The Health Resources and Services Administration (HRSA), within the U.S. Dept. of Health and Human Services, continues to support chiropractic research efforts. The HRSA, you may recall, is the funding agency for the chiropractic research agenda (see "Setting the Chiropractic Research Agenda: Conference II," DC, 10-20-97), co-chaired by William Meeker, DC, MPH, and Cheryl Hawk, DC, PhD, of the Palmer Center for Chiropractic Research.
The HRSA is also funding studies at Western States Chiropractic College, Los Angeles College of Chiropractic, and National College of Chiropractic.
Western States Chiropractic College
The HRSA has awarded a second million dollar grant to Western States to assess both chiropractic and medical treatment of low back pain. This project is a follow-up to a three-year study begun in 1994 in collaboration with Oregon Health Sciences University's (OHSU) Department of Family Medicine.
The second grant builds on data from the earlier study sample of 3,000 patients treated by 70 chiropractors and 111 primary care medical doctors in Oregon and southern Washington. "We know that patients are getting many kinds of treatment. This study will look at what those treatments are, their outcomes, and the cost-effectiveness of care," explained Mitchell Haas, MA, DC, WSCC associate professor of research, and the project's principal investigator.
Using that data, the study will describe and quantify two, three, and four-year pain and disability outcomes for patient care. "We hope to identify the predictors of long-term outcomes in both acute and chronic patients treated by chiropractors and medical doctors," specified Dr. Haas. He said the study will also examine how patient characteristics, attitudes, lifestyle behaviors, and self-care affect patient outcomes. "We also want to find out what these doctors are doing for patient health promotion and disease prevention," he added.
Co-investigators include Joanne Nyiendo, PhD, WSCC director of research; Bruce Goldberg, MD, OHSU's department of family medicine; Gary Sexton, PhD, OHSU's department of public health; and Miron Stano, PhD, school of business administration, Oakland University.
Bruce Goldberg, MD, who served as a co-investigator on the first project, says the grant clearly represents recognition of the importance of the work being done. "The fact that a health sciences university and a chiropractic college are collaborating on a health care study is significant," he observed. The grant, he noted, "indicates the tremendous interest in alternative health care shown by the public and medicine."
Western States President William Dallas, DC, agrees the grant is another step in chiropractic research's integration into mainstream science and education. "WSCC appreciates the collegial cooperation from OHSU and the funding from the Health Resources and Services Administration. The collaborative investigation holds promise for better answers to the age-old affliction of low back pain."
Los Angeles College of Chiropractic
The HRSA has awarded a $816,000 grant (over three years) to LACC for a study that will assess the effectiveness and cost effectiveness of spinal manipulation vs. spinal mobilization, heat therapy, and electrical muscle stimulation for treating neck pain. Pain reduction, functional improvement, and patient satisfaction will be assessed.
The three-year randomized study will be conducted in a large, multispecialty, managed care practice. The UCLA School of Medicine, acting as a subcontractor, will specify the roles, responsibilities and time commitments of each investigator.
Hal Morgenstern, PhD, who has been with the UCLA School of Public Health since 1985, and is an adjunct professor at LACC, is the principal investigator; co-principal investigators are Eric Hurwitz (LACC) and Philip Harber (UCLA); Al Adams of LACC will be one of the co-investigators.
The study will be only the third randomized clinical trial of spinal manipulation vs. spinal mobilization for neck pain. It will be the first of its kind to include a rigorous cost-effectiveness component.
National College of Chiropractic
As we go to press, the information coming out of National College concerning their HRSA grant is sparse. We can tell you that it is $431,000 grant, and that the study will compare the flexion-distraction technique vs. medical care for low back pain. The principal investigator is M. Ram Gudavalli, PhD, a member of National's research staff.
