Current Research Projects

Waco Traffic Safety District Helmet Promotion Project

Bicycle-related traumatic brain injuries are a serious public health problem in the US. Two-thirds of the 600 young bicyclists killed each year die due to complications resulting from traumatic brain injury. Each year, about 3,000 Texans die or sustain injuries from bicycle-related crashes. In 1997, 20 children ages 18 years and younger died from bicycle-related crashes in Texas and another 1,599 bicyclists were injured in non-fatal crashes; 45 percent were 11 to 15 years of age and 75 percent of the injuries occurred on city streets.

Available scant data demonstrate that bicycle-related crashes are a significant problem in Bell and McLennan counties with a rate surpassing the statewide average (17.3 vs 14.6 per 100,000). In spite of proven effectiveness of bicycle helmets in reducing head injuries, many children do not always wear helmets when riding. There is apparent lack of accurate data on helmet usage rates in Bell and McLennan counties; anecdotal evidence indicates that helmet usage rate in the two counties may not be higher than the statewide rate of about 7 to 15 percent.

In this project, we will form a community coalition that will implement and evaluate a multi-faceted, comprehensive, community-based program to promote traffic safety by increasing helmet ownership and usage among child bicyclists, in-line skaters and skate-boarders in Bell and McLennan counties of the Waco Traffic Safety District. Our specific aims include:

  • Increasing knowledge among children ages 5-18 years and their parents about helmet use
  • Distributing helmets to at least 25% of needy children ages 5-18 years
  • Increasing helmet ownership among children ages 5-18 years by 50% of baseline
  • Increasing observed helmet use by child (ages 5-18 years) bicyclists, in-line skaters and skate boarders by 50% of baseline

Weight And Contents Of Backpacks Carried By School Children

Backpacks carried by school children have several potential health consequences including back strain, altered gait, bad posture and eventual low back pain. Although, to our knowledge, there are no published studies on the prevalence of backpack-related problems, concern about children carrying heavy school bags has been expressed not only in this country but also internationally including countries such as India, Brazil, Poland and Egypt. Heavy packs, as well as those carried improperly on the backs of school children, can put pressure on joints and ligaments to cause back strain.

While children carry these heavy, one-size-fits-all backpacks, it is unlikely that all the items in the pack will be needed on the day the backpacks are carried to school. Yet, one wonders how many parents take the time to check the weights or contents of these bulky backpacks. The specific aims of this project are to:

  • Determine the average weight of backpacks carried by school children
  • Determine the percentage of body weight represented by the backpack loads
  • Determine the types of backpack carried
  • Classify the content of the those backpacks weighing more than 10 percent of their body weight>
  • Assess parental knowledge of the weights of the backpacks via children’s self-reports

Concussion Among High School Football Players

Concussion is a common occurrence in many sporting activities, particularly those involving contact such as football, hockey, boxing and wrestling. Although it is estimated that about 100,000 to 250,000 concussions occur in football annually in this country, there are no available statistics on the precise incidence of concussion. In addition, studies examining correlates of concussion are lacking. In this research, we propose to study the epidemiology of concussion among high school (n=31) football players in Central Texas.

Practice-Based Research Network

CenTexNet is one of the primary care practice-based research networks (PBRNs) funded by the Agency for Healthcare Research and Quality (AHRQ). CenTexNet was founded on October 17, 2002 and is based in Temple, Texas in the Department of Family & Community Medicine at Scott & White Memorial Hospital, and the Texas A&M University System Health Science Center College of Medicine. CenTexNet seeks to enhance the capacity of its members by providing resources for research, assisting with the research process and through collaboration with relevant experts. A Planning Committee and an Internal Advisory Committee govern CenTexNet. In addition, CenTexNet actively seeks the expert opinion and input from External Consultants.

CenTexNet was formed because one cannot simply overlook the fact that the majority of people residing in Central Texas first enter the healthcare system through a primary care office. Therefore, the importance of primary care research to the functioning of the entire healthcare system in Central Texas can’t be overstated. Many such networks have been formed in other areas with significant results and impact. PBRNs serve as laboratories for primary care and have been in existence since the mid-1970s.

Miscommunication as a Cause of Medication Errors in Elderly Ambulatory Patients

The long-term goal of this project is to improve patient safety through identification of the types of miscommunication that may lead to medication errors in the ambulatory/outpatient healthcare setting. The specific objectives of the proposed research are to:

  1. Assess discrepancies between patients’ medical records and their self-reported manner of taking their medications.
  2. Determine the incidence and types of miscommunications causing medication errors.
  3. Determine the incidence and types of adverse medication effects on patients resulting from miscommunications.
  4. Evaluate the effectiveness of a phone-initiated intervention by a nurse and subsequent physician patient education in resolving miscommunications causing medication errors.

Participants will comprise patients 65 years and older who are seeing a Family Physician for an illness or routine check-up. We will enroll patients (approximately 1,000 over a two-week period) until we obtain about 200 subjects with a medication discrepancy. Patients who enroll will be contacted by a clinical research nurse in 7-10 days by phone regarding their medication profile. The research nurse will compare medication instructions as documented by the doctor in the patient’s medical records with what the patient is actually doing at home. If there is no discrepancy the research nurse will survey the patient and thank them. However, if there is a discrepancy, the research nurse will survey the patient and initiate an intervention by contacting the patient’s physician. Research investigators will analyze patterns or trends of miscommunication and propose methods of improvement to be used by physicians in the interventional education of patients. Patient’s physician will continue with intervention through patient education and empowerment to resolve any miscommunication. The research nurse will administer a follow-up survey to both groups of patients (with or without a medication discrepancy) after one month to assess any changes in medication profiles with what patients are actually doing at home along with any adverse medication effects. A before-and-after evaluation design will be used to measure the success of the project. The proportion of patients found to have a medication discrepancy at the initial phone survey will be compared to that at the follow-up phone survey.

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