The Faculty Research Fellowship Program (FRFP) is designed to encourage faculty at the MGH Institute of Health Professions to develop a program of research in their area of interest. The program supports faculty efforts to achieve external funding for their research program by providing up to $10,000 seed grant to conduct pilot studies that serve as preliminary data for subsequent efforts. Up to $2000 of this must be dedicated to preparation of subsequent NIH proposal.

Grants are awarded for a one-year period (from October 1 to September 30). An ad hoc committee of faculty with research experience is appointed by the Provost’s Office to act as a peer review panel for all applications. The Committee makes recommendations to the Office of the Provost, who is responsible for awarding and monitoring the fellowships.

Awards were first granted for the 2004-2005 academic year, one to support research in topics relating to geriatric research and one to support research in a non-specified area.

Two $10,000 awards are available for this cycle. Neither of the awards is required to be given if it is determined that no meritorious applications have been submitted.

Application due: July 10, 2023 – submit to research [at] mghihp.edu
 

  1. July 10, 2023 - APPLICATION DUE - submit to research [at] mghihp.edu
  2. October 1, 2023: Award start date.
  3. September 30, 2024: Project end date.
  4. December 31, 2024: Final report due.
  • Applicants for these awards must currently hold a faculty appointment at the Institute and have, at minimum, a 10-month contract at a 0.5 FTE level.
  • Prior recipients of internal (IHP) Seed Grants are NOT eligible.  
  • Priority will be given to faculty who have not received start-up funds. 
  • The application clearly portrays a significant area in need of research, with well-defined research objectives and a scientifically sound approach to the study that is deemed meritorious by peer review.
  • The project is of appropriate scope and rigor to produce preliminary data for use in subsequent applications for extramural funding and publication, and a clear plan is described for how future funding will be pursued (e.g., timeframe, funding agency, type of grant, etc.).
  • Priority will be given to interdisciplinary approaches that align with the Institute's strategic vision and mission.
  • Applicant's ability to serve as Principal Investigator (PI) is evident by a track record of management /leadership and/or prior research collaborative activities commensurate with one’s stage of career.
  • The project is feasible based on proposed objectives, timeline, and budget.

Appropriate use of FRFP Award monies include, but are not limited to:

  • Project-related expenditures
  • Statistical consultation beyond available IHP-based resources if necessary
  • Support for travel to and from a research site
  • REQUIRED: $2000 must be used to prepare a subsequent NIH proposal
  • Awardees must submit an end-of-project year report of their activities to the Associate Provost for Research.
  • Awardees must meet with the Institute's grant account representative initially, and at least 90 days prior to completion, to ensure appropriate accounting and monitoring of funds.
  • Awardees must give a formal presentation of their research progress and results at the MGH Institute within the next academic year following the completion of the funding of their project.
  • Awardees must submit their findings for publication and provide a copy of submission to the Office of the Provost.
  • Awardees are expected to use this award as the basis for a subsequent extramural grant submission.

Final application by order of assembly and page limits:

