessment and support intervention for family caregivers of older adults.
Harriet Mather, MD, MSc
Hadeel Alkhairw, MD
Ben McVane, MD
Assessing the Health Needs of Newly Arrived Immigrants and Asylum-Seekers in Queens-Ben McVane, MD
New York City has seen a recent significant increase in the arrival of asylum-seekers. This project will conduct a health-focused needs assessment using respondent-driven sampling of newly arrived immigrants and asylum-seekers in Queens. Data will be used to plan, fundraise, and advocate for a New Arrivals Clinic at NYC H+H/Elmhurst to better address medical and social needs. Participants with unmet needs will be connected to appropriate resources through community partnerships with Make the Road New York and the Libertas Center for Human Rights at NYC H+H/Elmhurst.
Cardiovascular Precision Medicine and Remote Intervention-Eyal Shemesh, MD, and Deborah Reynolds, MD
Non-adherence to medical recommendations for controlling high blood pressure and cholesterol is the leading cause for adverse outcomes in patients with cardiovascular morbidity. This project will use a cardiovascular variability marker, unstable and variable blood pressure readings, identified from electronic health records as a marker of non-adherence to flag patients at increased risk for poor outcomes. Cardiology clinic patients will be enrolled in a remote intervention for three months to increase engagement in care and improve adherence to medical recommendations.
Eyal Shemesh, MD
Deborah Reynolds, MD
Payal Ram is the Research Program Coordinator for the New York City Partnership at the Arnhold Institute for Global Health, and the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai and the Global Health Institute at NYC Health + Hospitals/Elmhurst.