NYU School of Medicine

Pioneering improvements in

Population Health

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Department of Population Health

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NYU School of Medicine

Overview A deep gulf separates the advances in biomedical science of recent decades from commensurate improvements in the health of populations. Innovative, discipline-bridging science that advances our knowledge of the determinants of health and supports a broad array of health promoting interventions can narrow this gap. Designing and conducting such research is the grand challenge in which the Department of Population Health (DPH) is fully engaged.

Just as achieving wide-ranging health improvements in the real world relies upon contributions from multiple sectors, tackling the science involved in advancing population health requires the expertise of many disciplines. The Department of Population Health addresses this need by being home to research faculty drawn from a diverse range of specialties. The department and its faculty share the complementary goals of building cutting-edge science in their areas of inquiry and collaborating with other investigators throughout the academic community. Close partnerships with NYU’s Global Institute of Public Health and with other University schools and initiatives are integral to our approach.

Our mission: To advance the health of populations by discovering new knowledge that informs policy and practice, educating tomorrow’s leaders, and serving local, national, and global communities.

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Department of Population Health

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1 discovering through research The Department of Population Health is a thriving home to extramurally funded research that advances the health of populations.

Our research applies rigorous methods to address pressing challenges in the science of healthcare delivery, behavior change, personalized medicine, health economics, epidemiology, medical ethics, and biostatistics. Disease-specific foci include obesity, cardiovascular disease, cancer screening and prevention, tobacco and drug use, and preventable infections. Our faculty and staff share a commitment to research that addresses local and global communities, vulnerable populations, the elimination of health disparities, and the genetic, social, and environmental determinants of health. Our research embraces partnerships with basic scientists, clinicians, diverse communities, and policymakers.

Advancing knowledge that improves health and enhances the overall efficiency of disease prevention and healthcare delivery is no small task. By bridging the sciences of discovery and application, building on the strengths of our institutional setting and broader community, and heeding the call for high-quality research into society’s most pressing health and healthcare challenges, the department is poised to make substantial and enduring contributions to population health.

We are committed to a team science approach to advancing population healthrelated research, integrating expertise across wide-ranging areas of focus

with faculty from other NYU School of Medicine departments and institutes, the University at large, and beyond.

Providing expert consultation in the methods and disciplines of population health research is a key departmental contribution to our academic community. In addition to offering a vital service to faculty colleagues at our institution and elsewhere, consultation can foster deeper collaborations with external partners while providing support for the Department of Population Health and its faculty.

Disease-Specific Foci

• Cancer • Cardiovascular disease • Obesity

• Preventable infections • Tobacco, alcohol, and drug use

Common Themes

• Research across the full translational spectrum • Genetic, social, and environmental determinants of health • Health policy and evaluation • Health disparities, vulnerable populations

• Prevention and early detection • Healthcare delivery and system design • Local, national, and global communities

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Research: A Sampler Supporting Preventive Healthcare through Faith-Based Organizations

How can we leverage existing social networks to improve preventive care in high-risk communities? With funding from the National Institutes of Health (NIH), Gbenga Ogedegbe, MD, MS, MPH, leads the Faith-Based Approaches in the Treatment of Hypertension and Colon Cancer Prevention study (FAITH-CRC) to evaluate the effectiveness of two evidence-based interventions delivered through faith-based organizations in central Harlem, New York: a telephone-based lifestyle intervention to reduce blood pressure that employs motivational interviewing; and a culturally tailored patient navigation intervention to improve colon cancer screening among black men. Faith leaders help recruit community members and are trained to implement the interventions and provide support to participants.

The Impact of the New York City Sugar-Sweetened Beverage Policy on Calories Purchased and Consumed

Would limiting the size of sugar-sweetened beverages sold at fast-food restaurants make effective public policy? This project, led by Brian Elbel, PhD, MPH, with funding from the National Institutes of Health, the New York State Health Foundation, and the Robert Wood Johnson Foundation, examines the potential influence that a policy limiting the size of sugar-sweetened beverages sold to 16 ounces would have on New Yorkers’ purchasing and consumption behavior at fast-food restaurants.