  1. Proposal Cover Sheet, completed with your Academic Program Director’s (APD) signoff prior to submission (available on the Intranet under Office of the Provost – Research)
  2. Proposal Applicant Letter attesting to rationale for application in relationship to your career and program of research (1 page), accompanied by your biosketch using the NIH format.
    • Identify in your letter if this is your first application, a resubmission, or a new, different FRFP application. Describe how the funding will enhance your ability to obtain external grant funding and identify the intended grant(s).
  3. Project Abstract – Project Title and description of no more than 500 words
  4. Proposal (following the format for NIH R03 Grant Applications):
    • Specific Aims (1 page)
      • State concisely the goals of the proposed research and summarize the expected outcome(s), including the impact that the results of the proposed research will exert on the research field(s) involved.
      • List succinctly the specific objectives of the research proposed, e.g., to test a stated hypothesis, create a novel design, solve a specific problem, challenge an existing paradigm or clinical practice, address a critical barrier to progress in the field, or develop new technology.
    • Research Strategy (6 pages no counting bibliography/references): Organize the Research Strategy in the specified order and using the instructions provided below. Start each section with the appropriate section heading – Significance, Innovation, Approach. Cite published experimental details in the Research Strategy section and provide the full reference in the Bibliography and References Cited section.
      • Significance
        • Explain the importance of the problem or critical barrier to progress in the field that the proposed project addresses.
        • Explain how the proposed project will improve scientific knowledge, technical capability, and/or clinical practice in one or more broad fields.
        • Describe how the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field will be changed if the proposed aims are achieved.
      • Innovation
        • Explain how the application challenges and seeks to shift current research or clinical practice paradigms.
        • Describe any novel theoretical concepts, approaches or methodologies, instrumentation or interventions to be developed or used, and any advantage over existing methodologies, instrumentation, or interventions.
        • Explain any refinements, improvements, or new applications of theoretical concepts, approaches or methodologies, instrumentation, or interventions.
      • Approach
        • Describe the overall strategy, methodology, and analyses to be used to accomplish the specific aims of the project. Unless addressed separately in Item 15 (Resource Sharing Plan), include how the data will be collected, analyzed, and interpreted as well as any resource sharing plans as appropriate.
        • Discuss potential problems, alternative strategies, and benchmarks for success anticipated to achieve the aims.
        • If the project is in the early stages of development, describe any strategy to establish feasibility, and address the management of any high risk aspects of the proposed work.
        • Point out any procedures, situations, or materials that may be hazardous to personnel and precautions to be exercised. A full discussion on the use of select agents should appear in Item 11, below.
        • (Note: If an applicant has multiple Specific Aims, then the applicant may address Significance, Innovation, and Approach for each Specific Aim individually, or may address Significance, Innovation, and Approach for all of the Specific Aims collectively.
        • As applicable, also include the following information as part of the Research Strategy, keeping within the three sections listed above: Significance, Innovation, and Approach.
  5. Budget (2 pages): 
    • Page 1: Budget for the year (use the NIH format).
    • Page 2: Brief justification of each item in the budget.
       
  • A copy of the completed application should be given to your APD for review and sign-off approval regarding any effects on program resources, such as use of IHP facilities, prior to submission. 
  • Submit the proposal with the coversheet and APD signoff as one PDF document via email to: research [at] mghihp.edu
  • Proposals involving human subjects are not required to have IRB approval at the time of submission but must receive approval by the IRB before funds are awarded.
  • Support for grant management issues and monitoring of grant policy compliance occurs through the Institute’s research administration in the Office of the Provost.
  • All funds must be spent during the funding period otherwise they are forfeited.
  • Copies of all publications resulting from FRFP-supported research should be submitted to the Associate Provost for Research (Provosts’ Office). Published reports are required to acknowledge the support of the Faculty Research Fellowship Program at the MGH Institute of Health Professions, as follows: “This work was partially supported by a Faculty Research Fellowship from the MGH Institute of Health Professions.”
  • Compliance with fulfilling previously stated Responsibilities of the Awardees.

Exploring a novel peer mentoring intervention to support the mental health of young adults with intellectual and developmental disabilities: 2022-2023
$10,000 from MGH Institute of Health professions Faculty Research Fellowship Award: Ariel Schwartz, principal Investigator. 

Abstract:

Thirty to 50% of the approximately 6 million people living in the United States with intellectual and developmental disabilities (IDD) (e.g., autism, Down syndrome, and intellectual disability) have mental health conditions, such as anxiety, depression, and PTSD. Recent estimates suggest young adults with IDD (YAIDD) may be diagnosed with mental health conditions 4-5 times more often than those without IDD. Poor mental health is associated with difficulty achieving transition-related objectives, such as employment and community living. Yet, there are few effective mental health interventions designed for YAIDD with co-occurring mental health conditions. Further, mental health professionals often lack specific training in supporting YAIDD.

