The overarching mission of the UAB Center for Engagement in Disability Health and Rehabilitation Sciences (CEDHARS) is to advance scientific discovery, translational research, education, and engagement in the fields of disability health and rehabilitation sciences. To further this mission, pilot funding is made available on a regular basis.

Read more about past funding grants and recipients.

CEDHARS is pleased to announce the recipients of its spring 2023 pilot grant funding opportunity, “Secondary Data Analysis to Advance Health or Rehabilitation Outcomes Research in People with Disabilities.” Click here for the original request for proposals. (Request for proposal is available for reference.)

CEDHARS’ overarching mission is to advance scientific discovery, translational research, education and engagement in the fields of disability health and rehabilitation sciences. This pilot program aims to support the advancement of disability health research, and this specific funding cycle encouraged comparative research on health disparities in people with disabilities versus non-disabled populations. Applying data science to create clinical predictive rules for health and rehabilitation outcomes is within the scope of this initiative.

Applications were highly competitive and were peer reviewed using the NIH scoring framework. Three proposals were chosen for $25,000 of funding. To learn more and read the abstracts for each of the projects, click on the links below:

• Fedora Biney: “The Impact of Pre-Injury Psychiatric Difficulties and Post-Injury Emotional Distress on Caregiving Needs in Caregivers of Traumatic Brain Injury Survivors”
• Wendy Huacong: “The Impacts of COVID-19 Pandemic on Causes of Death and Mortality Rate Among People with Disabilities”
• Tanjila Nawshin: “Assessment of Construct and Criterion Validity and Principal Component Analysis of the National Center on Health, Physical Activity and Disability (NCHPAD) Wellness Assessment (NWA) Tool"

Dr. Fedora Biney

The Impact of Pre-Injury Psychiatric Difficulties and Post-Injury Emotional Distress on Caregiving Needs in Caregivers of Traumatic Brain Injury Survivors

• Principal Investigator: Dr. Fedora Biney, Assistant Professor, Heersink School of Medicine Department of Physical Medicine and Rehabilitation
• Collaborating Scientists: Jennifer Marwitz, MA, Director of TBI Research Department of Physical Medicine and Rehabilitation; Dr. Yue Zhang, Statistician Division of Gerontology, Geriatrics, and Palliative Care; Dr. Richard Kennedy, Associate Professor Division of Gerontology, Geriatrics, and Palliative Care

Traumatic Brain Injury (TBI) is gaining recognition as a chronic health condition, putting observations of caregivers’ experiences with post-injury emotional distress, depression, and unmet needs in the proper perspective. The characterization of long-term emotional and behavioral outcomes of TBI survivors has been a focus of research for decades. A similar longitudinal approach to characterizing the emotional functioning of TBI caregivers is warranted. To achieve this, it is critical to understand whether caregivers with pre-morbid psychiatric difficulties have unique needs, the extent to which these needs are being met and if pre-morbid psychiatric difficulties may predispose TBI caregivers to post-injury emotional distress. Furthermore, evaluating the stability of endorsement of emotional distress in caregivers beyond the first year post-injury is critical. The ultimate goal of such knowledge is to identify modifiable risk factors for post-injury caregiver emotional distress.

The current study will involve a secondary data analysis of the TBI Model Systems (TBIMS) National Database (NDB) Caregiver Resilience Module. This includes data collected from caregivers of individuals with moderate-to-severe TBI at 6 months, 1 year and 2-years post-injury across 6 TBIMS center sites. The aims of this study are 1) to examine differences in reported needs for TBI caregivers at 6-months post-injury 2) to examine the relationship between pre-injury caregiver psychiatric difficulties and level of met needs at 6-months post-injury 3) to determine whether TBI caregivers with pre-injury psychiatric difficulties endorse more significant mood problems at 6-months post-injury compared to caregivers without pre-injury psychiatric difficulty and 4) examine the stability of TBI caregiver depression and anxiety from 6 months to 2 years-post injury. TBI caregivers who endorse emotional distress following their relative’s TBI may be more likely to have unmet family needs. If caregivers with premorbid psychiatric difficulties experience more emotional distress in response to their relative’s TBI, then this may identify a subpopulation of caregivers to target treatment resources.