This controversial policy is currently being challenged in the courts.

To identify changes in consumption patterns over time if the policy continues, baseline data are already being collected on purchasing, consumption and the food environment at fast food restaurants in New York City and comparison communities. If the policy is implemented, data collection will continue every six months over three years.

Using Implementation Science to Improve Retention in HIV Treatment in East Africa

What are the best strategies for minimizing loss to follow-up in HIV care programs in resource-limited settings? Scott Braithwaite, MD, MSc, leads an NIH-funded research effort to use established computer simulation methods to assess the value of retention-incare interventions and compare their value to other ways in which resources may be spent.

Investigators identify the optimum set of interventions that maximize health outcomes for HIV patients and their communities, based on patient, program, and healthcare system characteristics.

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Discovering Novel Genetic Markers in Populations at Risk of Common Malignancies

Improving Tobacco Use Treatment through Clinical Decision Support in Dental Clinics

Can we leverage health information technology to improve the delivery of evidence-based tobacco use treatment? The tobacco cessation guidelines defined by the U.S. Preventive Health Service Task Force are highly cost-effective, but their use in routine practice is suboptimal. To close the gap between research and practice, Donna Shelley, MD, MPH, was awarded funding from the Agency for Healthcare Research and Quality to test a clinical decision support system to encourage evidence-based tobacco use treatment in dental clinics. Dental public health clinics afford a unique and untapped opportunity to help patients most in need of smoking cessation services. Improving the frequency and effectiveness of dentists’ interventions toward smoking cessation in these clinics is an essential step toward reducing tobacco-related health disparities and achieving national health objectives.

Integrating and Evaluating Pooled Studies with Heterogeneity

What is the best approach to pooling studies to increase sample size and improve inference? The strategy of pooling multiple studies is common in health research, but analyzing pooled data in the presence of heterogeneity is a difficult task.

Mengling Liu, PhD, recently received funding from the NIH to develop statistical methods that utilize the novel idea of penalty regularization to analyze pooled studies with heterogeneity. The project will facilitate the building of interpretable and accurate disease models that accommodate predictors with both homogeneous and heterogeneous effects.

How can we use parallel genetic sequencing to improve prevention and treatment for highrisk breast cancer families? With the funding from the Susan G. Komen for the CureÂŽ foundation, Tomas Kirchhoff, PhD, leads a multi-institutional study that aims to identify missing high-risk genetic hereditability to familial breast cancer. In this study Dr. Kirchhoff performs targeted next-generation sequencing on more than 300 high-risk breast cancer families of Ashkenazi Jewish heritage to identify novel high-risk diseasecausing mutations in epigenome regulatory pathways. The results will be immediately applicable to prevention efforts, and the novel genetic markers discovered in this study will significantly expand our understanding of how genetic susceptibility contributes to aberrant epigenetic processes seen in breast tumors.

These findings will point to new potential targets of improved and more personalized breast cancer treatment.

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educating the next generation of leaders The Department of Population Health prepares the next generation of scientists and health professionals to lead advances in population health through the discovery and translation of knowledge into policy and practice.

Our educational initiatives train health professionals and scientists to integrate the population context of health and disease and to draw on population-level approaches in their clinical, research, and policy initiatives.

Provide foundational training in population health disciplines and themes.

Department-sponsored educational programs teach the fundamentals of population health-related disciplines to the full continuum of learners, from medical students and predoctoral graduate students, to residents, fellows, faculty, and community partners.

Train leaders. The department is deeply committed to doctoral, fellowship, and postdoctoral training; to degree-granting programs; and to mentorship, career, and faculty development in order to prepare leaders in population health and related fields.