Guided by practices in mental health services for individuals without IDD, peer-delivered interventions are an evidence-based alternative to clinic-based, professionally-delivered services, as YAIDD with co- occurring mental health conditions can easily communicate with and support each other from a strengths- based perspective given their shared identities and life experiences. Exploring Mental Health Together (EMHT) is a novel peer mentoring intervention that incorporates theory-driven and evidence-based strategies to support use of coping (i.e., self-regulation) skills for YAIDD with co-occurring mental health conditions. While prior research suggests this approach is feasible and socially valid, it has only been tested in small samples in academic settings and mentors’ fidelity to deliver EMHT needs to be more closely examined, as mentor training has been expanded since the initial feasibility study.

This proposal aims to ready EMHT for a pilot RCT and community-delivery. First, we will examine mentors’ fidelity to EMHT after completion of expanded training (Aim 1). Next, as there is growing recognition of the need to design interventions with implementation considerations at the forefront, we will explore factors that will influence delivery of EMHT in community settings and build community partnerships. Specifically, we will conduct town halls and face-to-face meetings to identify inputs required for successful academic- community research partnerships (Aim 2) and conduct focus groups to identify supports, barriers, and modifications to feasible community-based delivery of EMHT (Aim 3). The outputs of this study will help the PI successfully compete for future funding of EMHT by laying the groundwork for a pilot RCT.
 

Speech Functions and Microvascular Hemodynamics in Adults at Risk for Alzheimer's Disease: 2022-2023
$10,000 from MGH Institute of Health professions Faculty Research Fellowship Award: Marziye Eshghi, principal Investigator. 

Abstract:

Impaired microvascular function is being increasingly implicated in Alzheimer’s disease (AD)-related neurodegenerative changes. Associations between apolipoprotein (APOE) ε4 possession (which is a major risk factor for both AD and cerebrovascular diseases), hemodynamic characteristics, as well as cognitive and motoric functions have not yet been fully characterized. The goal of this work is to identify relationships between acoustic/ kinematic speech measures and microvascular physiology in individuals according to genetic risk for developing AD. Evidence suggests that the onset of microvascular dysregulation occurs at the prodromal stage of AD, prior to the amyloid beta decomposition or the formation of neurofibrillary tangles. Our prior work has also confirmed that measures of speech motor control can reliably index early stage of neurodegeneration. Since both hemodynamic features and speech measures have shown sensitivity to early neurodegeneration, we propose here to assess speech markers and their corresponding cerebral hemodynamic properties as a complementary and ecologically valid strategy for identifying adults at risk of developing AD. Speech production is one of humans’ most complex motor behaviors, as it relies on integration of cognition, sensory, and motor processes, which are all affected in AD. Noninvasive magnetic resonance imaging (MRI) will be concurrently acquired with speech acoustic/kinematic measures to obtain microvascular cerebral hemodynamic information in speech related regions in a well-characterized cohort of adults with or without APOE ε4. We will further examine the extent to which hemodynamic parameters and measures of speech motor control are associated with cognitive functions as indexed by a standardized cognitive composite score (representing memory, attention, executive function, and processing speed). Hemodynamic parameters include measures of cerebral blood flow (CBF) and arterial transit time (ATT). Speech motor control will be quantified using acoustic and kinematic approaches to index articulation rate, coordination, consistency, precision, and sequencing during cognitively and motorically-demanding speech samples. We hypothesized that 1) compared to the ε4 noncarriers, ε4 carriers have reduced CBF and prolonged ATT in brain regions associated with speech motor function; 2) speech measures can detect ε4 carriers from ε4 noncarriers with high sensitivity and specificity; and 3) hemodynamic measures of speech motor regions are associate with reduced cognitive performance in ε4 carriers; and that alterations in hemodynamic measures will mediate speech and cognitive measures. The findings from the proposed research will help improve our understanding of the interaction between possessing APOE ε4 allele and cerebral hemodynamic characteristics of speech motor regions and how these associations can be used for early diagnostic and monitoring disease progression. The findings will also inform the extent to which speech motor tasks can be incorporated into neuropsychological testing to optimize the clinical assessment of AD and cerebrovascular conditions.

