DEPARTMENT OF PUBLIC HEALTH SCIENCES
ANNUAL REPORT 2006-07
MISSION STATEMENT
BRIEF HISTORY
ORGANIZATIONAL STRUCTURE
MAJOR DEPARTMENTAL AND DIVISION
ACCOMPLISHMENTS
Highlights
Research
Education
Service
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Mission and Background
The Department of Public Health Sciences focuses its energies, expertise and collaborations on enabling the University of Virginia and its School of Medicine to improve the health and well being of individuals and populations. By assembling multidisciplinary teams that combine expertise from biostatistics, clinical epidemiology, informatics and public health in collaboration with clinicians and scientists, we create new technologies for the generation, analysis, interpretation and management of basic and health-related data, as well as new educational and learning opportunities and program offerings. These efforts are intended ultimately to assist individuals, clinicians, communities and public health policymakers in making informed, wise, equitable and cost-effective choices, and to establish the University of Virginia and its School of Medicine as an international leader in medical science, technology and the increasingly complex challenges of public health and personalized medicine.
The Department of Public Health Sciences (DPHS) was originally established in 1995 as the Department of Health Evaluation Sciences. It was created to provide comprehensive and multidisciplinary scientific and analytical services to the University of Virginia Health System, as well as other components of the University. The initial business plan described the development of an infrastructure designed to initiate, expand and enhance clinical and translational research education and activities throughout the School of Medicine rather than the traditional investigator-initiated model.
The plan also called for development of a medical-management and quality-assurance capability that supported these activities in the University of Virginia Health Sciences Center. During 1996, a series of weekend retreats was held at the Darden School with senior leadership from across the School of Medicine and the Health Sciences Center to help launch these activities. In its initial five years, the department grew in size and began having an institutional impact and a positive financial record. Beginning in approximately 2000, however, the senior leadership of the School of Medicine and Health Sciences Center elected to discontinue their support for the medical-management and quality assurance capability described in the initial business plan. The department lost a number of its key senior faculty and morale dropped.
In 2002 with the arrival of a new dean and vice president, the department re-energized. It added a new focus on public health while also continuing its ongoing clinical informatics and biostatistical and epidemiological activities. New senior leaders were recruited to head clinical informatics, biostatistics and epidemiology, and a new division of public health and a new MPH program were begun. In 2005 the Department of Public Health Sciences was adopted as the department’s new name to reflect its emphasis on public health education, training and service. In 2007 the department successfully concluded a major two-year recruitment process with the appointment of Stephen Rich as a Distinguished Board of Visitors Scholar and the establishment of his new Center for Public Health Genomics at the University of Virginia.
As the formal mission statement indicates, DPHS is an infrastructure and discovery department devoted to finding new research strategies and providing new educational offerings for health promotion and preservation, disease prevention, diagnosis and treatment, as well as the development of contemporary tools in genetic risk assessment, medical decision making, biostatistical and epidemiologic methods, and medical service delivery for individuals and populations. DPHS continues its original mandate to provide support for students and investigators throughout the School of Medicine and across University grounds as they come together to learn about and develop: (1) new ways to evaluate more precisely the efficacy of new and existing medical care and health improvement practices, and (2) the efficient and fair delivery of health services.
The Department of Public Health Sciences, which is staffed by 35 primary, a large number of secondary academic appointments and a support staff of 13, is currently composed of three major divisions and one closely aligned Center:
· Clinical Informatics: communications technology to support and analyze biomedical research and health data.
· Biostatistics & Epidemiology: research and consulting on the application of statistical analyses to biomedical research data. Biostatistics and Epidemiology provides statistical support for many research projects at the University of Virginia.
· Public Health Policy & Practice: teaching, research and community interventions in public health practice and health care policy.
· The Center for Public Health Genomics : stimulates research in human genetics and expands the range of services available to the academic community of the University of Virginia.