Education Initiatives: A Sampler NYU School of Medicine Selective and Concentration in Healthcare Systems Innovation and Policy

The Health Policy and Health Systems Selective is part of NYU School of Medicine’s broader Curriculum for the 21st Century (C21), which emphasizes interdisciplinary education and research opportunities. This unique course, led by Mark D. Schwartz, MD, is one of the inaugural selectives to be offered in 2013 and is designed to equip future physicians with a deeper understanding of the health systems and policy context in which they work. Key learning objectives include understanding the core structure, functions, and financing of the U.S. healthcare system; critically evaluating healthcare delivery innovations and policy issues; exploring strategies for improving healthcare quality and safety; and discussing principles of medical economics and its effect on disparities.

NYU School of Medicine

Selected students can build on this foundation by undertaking a mentored project in health policy, allowing them to graduate with a concentration (“major”) in Healthcare Systems Innovation and Policy.

NYU Master of Arts Program in Bioethics

The MA program in bioethics is a major focus of the NYU Center for Bioethics, one of the first programs in the world to promote a broad conception of bioethics encompassing medical and environmental ethics. Led by Arthur L. Caplan, PhD, the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics, students develop concepts and analytical skills that enable them to think critically about pressing bioethical and environmental issues and their implications for biomedical research, public health, and environmental policy and practice. Sample topics include clinical and research ethics, global ethics, ethics of new biotechnologies, and environmental and climate ethics.

Doctoral Training in Epidemiology and Biostatistics

The Environmental Health Sciences program of the Graduate School of Arts and Science at NYU offers doctoral programs in epidemiology and biostatistics, which are led by the Divisions of Epidemiology and Biostatistics within the

Department of Population Health. The epidemiology doctoral program trains scientists to advance the frontiers of knowledge on the influence of genetic and environmental factors on human health, providing a scientific basis for translating this knowledge into public health action. The biostatistics doctoral program trains leaders in the methodology, theory, and application of biostatistical methods across the entire spectrum of biomedical research. Both programs are designed to prepare doctoral students for productive careers at the forefront of research.

NYU School of Medicine Master of Science in Comparative Effectiveness Research

NYU School of Medicine’s Clinical and Translational Science Institute (CTSI) offers an MS in clinical investigation, and the Department of Population Health leads a concentration in comparative effectiveness research (CER). Led by Scott Braithwaite, MD, MSc, the CER concentration prepares trainees for research careers conducting CER focused on health decisions affecting urban underserved communities. Courses address decision analysis, meta-analysis and systematic review, advanced methods in observational data analysis, cost-effectiveness analysis, and decision aids and clinical decision supports.

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Department of Population Health

Cardiovascular Research Training Institute Program

The Cardiovascular Research Training Institute program (CaRT), co-sponsored by NYU School of Medicine and the University of Ghana, trains scientists committed to a career in cardiovascular research in Ghana.

Led by Gbenga Ogedegbe, MD, MS, MPH with NIH funding, CaRT is designed to establish a sustainable cardiovascular research capacity in Ghana, and a steady flow of innovative and context-specific cardiovascular research projects targeted at hypertension, diabetes, chronic kidney disease, and stroke prevention. CaRT aims to build a network of 40 investigators with expertise in cardiovascular research, and will develop training and mentoring curriculum that can be replicated in a variety of low-resource settings in subSaharan Africa.

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local, national, 3 serving and global communities The Department of Population Health engages with our institution and our community to improve disease prevention, healthcare delivery, and health outcomes.

NYU Langone Medical Center

The department actively partners with staff throughout NYU Langone Medical Center and its healthcare delivery system to advance measurable improvements in care, health outcomes, and financial performance. The department’s Center for Healthcare Innovations and Health Outcomes, to launch in late 2013, will become an academic home for the applied sciences of care quality, patient safety, rapid cycle improvement, decision support, and related areas. Its work will inform delivery system strategies and interventions to improve the health of defined populations while advancing applied, generalizable research.

Community Partners

We seek to apply new knowledge to advance health promotion and disease prevention for our patient populations and local communities. Our work on genetic, environmental, socioeconomic, and behavioral determinants of disease informs the implementation and evaluation of specific healthcare, policy, and community-based initiatives to prevent adverse health outcomes.

The department is committed to advancing the health of New York City communities, and to working in concert with NYU Langone’s leadership to develop the institution’s Community Service Plan.