Impact of physical activity and strength training on long term health outcomes in community-dwelling older adults with cardiovascular multimorbidity​: 2019-2020
$10,000 from MGH Institute of Health professions Faculty Research Fellowship Award: Shweta Gore, PhD, DPT, GCS, CLT, Principal Investigator. 

Abstract: 

The prevalence of multimorbidity or multiple chronic conditions (MCC) is rising exponentially in older adults and accounts for a huge burden of health care costs. Cardiovascular related MCCs in older adults represent the largest cause of morbidity and mortality both within the US and globally. Regular physical activity is associated with optimal health outcomes in the healthy population and prevents the risk of cardiovascular disease. Additionally, strength training is associated with improved functional outcomes and quality of life in individuals with cardiovascular disease; however, little is known about the impact of physical activity and participation in strengthening exercise on long-term prognostic health outcomes in community-dwelling older adults with cardiovascular MCC.

This study aims to determine the associations of physical activity and of time spent in strengthening exercise with all-cause and cardiovascular-related hospitalizations and mortality in community-dwelling older adults with cardiovascular MCCs.

To answer these questions, the National Health and Nutrition Examination Survey (NHANES) data linked to Medicare claims data and National Death Index will be utilized to prospectively follow older adults with cardiovascular MCC for a period of five-years or until they die. Activity level measurement will be collected using the Actigraph 7164 accelerometer. Separate multivariable logistic regression models with all-cause and cardiovascular-related hospitalization as categorical dependent variables will be constructed to determine the associations between physical activity and strengthening exercise and hospitalization after controlling for covariates. Cox proportional hazard models will be utilized to determine the association of physical activity and strengthening exercise with all-cause and cardiovascular-related hospitalizations and mortality after adjusting for covariates. Receiver-Operating Curves (ROC) will be plotted to determine the optimal physical activity cut-points with the best sensitivity-specificity combination in identifying a hospital admission from cardiovascular causes and from all causes.

Factors Impacting Discharge to Community from Home Health Care for Individuals with Alzheimer’s Disease and Related Dementias: 2019-2020
$10,000 from MGH Institute of Health professions Faculty Research Fellowship Award: Sara Knox, PT, DPT, GCS, CEEAA, Principal Investigator.

Abstract: 

Post-acute care is a prominent and costly component of the health care continuum. Interest in post-acute care health outcomes and strategies to minimize health care expenditures is widespread among stakeholders in the health care system. Recent legislation has highlighted the importance of discharge to community as a priority healthcare outcome for payers and patients. Home health agencies provide care to more beneficiaries than any other post-acute setting. A significant portion of individuals receiving home health care have a diagnosis of Alzheimer’s disease or related dementias (ADRD). Individuals with ADRD are known to have poor health outcomes associated with care transitions, including discharges. Yet, there is a paucity of research addressing factors associated with negative outcomes after discharge from post-acute care settings, and little information regarding effective strategies to optimize positive outcomes after discharge.

Objective: The objective of this proposed study is to determine factors associated with successful discharge to community (DTC) for individuals with ADRD. Methods: This proposed study will be a retrospective cohort study of Medicare fee-for-service beneficiaries, with and without ADRD, who had a home health episode between June 30, 2013 and July 1, 2015. The outcome variable of interest will be successful DTC as defined by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). Predictor variables will include the types of services provided, length of care, number of visits, early discharge, and low utilization. The predictive value of these factors on successful DTC will be examined using logistic regression.

Expected Results: It is expected that factors associated with successful DTC will differ in the presence of an ADRD diagnosis. Importance: DTC is an actionable health care outcome that home health care agencies and clinicians can positively impact. Improving our understanding of factors associated with successful DTC for individuals with ADRD can better inform allocation of resources, development of discipline specific plans of care, and discharge planning during home health care. This is a critical first step in improving successful DTC after home health care for individuals with ADRD.

Work function assessment: A pathway to minimizing work disability: 2018-2019
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Rawan AlHeresh, PhD, Principal Investigator.

