The Summer Research Program in Family Medicine provides medical students with unique opportunities to carry out clinical research aimed at improving medical practice and patient care. In past summers, students have worked with faculty mentors on a variety of projects including chronic fatigue syndrome, patient autonomy and health behaviors of university faculty. 

The student will carry out a clinical research study and learn the basics of planning, implementing, and reporting a research study. Recent Family Medicine research students have published results of their studies in peer-reviewed medical journals and have presented reports at national and international conferences. Through their work with mentors in the department, students become more aware of the research and clinical activities of Family Medicine faculty and develop an understanding and appreciation of Family Medicine as a specialty.

Description of possible research projects

One project will involve testing an intervention to improve colorectal cancer screening (CRCS)among patients attending the Family Care Center. Colorectal cancer is largely preventable if caught early. There are several screening tests available, yet less than half of the population receives appropriate screening. Students will be involved in all aspects of the study, including finalizing the design of the intervention. The student will also help in writing up some manuscripts based on other data that has been collected regarding colorectal cancer screening. 

Another study is a qualitative study for why specific patients receive or do not receive screening. We will have 16 transcripts from physicians across the state regarding 3 patients who have been screened and 3 patients who have not been screened for colorectal cancer. The student researcher will analyze the data qualitatively using nVIVO or another qualitative analysis program. We will look for common themes for why physicians screen or do not screen specific patients. The student will also help in writing some other manuscripts using data that has already been collected regarding colorectal cancer screening. 

Contact 
Barcey Levy, PhD, MD 
Family Medicine 
01292 E PFP 
4-7762 
barcey-levy@uiowa.edu

Description of possible research projects

The world community is aging and, along with the aging process, an increasing proportion of the population is encountering functional decline (U.S. Department Health and Human Services 1999). The best national estimate is that approximately 35% of the population 65 years and older have activity limitations from chronic diseases, with those 75 years and older having a higher prevalence of 45% (U.S. Department of Health and Human Services, 2003). Declining self-sufficiency of the aging population increases the societal burden associated with providing resources to compensate for the disabilities that arise. The purpose of this research is to conduct secondary analyses of the Keokuk County Rural Health Study (KCRHS) from Round 1 and Round 2 that includes data on function using the Functional Evaluation Framework to evaluate the relationships among an elderly person’s abilities, motivations, and opportunities that most significantly affect that person’s function in a rural area of the United States. By identifying modifiable risk factors that predict functional decline, interventions may be focused to ultimately reduce societal burden by preserving or improving elders' function. The KCRHS is a population-based, prospective study of health status and environmental exposures of a large, stratified, random sample of residents in one rural Iowa county. Following are the objective and specific aim. 

Overall Objective: To examine the prevalence of function problems at baseline and four years later for a cohort of persons 60 years and older who are in the KCRHS and determine which ability, motivation, and opportunity factors are associated and can be modified to improve function. 

Specific Aim I: To identify the levels of function, ability, motivation, and opportunity at baseline and 4 years later. 
Specific Aim II: To test and compare whether characteristics of the older person, their ability, motivation, and opportunity are associated with function. 
Specific Aim III: To test if there is a cohort change in function over a four-year period. 

Contact 
Dr. Gerald Jogerst 
Family Medicine 
01290-G PFP 
384-7704 
gerald-jogerst@uiowa.edu

Description of possible research projects

Good sleep is associated with prolonged survival and is essential to the normal biological function. Often, however, a good night’s sleep does not come easily. Population-based epidemiological studies have found high percentages of persons with sleep problems: 33-43%. Despite insomnia’s prevalence and impact, it is both underreported and undertreated in primary care. A team of investigators including faculty from the Departments of Family Medicine, General Internal Medicine, Epidemiology, Neurology, and Psychiatry have been studying factors that influence insomnia in the community. This same team would now like to study factors that influence the clinical management of insomnia. Questions that will be addressed include the following: 1) to what extent do patients with insomnia report the problem to their primary care physician, 2) what factors influence the reporting of these problems, 3) what are physician management strategies for insomnia, and 4) what management strategies are most effective. 

Methods 
Patients in participating clinics will be screened for insomnia using a questionnaire. Patients who screen positive will be asked to participate in our research. The research will involve structured interviews of the patients about their discussions with physicians and of physicians about their management. A follow-up interview of patients will examine the success of the physician’s management strategy. A physician survey and interview will also be conducted. 

Student Role 
The students will conduct and record interviews with patients and/or physicians, tabulate and analyze the interviews, help interpret the analyses, and help prepare a manuscript about the study. 

Contact 
Dr. Gerald Jogerst 
Family Medicine 
01290-G PFP 
384-7704 
gerald-jogerst@uiowa.edu  

Description of Possible Research Projects

There are well developed guidelines defining good care for Type 2 Diabetes. But the care patients receive is not always in accordance with these guidelines. For example, most adult diabetics should be on anti-platelet therapy to prevent heart attack and stroke. Blood lipids should be aggressively controlled. Glycemic control should be regularly monitored using testing of hemoglobin A1C. 

The student involved in this project will review the care of Type 2 Diabetes at the Free Medical Clinic in Iowa City by undertaking a comprehensive chart review. While the Free Medical Clinic provides care to patients facing a number of obstacles to health care, they also provide care using a coordinated care model. This model entails a case manager, disease management protocols, and medical charts organized for chronic disease care. The care delivered at the Free Medical Clinic will then be compared to care routinely delivered at UIHC by using previously collected data. We are interested in whether care delivered using a coordinated care model at the Free Medical Clinic approaches that delivered at our institution. These findings will be used for future quality improvement projects. 

Contact 
George Bergus, MD 
Family Medicine 
01292-C PFP 
384-7566 
george-bergus@uiowa.edu