MAJOR DEPARTMENTAL AND DIVISION ACCOMPLISHMENTS 2006-07
- Funded Research expands to $33,165,396
- New University Center for Public Health Genomics established
- Department plays major role in CTSA application
- New web based search engine for Pub Med (www.ReleMed.com) launched
- New Certificate Courses offered to UVA residents and fellows
- New NLM Funded Informatics training grant with Systems Engineering
- New Global Public Health Partnership with Center for Global Health
- New MPH Health Disparities for MD-MPH Degree
- James Harrison named Director of Cancer Informatics for Cancer Center
- New expanded agreement with Health Sciences Center for CDR
DPHS faculty served as principal investigators on 15 grants and as collaborators on 87 RO1 grants, program projects, training grants and other comparable undertakings. These same faculty submitted 16 new grant proposals for which they would serve as principle investigator and 86 for which they would serve as collaborators.
Research dollars generated on grants where a DPHS faculty member served as principle investigator totaled $33,165,396, with $31,750,828 credited to the Center for Public Health Genomics that joined the department in January 2007. Research grants in other departments in which DPHS faculty served as collaborators totaled approximately $20 million.
Members of the department’s faculty published 46 peer-reviewed papers as first or senior authors and 115 such papers as collaborators; they also published 12 white papers and chapters.
Additionally, two new NIH grants were funded this year, an R01 and an R03, with Division of Biostatistics and Epidemiology faculty serving as the principal investigators.
The Center for Public Health Genomics (CPHG) was created in January 2007 in recognition of the need for integration of molecular genetics, statistical genetics, genetic epidemiology, bioinformatics and public health policy. The resources for this Center were contributed by several University of Virginia sources, including commitments from the Board of Visitors, the School of Medicine, and the Department of Public Health Sciences. Previously, genomics research at the University of Virginia was limited to selected laboratories, with many investigators focused on genes within model systems (e.g., mice) rather than humans. Relatively few genomics resources were available for investigators at the University, thereby limiting the University’s ability to extend research into diseases of clinical significance. As a result of these programmatic needs, the CPHG was established to stimulate research in human genetics and to expand the range of services available to the academic community of the University of Virginia.
Members of the department also played major roles in the development of the University of Virginia Clinical & Translational Research Award (CTSA) application, one of the major research grant application efforts for the School of Medicine. The importance of biomedical informatics to the future of translational research was emphasized by the requirement to include a Program in Biomedical Informatics in the CTSA application. The Division of Clinical Informatics co-wrote this section with the University’s Department of Computer Science. It was one of the two highest-rated sections during the proposal’s initial review. The Division of Clinical Informatics is currently co-writing its revision for resubmission in the fall of 2007.
Similarly, the Division of Biostatistics and Epidemiology authored the Biostatistics Program portion of the January 2007 CTSA submission. It, too, was cited as a major strength of the application. Division members from Biostatistics and Epidemiology are continuing their participation in the re-submission of this application.
While officially on reduced assignment for much of the 2006-07 academic year, the chairman of the department invested considerable time and effort in development efforts on behalf of the University. Working with staff from UVA’s Office of Corporate and Foundation Relations, the chairman contacted and engaged several external corporations, foundations and agencies. As an initial result of these efforts, a new research and development agreement was recently signed between DPHS and Genworth, a major life- and long-term-care insurance provider based in Richmond, Virginia.
The chairman, in conjunction with Dr. Mir Siadaty who serves on the Division of Clinical Informatics faculty, created a new biomedical search engine called Relevant Medicine (or ReleMed as it is more familiarly known). The search engine, which launched in January 2007, allows users to access and more efficiently use PubMed, the National Library of Medicine’s major repository of the world’s biomedical research publications. ReleMed, located online at www.ReleMed.com, has received overwhelmingly positive reviews from health sciences librarians and is currently ranked Number 5 by Google among more than 30 biomedical-literature-related search engines.
The Division of Public Health Policy and Practice celebrated the publication of “Health Care Half-Truths: Too Many Myths, Not Enough Reality,” a book co-authored by Carolyn Engelhard and the University of Virginia’s Executive Vice President and Provost, Arthur (Tim) Garson.