Abstract: 

Arthritis and rheumatological conditions has a profound impact on employment, with estimates showing approximately one-third of people with arthritis and rheumatological conditions becoming unemployed within 10 years of being diagnosed, of those who are still employed work function is lower compared to those who do not have arthritis. The high prevalence of arthritis-related work loss in the working aged population makes this disease group a strategic population to test interventions to prevent or minimize work loss. Work loss -or unemployment- is a rare outcome requiring very large samples and long follow-up time periods necessitating high study costs. Targeting intermediate outcomes such as work function, defined as work-related task performance, could be fruitful. Responsive and sensitive work function assessment tools, however, do not exist. Additionally, the field is lacking assessments that are person-centered and cover the breadth of work function as a construct, where modern statistical methods like Item-Response (IRT) Theory could be utilized. 

The objective of this study is to develop a comprehensive question bank for assessing work function in two major domains; physical work demands, and mental/behavioral work demands to be used as a foundation for IRT testing and ultimately develop a Computer Adaptive Test (CAT). 

The methods will begin by completing a thorough literature review to identify the existing assessments pertaining to work function using scientific databases such as PubMed, CINAHL, Medline, EBSCO, and hand searches if necessary. All literature pertaining to work-related assessment such as health, economics and occupational medicine will be searched and examined for content. The ICF taxonomy will be used as a conceptual foundation to characterize the aspects of interactions between the persons abilities, work-related activity demands, and the environment of the workplace when developing the physical and metal/behavioral content models. We will then use focus groups compromised of clinicians to identify new test items that were not covered in the literature review process. We aim to generate 100 items for each of the work function domains. Next, we will seek feedback from national and international experts to review the items we generated in the previous step. The feedback will pertain to domain fit, actual content of items, item response options, clarity of item and importance of inclusion in item bank. Final step in this proposal will be to complete cognitive testing to find out if the respondents understood the questions consistently as intended with ease.

This proposed project will generate a new and refined item pool to assess function in the workplace for people with arthritis and rheumatological conditions and allow for the application of IRT and CAT methodologies. This will ready the item pools for feasibility and distributional characteristics and ultimately for calibration and subsequent inclusion in a CAT platform. 

Speaking Along: The Effects of Speech Entrainment in People with Aphasia: 2018-2019
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Lauryn Zipse, PhD, CCC-SLP, Principal Investigator.

Abstract:

People with some sub-types of aphasia produce halting, nonfluent spoken output that may be agrammatic. Many people with aphasia (PWA) also have concomitant apraxia of speech (AOS), a motor speech disorder that further affects speech fluency. Speaking or singing in unison is a component of many aphasia therapies designed to promote increased spoken output or improve fluency. However, the conditions under which unison production is effective, whom this technique works for, and why it works, remain poorly understood. The proposed study will test whether the prosodic structure of the utterance affects the degree to which PWA benefit from speaking along to speech. Metrical prosody will be compared to conversational prosody; the former is based on musical structure, with timing governed by regularly occurring intervals and integer sub-divisions of these intervals, while the latter is dictated by syntactic and prosodic rules, i.e, is dependent on linguistic knowledge.

This study will also investigate whether PWA are truly entraining their speech to the spoken model, such that their speech coincides with, rather than closely follows, the stimulus. Entrainment requires prediction of what is coming next in the signal. Although it has been assumed that PWA entrain their speech to a model in unison conditions, this has never been confirmed. The proposed study will time-lock the speech output measures to the stimulus signal, evaluating whether entrainment is occurring when the prosody is metrical vs. conversational, under conditions of either high or low phonological and motor speech demands. The results from this study will be used to evaluate a two-route model of speech planning, in which speech can be organized according to a metrical or a prosodic framework, and in which these frameworks can be damaged or preserved independently.

Piloting an Adaptive Agent Based Model to evaluate Frailty in the pre-elderly and elderly populations: 2017-2018
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Andrew B. Phillips, PhD, RN,  Principal Investigator.

