FOR IMMEDIATE RELEASE

CONTACT: Nicolette Castagna

(850) 644-1506; nicolette.castagna@med.fsu.edu

July 2019

TALLAHASSEE, Fla. — With a $3.75 million grant from the federal Health Resources and Services Administration (HRSA), the Department of Geriatrics at the Florida State University College of Medicine will help shape the future of health care in Florida.

Florida’s older adult population will number almost 7 million by 2040 and is typically challenged by chronic illness and high numbers of medications. As one of only two programs in Florida funded by HRSA’s national Geriatrics Workforce Enhancement Program (GWEP), the Florida State-based North and Central Florida GWEP will address these needs.

“We have partnered with national, state and local stakeholders to strengthen the capacity of community organizations to improve care and support for our aging population,” said Project Director Paul Katz, chair of the department and co-principal investigator of the grant.

As of 2018, the United States had fewer than 3,600 full-time practicing geriatricians and 49.2 million older adults. The demand is especially high in Florida, a state that had only 404 geriatricians in 2017. But the good news is that geriatricians are only one part of the expanding range of health-care options for older adults, and the College of Medicine is committed to developing training and resources for a wide range of health-care professionals.

“Rather than treat an 85-year-old the same as a 30-year-old, we are working to improve processes that screen for cognitive impairment, depression and falls, and reduce medications so that we can address this population’s unique needs,” Katz said. “All these things systematize a comprehensive approach for older adults and improve quality of care.”

As a geriatrician and an educator, Lisa Granville, associate chair of the Department of Geriatrics and co-principal investigator of GWEP, knows the importance of incorporating key geriatric-care strategies into practice and training.

“Many look at the complexities of geriatrics and feel overwhelmed,” she said. “Our goal is to provide strategies that feel simple, focus on high-yield areas and empower people to take action toward providing older adults with the best care possible.”

Building upon the success of previous GWEP funding ($3 million since 2015), the current projects will continue to increase access to a geriatrics-trained workforce. They will encourage strategies that focus on maintaining and reinforcing abilities that people retain even while suffering from dementia; provide programs that improve family caregiver mental health; train hundreds of professionals within the primary care spectrum; and more.

“What’s unique about this grant is that it highlights interprofessional care and all the different pieces it takes to holistically care for older adults,” said Nicolette Castagna, GWEP community engagement director. “The workforce is defined very broadly, and we’re working with everyone from home health workers to faith-based caregivers, PAs, nurses, physicians, health educators, and assisted-living residents and their families.”

Granville said the GWEP is well positioned to strengthen geriatrics-care knowledge and collaboration across Florida’s workforce and improve support within communities as people age.

“Many people talk about the aging population and the concerns coming in the future,” Granville said. “However, as the state with the highest percentage of older adults, Florida is already working on solutions. It’s a privilege to have the opportunity to broadly explore strategies for enhancing the health of older adults.”

For more information about programs and access to geriatrics care and community education resources, please visit REACH.med.fsu.edu. 

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CONTACT: Ron Hartung, College of Medicine

ronald.hartung@med.fsu.edu, (850) 645-9205

July 2019

COLLEGE OF MEDICINE’S ‘WHAT IF?’ QUESTIONS COULD HELP FLORIDA COMMUNITIES TACKLE CANCER DISPARITIES

TALLAHASSEE, Fla. — Imagine that a health-conscious benefactor, alarmed because substantially more black women than white women are dying from breast cancer in your community, donated a new mammography van. Smart gift, right?

Not necessarily, says Florida State University researcher George Rust, a professor of behavioral sciences and social medicine. It’s possible that the screening rates among black and white women in that community could both be above 90 percent — so the new van would be the wrong intervention.

Finding the right intervention is what Rust’s newest project is all about. Backed by a three-year Bankhead-Coley research grant from the Florida Department of Health totaling more than $800,000, it uses big-data analytics to produce user-friendly information for any Florida community.

“While the quest continues to be to cure cancer,” Rust wrote in his project’s abstract, “the greatest opportunity for dramatically reducing cancer deaths in the next decade is more efficient use of existing innovations to achieve early diagnosis and effective treatment for all segments of the population.”

Rust is targeting what he calls two of the most screenable, treatable and curable cancers: breast and colorectal. Focusing on the gaps between whites and African Americans, he wants to provide communities with the means to find out why their specific gap exists — and then encourage them to do something about it.

“Let’s say Community A has a big screening gap — we could say, ‘Here’s your most strategic opportunity to save lives — if you could equalize those screening rates, this is how many lives you could save,’” Rust said. “In a different community, where the screening rates are equal, we might be able to say, ‘Here’s where you need to focus your efforts. Maybe it’s in partnership with hospitals and oncologists to really make sure that the new lifesaving treatments are getting equally to everyone who needs them. And that’s how many lives you could save if you did that.’”

He’s also trying to shift the national conversation by pointing out that some communities are actually eliminating some disparities. In other words, disparities are not inevitable. “We need to start holding each other accountable in getting there,” he said, “as opposed to wringing our hands and feeling powerless.”

Rust says the project, “Modeling Paths to Cancer Health Equity,” can only be done through collaboration. He is working with FSU’s statistics and geography departments, as well as health services researchers in the College of Medicine. He is also hiring a computer-simulation-modeling researcher. Penny Ralston, dean emeritus of the College of Human Sciences, will coordinate community engagement through the Health Equity Research Institute and its community partners across Florida.

“If we can develop a fairly accurate model of predicting what the death rates are for cancer — based on what the screening rate is, what the quality of treatment is, what the delays in diagnosis are — then we can play the ‘What if?’ games,” Rust said. “We can ask the computer questions such as: ‘What if we move the screening rate by this much?’ ‘What if we decrease the lag time in diagnosis by this much?’ ‘What if we increase the proportion of people who are going to a cancer center or getting the optimal cancer treatment — how much could we eliminate the gap between black and white outcomes?’”

It’s like personalized medicine, he said — except this time the community is the patient.

Using the data to build the models is crucial, of course. But for Rust, what matters most is what happens afterward.

“We envision this as a way to enhance communication and in some ways to democratize the data,” said Rust, who was founding director of the Morehouse School of Medicine National Center for Primary Care. “To have community members who are advocates and stakeholders be able to take this information and say, ‘We need to work on this part of the puzzle.’ Maybe that means rattling the cage of a hospital administrator, if people going to the same hospital are not getting the same treatment.

“Or maybe it’s that people in the community are going to this trusted hospital because it served them well over many decades but, truth be told, another hospital that maybe lost their trust has more cutting-edge cancer treatment now. Then that becomes an opportunity for community dialogue: How does the community want to handle that? Do they want to urge community members to get their care from the hospital that lost their trust? Or do they want to talk to the other hospital and say, ‘Why can’t you provide care that’s just as good as what’s being done over there?’”

The aim is to come up with an app or other tool that’s not just for academics but easily understandable in any community — one that drives action to achieve health equity.

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