Education
The Department of Public Health Sciences offered two graduate programs during 2006-07: the Master of Science in Clinical Research (with 30 students enrolled and 12 students awarded the degree), and the Master of Public Health (with 30 students enrolled and 9 students awarded the degree). The department also provided educational opportunities to many other graduate and undergraduate students, as well as residents, fellows and faculty. The latter was accomplished through the newly established certificate program supported by the Health Sciences Center administration. This program offers residents and fellows the opportunity to attend intense four two-week courses on topics such as epidemiology and biostatistics taught by DPHS faculty. These courses meet new residency training program requirements, and the academic credits earned can also fulfill some of the requirements within the two degree programs offered by the department: Masters of Science in Clinical Research and Masters of Public Health. The first of these certificate courses, Introduction to Epidemiology, was held in the summer of 2007 and was taught by Dr. Viktor Bovbjerg from the Division of Biostatistics and Epidemiology. The reviews of Dr. Bovbjerg’s teaching by the residents were extraordinarily positive, achieving an overall ranking of 4.8 on a 5-point scale.
DPHS and its Division of Clinical Informatics led a successful effort to gain funding from the National Library of Medicine for a PhD training program in medical informatics, one of only 18 funded nationally. This five-year program involves an innovative collaboration between the Division and the Department of Systems and Information Engineering in the School of Engineering.
DPHS also provided the required fourth-year Medical School course, DxRx: Health Care System, which introduces students to the range of organizational, economic, political and legal dimensions of the health care system. In addition, a fourth-year elective in Public Health Policy and Practice provides students with opportunities to work in state and local health departments.
Through its Division of Public Health Policy and Practice, the department has created a new Global Public Health Minor, in partnership with the Center for Global Health, that provides selected undergraduates with the possibility of internships in public health, enrollment in graduate courses in public health, and special meetings with visiting scholars.
This year the Five-Year BA/BS-MPH Program began admitting undergraduates into the public health program at the end of their third year of undergraduate studies so that they can focus on public health research, education and community projects over the two years that bridge their final undergraduate year and the one-year MPH program.
To support the University’s emphasis on diversity, the department created a new MPH Health Disparities Focus for MD-MPH students in the Medical School’s Generalist Scholars Program.
Finally, a new Clinical Translational Research course was established and co-taught by Division of Public Health Policy and Practice faculty members: Erik Hewlett, the School of Medicine’s associate dean for research; and Philippe Sommer, a professor at the Darden Graduate School of Business.
Service
Department faculty serve on many of the most important research committees in the University and the School of Medicine, including the Institutional Review Board, the GCRC Protocol Review Committee, the Cancer Center Protocol Review Committee, the Cancer Center Data Safety and Monitoring Committee and the Children’s Hospital Grant Review Committee. Division members have also served on a number of administrative committees, including the School of Medicine Promotion and Tenure Committee. In addition, the Department has contributed strongly to strategic planning for biomedical informatics; for example, DPHS faculty developed plans for a Core Facility in Biomedical Informatics at the request of the Research Advisory Council (RAC) and the School of Medicine Dean's Office.
James Harrison, Division Director of Clinical informatics, was appointed Director of Cancer Informatics in the University of Virginia Cancer Center.
The Department, through its Division on Public Health Policy and Practice, was active in a variety of community-service endeavors. Masters of Public Health students, working with Division faculty, were invited to present their community research projects at the American Public Health Association Annual Conference. The accepted abstracts included Jennifer Young’s “Ethical and legal issues regarding HPV vaccine legislation”; Michele Bucci’s “Comparison of mothers’ motivation to prevent preschool childhood obesity across four ethnic groups”; and Rebecca Angevine’s “Barriers to HAART adherence in a cohort of adolescents in urban Uganda .” At the recent University-wide Conference on Health Care Disparities, the Department presented its first Public Health Community Impact Award to Dr. Wendi El Amin from the Department of Family Medicine.
The Department continues to serve as the developer, manager and consulting entity for the Clinical Data Repository (CDR), a research and education resource. The Division of Clinical Informatics is working hard to maintain and improve the access of researchers and students to the CDR, in a manner consistent with federal guidelines and national best practices. This year the Division successfully negotiated a Memorandum of Understanding with the Health System to allow new data types that are beginning to populate the electronic medical record to also flow to the CDR for research applications, and also to act as the Health System Honest Broker in managing access to the data.
The remainder of this annual report consists of faculty listings by Division, the executive summaries from each of the three Division’s annual reports, detailed documentation of all accomplishments, along with summaries of the current status of the Center for Public Health Genomics, the Masters of Science in Clinical Research and the Masters in Public Health degree programs.