Abstract: 

The elderly population is the United States places an increasing demand on both our economic and healthcare resources. Those over age 65 account for approximately 34% of healthcare spending, but only 14% of the population1. This disproportionate cost is reflective of the increasing number of chronic conditions we experience as we age. Changing this dynamic is important to improving the quality of life of our aging population and reducing the demand on our economic and healthcare resources. Advances in technology nutrition, medication, and genomics have served to improve our management and understanding of these disease processes. Other influencers of health such as our environment, social well-being, cognitive health, physical activities, and access to care represent further influencers of the aging process and health. Less understood are the ways in which these influencers interact and contribute to aging. How much does our environment contribute our health later in life? Are there “points of no return” during middle age where behavioral, medical, or other interventions become less effective? How do our behaviors and choices interact with physical, mental, and other health indicators to predict future health?

Frailty has been identified as a key measure of the decreased “physiologic reserve” that results in cumulative declines and increased vulnerability to chronic illness. While there are several proposed measures of frailty that have been validated against specific data sets, there are minimal studies on the influence to be given to the criteria that assess overall frailty risk. The result is a need for a more dynamic rather than static model of frailty that reflects the interrelationships among the current five frailty criteria (Shrinking, Weakness, Poor endurance and energy, Slowness, and Low physical activity) as well as the many potential physiological, cognitive, environmental and other factors that in combination contribute to frailty.

The science of Adaptive Agent Models (AAMs) are one method of dynamic evaluation using complex systems science. AAM is a bottom-up methodology that considers individual agent attributes such as age, sex, socioeconomic status, physical and mental health, etc., and the multiple interactions that take place among multiple agents, the environment, and the other “agents” within a complex system. An AAM has the ability to examine both individual behaviors and environmental characteristics that contribute to frailty and identify those that have the greatest influence. Our growing understanding of aging, combined with an increasing availability of large data sets and new computational methods, create an ideal opportunity to develop an AAM at this time.

The first step in achieving this goal is development of a Pilot AAM utilizing the method through replication of well documented frailty measures and outcomes. Validation of a simple Pilot AAM is a critical starting point for future models that have the capability to improve or replace existing frailty instruments and identify opportunities for early intervention in the aging process at the primary care level. The results from this Pilot should provide initial data on the relative influence of each of the five frailty criteria on frailty prevalence and mortality.

1. National Health Expenditures Fact Sheet. 2016.

Regulation of IL-1β Production by Mcl-1: 2015-2016
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: John Wong, PhD, Principal Investigator.

Abstract:

Interleukin-1 beta (IL-1β) is a cytokine involved in the immune response to microbial infection and the development of many human diseases. IL-1β is synthesized as a precursor in immune cells. The precursor is processed by a multimeric protein complex called the NLRP3 inflammasome to yield mature IL-1β that is secreted from the cell. Different kinds of danger signals (microbes, DNA damaging agents, toxins, etc.) stimulate immune cells to produce IL-1β by activating the NLRP3-inflammasome, yet how these danger signals cause inflammasome activation is not known. I hypothesize that Mcl-1 regulates the NLRP3-mediated activation of IL-1β production in mammalian cells by acting as an inhibitor. Mcl-1 fits the criteria of such a candidate because it has a short half-life, plays a role in cell survival, and belongs to a family that binds NLRP3-like members. In addition, my preliminary data demonstrated that Mcl-1 is degraded in response to stimuli that activates NLRP3. To test whether the hypothesis of Mcl-1 being the regulatory protein of the NLRP3-inflammasome is true, I will artificially increase and decrease the expression of Mcl-1 in mouse bone marrow-derived macrophages using lentivirus and siRNA, respectively. Understanding how the production of IL-1β is regulated may lead to effective treatments to block IL-1β production in many diseases.

Infusing Robot-Assisted Therapy with Motor Learning Principles: An Active Learning Program for Stroke (ALPS): 2015-2016
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Susan E. Fasoli, ScD, OTR/L, Principal Investigator. 

