Dr. Jennifer Kraschnewski, professor of medicine, public health sciences and pediatrics at Penn State College of Medicine, has received $2.69 million through the Patient-Centered Outcomes Research Institute (PCORI) to establish projects aimed at addressing COVID-19 health disparities among nursing home residents and racial and ethnic minorities.
Kraschnewski, a Penn State Health primary care clinician-investigator who studies community health interventions, said the funding will be used to provide training to two groups of people who work directly with populations at risk for poor outcomes from COVID-19 — nursing home staff and community health workers.
The first project will span two years and aims to identify how evidence-based infection control guidelines can be implemented effectively in Pennsylvania nursing homes. Nationally, only 3% of nursing home staff have completed a basic infection control course. Nursing home residents and staff have been disproportionately impacted by the COVID-19 pandemic, with approximately 175,000 confirmed resident cases and more than 45,000 deaths in the United States. In Pennsylvania long term care facilities, there have been more than 20,000 cases of COVID-19 and more than 5,000 deaths.
“Nursing home residents are one of the most vulnerable populations during the COVID-19 pandemic,” Kraschnewski, director of Project ECHO at Penn State, said. “We hope this work will ultimately reduce infections and decrease hospitalizations and deaths, while improving resident quality of life by increasing nursing home capacity to adopt, implement and maintain infection control guidelines.”
Researchers will compare the use of Project ECHO, which enables nursing home staff and university-based experts to disseminate guidelines and best practices through interactive virtual sessions, to a Centers for Disease Control and Prevention nursing home infection-control webinar series. This project builds off of pilot work funded by the Penn State Huck Institutes of the Life Sciences and the Penn State Social Science Research Institute.
“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge to address the unprecedented and constantly evolving challenges created by this pandemic,” said PCORI Executive Director Nakela L. Cook. “We look forward to following the study’s progress and working with Penn State College of Medicine to share the results.”
The goal of the second project, set to last a year, is to increase the use of community health workers in health disparities research. Penn State Clinical and Translational Science Institute will support this project through its community engagement coordinator, Andrea Murray. Their team will provide training and connect researchers and community health workers interested in addressing pandemic-related health disparities in Hispanic communities.
“Community health workers have risen as critical connections to at-risk communities during the pandemic,” said Kraschnewski, a researcher at Penn State College of Medicine. “This project will fill important gaps by providing research training for community health workers and connecting them with researchers interested in community-engaged research.”
This second project is funded by the Eugene Washington PCORI Engagement Award Program, developed to bring more patients, caregivers, clinicians and other health care stakeholders, such as community health workers, into the research process.
A robust stakeholder network equipped with expertise and experience will guide both projects. These connections include an established network of more than 100 community-based organizations, state and federal policymakers, state professional organizations, insurers, family and resident advisory councils, and regional Hispanic communities.
“Research that meaningfully impacts communities suffering from health disparities starts with a network of people invested in bringing about change,” Kraschnewski said. “We are grateful for the collaboration of these important community leaders and hope our work will reduce poor outcomes from COVID-19 in our most vulnerable populations.”
William Calo, Betsy Aumiller, Nicole Osevala, Ayesha Ahmad, Aditya Joshi, Lan Kong, Doug Leslie, Gavin Macgregor-Skinner and Catharine Paules of Penn State College of Medicine; Janice Whitaker of Penn State's College of Nursing; Francis King, Penn State College of Health and Human Development; and Sanjeev Arora and Elizabeth Clewett, University of New Mexico Health Sciences Center, also are contributing to this research.