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Service Initiatives: A Sampler The Community Service Plan

The Community Service Plan (CSP) is an important initiative through which NYU Langone Medical Center helps affect positive health changes in the communities it serves.

The Department of Population Health, working in close collaboration with colleagues across NYU Langone, leads the development and implementation of the plan. Based on indepth community health needs assessment and partnerships with community leaders, the CSP will promote the use of evidencebased interventions in the areas of behavioral health, obesity, tobacco use, and prevention of cardiovascular disease and cancer.

7-Day Hospital Initiative

NYU Langone Medical Center’s 7-Day Hospital initiative focuses on making healthcare services available throughout the week in order to improve healthcare quality, reduce length of stay, and improve patient satisfaction. Since 2012, the medical center has expanded the number of attending physicians, care managers, and social workers available on weekends; increased access to diagnostic testing on

Saturdays and Sundays; and improved weekend discharge planning. The 7-Day Hospital initiative research team, led by DPH faculty, evaluates the implementation of this initiative and its effect on care and outcomes. Researchers are developing metrics to assess variation in and intensity of hospital care, as well as designing quasi-experimental studies to determine how different aspects of the initiative affect clinical outcomes, length of stay, and quality of patient care.

Prevention Research Center

The mission of the NYU School of Medicine Prevention Research Center (NYUSOM PRC) is to build community capacity and leadership for health promotion and disease prevention across diverse populations, using a community-based participatory research approach. Supported by the Centers for Disease Control (CDC) under the leadership of Mariano Rey, MD, and Nadia S. Islam, PhD, the NYUSOM PRC engages actively in research, policy, and training initiatives targeted toward improving health among immigrant, minority,

and underserved communities. Research efforts include evaluating community health worker (CHW) programs to promote diabetes prevention and care among Asian and Latino communities and participation in the NYUSOM Men’s Health Initiative, which tests the effectiveness of interventions designed to improve health behaviors and healthcare access among black men. The NYUSOM PRC also supports the NYU Nutrition and Obesity Prevention Policy Research and Evaluation Network (NOPREN) collaborating center, which develops and disseminates evidence-based policy recommendations to address nutrition and obesity prevention for minority communities in urban settings. To further its mission of empowering community leaders to promote health, the PRC offers the Community Health Worker Training and the Community Empowered Research Training programs.

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advancing discipline-bridging science Core units in the Department of Population Health span basic, clinical, and applied science. The department encourages and fosters opportunities for rich collaboration across these research specialties.

Health and Behavior

Epidemiology

The Division of Health and Behavior focuses on strategies for fostering healthful behaviors across a wide variety of conditions and settings. The division is home to the Center for Healthful Behavior Change as well as programs in Health Choice, Policy and Evaluation, Health Equity, Early Childhood Health and Development, Global Health, and community service.

The Division of Epidemiology studies the causes and patterns of disease occurrence in different groups, and serves as the quantitative foundation for public health interventions. Core areas of focus include genetic risk and environmental, dietary, and hormonal exposures.

Medical Ethics

Comparative Effectiveness and Decision Science

The Division of Comparative Effectiveness and Decision Science bridges the worlds of decision science, cost-effectiveness, comparative effectiveness, and metrics development. The Division is home to the Sections on Value and Effectiveness (SOLVE) and Tobacco, Alcohol and Drug Use. Biostatistics

The Division of Biostatistics focuses on study design and collection, analysis, and interpretation of data to improve human health.

The faculty advances the entire spectrum of biomedical research through innovation in methodology, theory, and the application of biostatistical methods.

The Division of Medical Ethics conducts interdisciplinary research on key areas of bioethics including research ethics, rationing and allocation of health resources, the provision of mental health services, and vaccination policies.

Health Choice, Policy and Evaluation

The Section on Health Choice, Policy and Evaluation aims to define and optimize the influence of public policy on health and health choices. Using behavioral economics and other approaches, the faculty focuses on disadvantaged populations and pressing public health problems such as obesity.