Abstract:

Rehabilitation robots and passive gravity-assist orthoses provide clinicians with new treatment options to improve upper extremity (UE) motor capacity and performance after stroke. Systematic reviews of robot assisted therapy for the paretic UE confirm gains in motor capacity as measured by clinical assessments, but provide little evidence of improved UE performance during daily tasks and occupations.1,2,3 These findings may be attributed to the limited availability of rehabilitation robots to train the paretic hand and a primary focus on intensity of practice with little regard for other principles of motor learning and experience-dependent neuroplasticity.4,5 These principles, including the salience of training tasks, transfer of acquired skills to similar activities, and active engagement and problem solving, are key to task-oriented training paradigms in stroke (e.g. constraint-induced movement therapy) but have not been well integrated into robot-assisted therapy protocols. The transfer of robot-trained movements to UE activities within the home and community needs further exploration before widespread use in rehabilitation practice is expected.

The objectives of this pilot project are to 1) generate and test a feasible and reproducible protocol in which motor learning principles are more fully infused into robot-assisted therapy and 2) examine participant outcomes via measures across domains of the International Classification of Functioning (ICF).6 Specifically, we will develop a structured Active Learning Program for Stroke (ALPS) that promotes identification of interfering and changeable UE impairments; establishes clear patient-centered goals; encourages active problem solving and UE self-management; and facilitates self-efficacy and confidence in UE use via challenging and meaningful practice. We will provide participants with a home action plan that will combine ALPS training with patient-targeted treatment activities to encourage the transfer of acquired skills to activities in the home and community. Persons with moderate UE impairments more than six months post stroke will be randomly assigned to one of two intervention groups in which they receive ALPS training with either 1) robot assisted therapy (RT) alone, or 2) robot-assisted therapy plus therapist-guided task-oriented training (RTTOT).

A neurophysiological examination of individual differences in the efficiency of feedback processing: 2014-2015
$10,000 from the MGH Institute of Health Professions Geriatric Faculty Research Fellowship Award: Yael Arbel, PhD, CCC-SLP, Principal Investigator.

Investigating the impact of summer experiences on reading for students with language-based learning disabilities: 2014-2015
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Joanna Christodoulou, EdD, Principal Investigator.

The Influence of Nursing Home Structure and Process on Long-term Feeding Tubes for Dysphagia: 2013-2014
$10,000 from the MGH Institute of Health Professions Geriatric Faculty Research Fellowship Award: Ruth Palan Lopez, PhD, GNP-BC, Principal Investigator.

Pilot HIV Prevention Study for Adolescent Young Women: 2013-2014
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Ellen Long-Middleton, PhD, RN, FNP-BC, Principal Investigator.

Feasibility of Implementing a Portable Sit to Stand Measure Among Participants with Hip Fracture Who Have Mild Cognitive Impairments: 2012-2013
$10,000 from the MGH Institute of Health Professions Geriatric Faculty Research Fellowship Award: Janet Kneiss, PhD, PT, MS, Principal Investigator.

Depressive Symptoms, Stress and Quality of Life in Older Adults with HIV/AIDS: Impact of Race, Gender and Length of Diagnosis, 2011-2012
$10,000 from the MGH Institute of Health Professions Geriatric Faculty Research Fellowship Award; Jeanne Cartier, PhD, PMHCNS-BC, Principal Investigator.

The Acquisition of Critical Thinking Skills in Physical Therapy Students: A Preliminary Study 2011-2012
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Tracy Brudvig, PT, DPT, PhD, OCS, and DJ Mattson, DPT, EdD, SCS, Principal Investigators.

Abstract:

Background. Physical therapist practice has increasingly developed into autonomous practice increasing the need for students to demonstrate high levels of critical thinking ability. Despite this need for current practice, measuring the level of critical thinking
ability and evaluating changes during academic and clinical experiences have not been adequately reported in the literature. Purpose. The purpose of this study is to determine critical thinking skills in physical therapy students at the time of matriculation and to
determine whether these skills improve as the students progress through the curriculum. Methods. Data will be collected using the California Critical Thinking Skills Test from July 2011 through August 2012. Information will be gathered upon student matriculation
and again after one year of academic and clinical work. Various factors such as cultural background, learning style, and demographic data will be analyzed for their impact on critical thinking ability. Statistical analysis will include description statistics and parametric analysis. Unique aspects of this proposed study include a sample of physical therapy doctoral students, cultural diversity sample of internationally trained physical therapists, and the measurement of acquisition of critical thinking skills over time. Relevance. The results of this study will serve as a foundation for additional research focusing on best teaching practice along with providing a framework to initiate interprofessional research collaboration here at the Institute along with potential collaboration with other institutes of higher learning. 

