Wright Center Welcomes Three VCU Faculty to its Leadership Team

Three VCU faculty joined the leadership team of the Wright Center – official today. They bring a breadth of expertise and experience to the center’s mission of providing the infrastructure and resources that promote interdisciplinary human health research at VCU.

Robert Winn, M.D., who became director of VCU’s Massey Cancer Center in December, joins the Wright Center leadership team as an expert in lung cancer and community-based health care, including creating community-to-bench health models that combine discovery and implementation sciences into a single health delivery and research system. Winn will bring expertise to community collaboration and recruitment, translational workforce development in underrepresented communities, and faculty training techniques for improving diversity.

Winn comes from University of Illinois at Chicago where he has served as director of their cancer center and as associate vice chancellor of health affairs for community-based practice at the University of Illinois Hospital and Health Science System.

Robert L. Findling, M.D., MBA, joins Wright from the Department of Psychiatry, which he became the chair of last year. Findling is a renowned child psychiatrist and has over 20 years of experience conducting clinical research in child, adolescent and adult psychiatry fields – with expertise in pediatric psychopharmacology, acute efficacy studies, long-term treatment studies, characterization of young people with mental illness, and how to conduct successful clinical trials. He has served as principal investigator and as a coordinating principal investigator on multi-site clinical trials and longitudinal studies funded by the National Institute of Mental Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Vimal K. Mishra, M.D., an associate professor of medicine and health administration, joins the Wright Center as a researcher who has been heavily involved in the development of VCU’s telemedicine program. Misha will oversee informatics methods to enhance community engagement, such as Project ECHO (Extension for Community Health Outcomes), which builds mentoring based learning networks that connect subject-matter experts to practicing providers, clinicians and social health care professionals across Virginia. Currently, Project ECHO offers services in the areas of opioid addiction, sickle cell disease management and palliative care.

Welcome to the Wright Center team!

Robert Winn, Vimal Mishra and Robert Findling

VCU researcher leads study aimed at improving care for people with chronic conditions

Close-up Of Doctor Measuring Patients Blood Pressure With Stethoscope

The U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality has awarded a nearly $2 million grant to the Virginia Commonwealth University School of Medicine Department of Family Medicine and Population Health to test a model of care that aims to better connect primary care clinicians with community resources and health system services.

People who struggle with multiple chronic conditions often also have unmet social needs, unhealthy behaviors and other mental health challenges, said Alex Krist, M.D., a professor of family medicine in the School of Medicine who will lead the research funded by the grant.

“While primary care providers do their best to address the root causes of multiple chronic conditions, few medical practices can undertake a systematic approach without broader health system and coordinated community support,” Krist said.

The new care paradigm is intended to improve on conventional models, helping primary care providers better address the root causes of poor health.

“A sea change is occurring in which health systems and communities increasingly recognize the need to address underlying issues that contribute to multiple chronic conditions,” Krist said. “The health systems and community partners are experimenting with, and investing in, new models for connecting patients with needed services, but primary care clinicians, whose regular contact with patients make them more familiar with patients’ needs than large health systems and specialists, are often not included in the new systems.”

One in four Americans has multiple chronic conditions, such as high blood pressure, diabetes and depression. These conditions last for a year or more and require ongoing medical attention. That number rises to 3 in 4 Americans age 65 and older, according to the Centers for Disease Control and Prevention.Headshot of Alex Krist

As a family medicine physician in Northern Virginia, Krist observes firsthand the impact that underlying issues such as unmet social needs, unhealthy behaviors and mental health challenges can have on managing chronic conditions. He is also keenly aware of the challenges primary care physicians face in helping their patients address those issues.

“As a clinician, these are the types of things I see every day with my patients,” Krist said. He added that doctors frequently rely on medications, diagnostic tests and specialty referrals to manage chronic conditions rather than working toward resolving the underlying issues.

“The current model of care is not set up to seamlessly connect physicians with resources that will help resolve their patients’ problems,” Krist said. He hopes the proposed care model will help bridge that gap.

Krist, who is the co-director of community-engaged research at the VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research, will lead a research team that includes VCU investigators along with community partners and colleagues at the University of Colorado and University of Texas Health Science Center. The research was informed by a pilot grant awarded to Krist by the Wright Center, through which he and colleagues tested a social needs screening tool that will be used for the study.