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Tobacco, Alcohol and Drug Use

Center for Healthful Behavior Change (CHBC)

The Section on Tobacco, Alcohol and Drug Use conducts research on prevention, treatment, and policy strategies to reduce the burden of substance use. Integrating screening and treatment of substance use into routine primary care and criminal justice settings is a core area of focus.

The Center for Healthful Behavior Change develops, implements, and disseminates innovative evidence-based behavioral interventions in routine clinical practice and community-based settings. The Center is dedicated to developing a new cadre of investigators with expertise in translational behavioral medicine and serve as a resource for researchers in the development of conceptual, theoretical, and applied models of health behavior change through inter- and multidisciplinary collaboration.

Health Equity

The Section for Health Equity works to promote health equity in racial and ethnic minority populations and other socially disadvantaged communities through community-engaged research, education, training, and policy initiatives. The section applies a multiprong, asset-based approach to understanding, addressing, and reducing disparities in health status and access to care through interventions that target individual, family, community, system, and structural barriers related to social and health inequities.

Healthcare Innovations and Health Outcomes (HIHO)

The Center for Healthcare Innovations and Health Outcomes, set to launch in late 2013, will bridge NYU Langone’s delivery system with its academic expertise to advance innovation in healthcare delivery, improve quality of care, reduce costs, and enhance health outcomes.

Section for Value and Effectiveness (SOLVE)

The Section for Value and Effectiveness works to improve healthcare by performing research that improves Personalization, Prioritization, and Resource Allocation. SOLVE is committed to improving healthcare by performing scientifically rigorous research that informs clinical care and health policy.

Center for Early Childhood Health and Development (CEHD)

The Center for Early Childhood Health and Development (CEHD) works to promote health and development among ethnically diverse children living in low-income communities. The Center is home to ParentCorps, an evidence-based family-focused intervention that aims to promote highquality home and classroom experiences for young children. Faculty are experts in prevention science, intervention development, behavior change and implementation science.

We’re Open for Business!

Telephone: 646-501-2515 / www.NYULMC.org/pophealth Department Administration Founding Chair: Marc N. Gourevitch, MD, MPH Professor of Population Health, Medicine and Psychiatry Telephone: 646.501.2522 Email: marc.gourevitch@nyumc.org Vice Chair: Mark D. Schwartz, MD Vice Chair for Education and Faculty Affairs Telephone: 646.501.2627 Email: mark.schwartz@nyumc.org

Division of Health and Behavior and CHBC Division Director: Gbenga Ogedegbe, MD, MS, MPH Telephone: 646.501.2626 Email: olugbenga.ogedegbe@nyumc.org

Division of Epidemiology Division Director: Richard B. Hayes, DDS, PhD, MPH Telephone: 212.263.6500 Email: richard.b.hayes@nyumc.org

Health Choice, Policy and Evaluation Section Head: Brian D. Elbel, PhD, MPH Telephone: 212.263.4283 Email: brian.elbel@nyumc.org

Division of Comparative Effectiveness and Decision Science and SOLVE Division Director: Ronald Scott Braithwaite, MD, MSc Telephone: 646-501-2555 Email: scott.braithwaite@nyumc.org

Division of Medical Ethics Division Director: Arthur L. Caplan, PhD Telephone: 646.501.2739 Email: arthur.caplan@nyumc.org

Section of Tobacco, Alcohol and Drug Use Section Heads: Donna Shelley, MD, MPH, and Scott Sherman, MD, MPH Telephone: 646.501.2543 Email: donna.shelley@nyumc.org

scott.sherman@nyumc.org

Division of Biostatistics Interim Division Director: Mengling Liu, PhD Telephone: 212-263-6614 Email: mengling.liu@nyumc.org

Center for Early Childhood Health and Development Director: Laurie Miller Brotman, PhD Telephone: 646-754-5192 Email: Laurie.Brotman@nyumc.org

Section of Health Equity Section Head: Chau Trinh-Shevrin, DrPH Telephone: 212.263.1225 Email: nyuhealthequity@nyumc.org