Investigation of Rhythmic Processing in Aphasia, 2010-2011
$10,000 from the MGH Institute of Health Professions Geriatric Faculty Research Fellowship Award: Lauryn Zipse, PhD, CCC-SLP, Principal Investigator.

Abstract: 

The ability to tap to a rhythm has been anecdotally noted to be impaired in aphasia, but this deficit has not been established experimentally. Interestingly, rhythmic tapping is a component of at least one therapeutic approach designed to increase speech fluency in nonfluent aphasia. It may be that rhythmic processing and speech fluency are both manifestations of a more global processing capability, and that this capability can be targeted in some types of aphasia in order to increase therapeutic efficiency. To investigate this possibility, it is first necessary to establish whether there is in fact a rhythmic processing deficit in nonfluent aphasia and to examine whether other factors, such as impaired working memory, could account for such a deficit. In this project, we will develop a comprehensive test of rhythmic processing and related abilities, and then use this test to assess rhythmic processing in 15 individuals with aphasia and 15 agematched control participants. We will look at rhythmic processing in the context of speech and music, and assess perception as well as production of rhythms. The individuals with aphasia will also complete clinical speech-language testing so that any rhythmic processing deficits can be considered in terms of type and severity of aphasia.

Person, Place, and Prevention in Primary Care: A Multilevel Analysis of Variation in Behavioral Health Preventive Service Deliver, 2010-2011
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Alex Hoyt, PhD, MSN, FNP. Principal Investigator.

The Lived Experience of Pregnancy with Chronic Illness, 2010-2011
$10,000 from the MGH Institute of Health Professions Faculty Research Fellowship Award: Linda Tyer-Viola, PhD, RN, Principal Investigator.

Abstract: 

The purpose of this qualitative descriptive study is to explore and describe the experience of pregnancy with a chronic illness among women in the third trimester of pregnancy. The goal of this proposed project is to provide preliminary data on this specific population for further support for research. The rate of chronic illness among women in the United States is growing with as many as 39% of women of childbearing age (19-45 years) having a chronic diagnosis. With advances in treatment coupled with the recognition that women’s health care needs are different than those of men, women with chronic illness are living healthier lives. Care for chronic illness varies depending on the physiologic and psychological condition and symptoms. Living with chronic illness is often described as a process of constant integration within living with illness and living life. Two common symptoms expressed by women are underlying depression and fatigue. The presence or exacerbation of these symptoms are also known to affect
perinatal outcomes during pregnancy. When there is a major life change, such as pregnancy, the balance of life and the stress of integration, may affect the overall well being of the mother and child that may result in symptom alterations. How these symptoms are affected by pregnancy and how women with chronic illness experience pregnancy is not well understood. Using a phenomenological research design, pregnant women with a history of an illness that has been treated for at a minimum of three months prior to pregnancy that is considered to be persistent, incurable and may worsen over time, will be enrolled from the Vincent Obstetrical Service at MGH. After consent, the women will participate in an open ended tape recorded interview on the experience of pregnancy with a chronic illness. Interviews will occur in a private setting of the participant’s choice. Data will be analyzed using Colaizzi’s methods with themes extracted and defined and an exhaustive description of the phenomenon created. This description will then be confirmed with additional participants. Data collection and analysis will be concurrent to ensure deeper understanding of emerging themes.
Trustworthiness of these data will be maintained within the research process by obtaining a purposeful sample till saturation of themes is achieved. Rigor of validity of data will be maintained by the PI and an expert in qualitative research analyzing these data for agreement. Creditability will be ensured by member checking the analysis with participants. The expected outcome is an exhaustive description of the lived experience of women with chronic illness and the identified themes that resonate within their lives during pregnancy. 

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