For five years, the researchers, clinicians and community partners will work with patients with multiple chronic conditions from 60 primary care practices in the Richmond metropolitan region on a randomized, controlled clinical trial. The clinical trial includes developing individually tailored care plans and fostering connections between primary care practices and community resources.

“We are trying to see if addressing the root causes of poor health will do a better job of improving health than traditional medical care models,” Krist said. “It goes back to the concept that we think these root causes are critical drivers of health. Trying to address them better has much stronger potential for improving health than traditional means.

“We believe this study can show doctors a new way to help their patients,” Krist said. “Instead of just giving patients more pills to control chronic disease, doctors can find the root causes of poor health. With the support of health system and community programs, doctors and patients can address these root causes to truly promote health and well-being.”

Interdisciplinary VCU research team overcomes obstacles to improve health for people with diabetes

By Anne Dreyfuss
VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research

At first, it seemed like it wasn’t going to happen. An interdisciplinary research team of Virginia Commonwealth University faculty members and students had applied for federal funding to create a virtual diabetes education program that would empower people living with diabetes to manage their disease, but their grant application was denied.

“We thought we were going to receive funding,” said Alex Krist, M.D., a family medicine professor at VCU School of Medicine. “At the last minute we didn’t, but Privia Medical Group offered to help us as part of their clinical mission.”

Read More

A study in the science of play: Does early engagement help premature babies thrive?

The team of researchers was awarded a $2.84 million grant from the National Institutes of Health to facilitate the multi-site clinical trial, “Efficacy of Motor and Cognitive Intervention for Infants Born Preterm (SPEEDI2).”The program is based on two smaller studies using Supporting Play, Exploration and Early Developmental Intervention (SPEEDI) developed through a series of studies at Children’s Hospital of Richmond at VCU. Stacey Dusing, Ph.D., a board-certified pediatric physical therapy specialist and associate professor in the Department of Physical Therapy at VCU and the Department of Pediatrics at CHoR, is the principal investigator for the project and the impetus behind the study concept. Read More

Dr. Patricia Kinser Discusses Complementary Approaches for Perinatal Depression

The C. Kenneth and Dianne Wright Center for Clinical and Translational Research at VCU held a Discovery Dialogue seminar on Monday, February 8 at the Main Hospital’s Learning Center.

Patricia Kinser, Ph.D., RN, WHNP-BC, assistant professor for the VCU School of Nursing’s Department of Family and Community Health Nursing, led a presentation titled, “When Mommy Gets Depressed: A Discovery Dialogue about Complementary Approaches for Perinatal Depression.” 

Studies of depression over the lifespan of men and women have found that women in their reproductive years (24-30) are at the highest risk for developing depression. Statistics such as this led Kinser to dedicate the focus of her research on depression. She works with a special emphasis on perinatal women experiencing major depressive disorder and the effects of intervention techniques such as yoga and mindfulness-based stress reduction.

“Sometimes clinicians asking the right kind of questions serves as an important intervention,” said Kinser. “However, screening alone is not enough. We’ve seen results that indicate that when pregnant women treat depressive symptoms early on during their pregnancy, they may minimize time of exposure to symptoms by developing fetus.”

Complementary health approaches include:

  • Mind-body practices
    • Physical activity
    • Yoga
    • Guided imagery
    • Massage
    • Acupuncture
    • Mindfulness-based stress reduction
  • Other
    • Omega-3s (such as DHA and EPA from fish or fish-oil supplements, and ALA from nuts, flaxseed and leafy vegetables)
    • Bright-light therapy

Kinser has put yoga into practice as a complimentary approach for perinatal depression because it is relatively easily available in the United States, it has minimal side effects and it focuses on wellness rather than illness. Additionally, Kinser’s research uncovered that study participants who practiced yoga not only experienced mental health improvements, but sustained them as well. 

“The use of yoga as a treatment for depression is important because it can be adapted to one’s mood,” Kinser said. “If depression is keeping you from getting out of bed, we can suggest yoga exercises you can complete in bed. If your mind is racing and you need to move a lot to refocus your thoughts, there are options for more active yoga practices as well.”

Kinser is currently studying psychobehavioral and biomarker outcomes in the integration of yoga into prenatal care programs in Richmond, Va. She hopes to see an increase in the practice of yoga as a means of early intervention and/or prevention of the development of postpartum depression.

For additional information on postpartum stress, visit www.postpartumva.org or www.pospartumstress.org.