Laurene M. Tumiel-Berhalter, PhD.

Laurene M. Tumiel-Berhalter, PhD, will lead a participatory research study to help patients in inner-city Buffalo self-manage multiple chronic conditions.

$800,000 Grant Funds Chronic Disease Self-Management Study

Published February 14, 2013

Laurene M. Tumiel-Berhalter, PhD, associate professor of family medicine, has received a three-year, $800,000 grant from the National Institute on Minority Health and Health Disparities (NIMHD) to assess the needs of a cohort of patients with complex chronic disease.

“Challenges are compounded in underserved communities, where resources are limited, chronic disease is common and risk factors are elevated.”
Laurene M. Tumiel-Berhalter, PhD
Associate professor of family medicine

Empowering Patients with Multiple Conditions

The study will involve patients at two primary care sites in medically underserved areas of Buffalo: Jericho Road Family Practice and UBMD Family Medicine at Jefferson.

Researchers will ask 120 patients what factors help or hinder their ability to self-manage multiple conditions. The research team will then design and implement a pilot intervention to address identified needs.

In evaluating the success of the intervention, researchers will look primarily at changes in chronic disease outcomes but also at measures of patient empowerment such as social support, patient activation, self-management skills, functional status and quality of life.

Exploring Obstacles of Underserved Population

Not only is it increasingly common for patients to have multiple chronic conditions, but these patients—and their primary care providers—face significant challenges.

Many patients see multiple specialists, must manage competing demands and may need to follow guidelines for specific conditions that do not account for complications of multiple conditions.

In addition, chronic disease contributes significantly to health disparities, notes Tumiel-Berhalter.

“Challenges are compounded in underserved communities, where resources are limited, chronic disease is common and risk factors are elevated.”

Shared Input Fosters Success

The research project emphasizes shared leadership, helping to ensure that “everyone is on the same page,” says Tumiel-Berhalter. The goal, she notes, is to “improve both practice and patient outcomes.”

“We want the intervention to be something that sticks and that fits in with the work these practices are doing,” she says. Through her previous work developing and working with patient action teams, she finds that “patients are constructive and creative, and guide what needs to be done.”

In addition to Tumiel-Berhalter, the research team involves three other principal investigators from the Patient Voices Network.

Two are providers from the practice sites who also serve as clinical assistant professors of family medicine: Donald P. Bartlett, PhD (Jefferson) and Myron Glick, MD (Jericho). Pamela Harold is a patient representing patient action teams from both sites.

In 2010, Tumiel-Berhalter used an NIMHD grant to establish Patient Voices Network, a partnership between UB’s Department of Family Medicine’s Primary Care Research Institute (PCRI) and Jericho Road Ministries.

She also serves as the PCRI’s director of community translational research.