Dr. Wendy Huacong

The Impacts of COVID-19 Pandemic on Causes of Death and Mortality Rate Among People with Disabilities

• Principal Investigator: Dr. Wendy Huacong, Postdoctoral Fellow and Statistical Analyst, Heersink School of Medicine Department of Physical Medicine and Rehabilitation
• Collaborating Scientist: Dr. Yuying Chen, Director of the National Spinal Cord Injury Statistical Center, Department of Physical Medicine and Rehabilitation

People with spinal cord injury (SCI) are vulnerable to respiratory infections and at risk for severe COVID-19 disease because of the weak strength of respiratory, diaphragmatic, and abdominal muscles. In addition, people with SCI are at higher risk of chronic complications, such as obesity, diabetes, and cardiovascular disease, compared to people without SCI. Those complications are also known risk factors of negative outcomes after COVID-19, which may contribute to excess deaths among people with SCI. Small case series and studies from the Veterans Health Administration suggests that COVID-19 mortality rate was high in people with SCI, ranging from 10-19%. The COVID-19 positive rates and mortality rates were elevated in Veterans with SCI (6.35% and 12.0%), when compared with the general population (1.79% and 0.68%). Therefore, it is needed to examine the change in causes of death and mortality rate in people with SCI during COVID-19 pandemic in a large sample size of non-Veterans with SCI.

The proposed Aim #1 of evaluating the impact of COVID-19 on cause of death will identify the causes of death that had increase during the pandemic as well as at-risk groups for each cause of death. The Aim #2 of assessing the impact of COVID-19 on mortality will determine whether excess death caused by COVID-19 infection occurred in people with SCI and which causes of death had increased mortality rate during the pandemic, when comparing with the general population. New knowledge gained from this study can inform the work of practitioners and policy makers to prevent death for persons with SCI and other disabilities in the future public health crisis.

Tanjila Nawshin

Assessment of Construct and Criterion Validity and Principal Component Analysis of the National Center on Health, Physical Activity and Disability (NCHPAD) Wellness Assessment (NWA) Tool

• Principal Investigator: Tanjila Nawshin, PhD Student, School of Health Professions Department of Health Services Administration
• Collaborating Scientist: Dr. Navneet Baidwan, Postdoctoral Fellow, SHP Research Collaborative

People with mobility limitations (ML) have a disproportionately higher rate of acquiring secondary conditions such as obesity, hypertension, type 2 diabetes, etc. than those without ML. Such secondary conditions often result from their poor access to home- and community-based health promotion/wellness programs. Additionally, there is a lack of brief validated measures that assess wellness in this population. The National Center on Health, Physical Activity and Disability (NCHPAD) developed a 16-item wellness assessment tool called the NCHPAD Wellness Assessment (NWA) to assess physical, mental, and emotional domains of health and understand the overall wellness status of individuals with disabilities and ML.

One of the health promotion programs within NCHPAD is Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR) that consists of a comprehensive set of evidence-based wellness practices. NWA is a tool used to evaluate the effectiveness of the MENTOR program by assessing the pre- and post-intervention wellness status of the program participants. The NWA tool has face validity, but the construct (e.g., convergent and divergent) and criterion (e.g., concurrent) validity of the tool has not been assessed yet. the proposed project seeks to evaluate its convergent validity by comparing the NWA test scores with the Short Form-36 (SF-36) Health Survey and Patient Reported Outcomes Measurement Information System (PROMIS) Global-10, divergent validity by comparing the NWA score with Modified Fatigue Impact Scale (MFIS), and concurrent validity by comparing the NWA score with PROMIS-10 and Godin Leisure-Time Exercise Questionnaire (GLTEQ) scores collected from participants in the MENTOR program. We also propose to conduct a principal component analysis (PCA) of the NWA tool to determine the items that explain maximum variation of its score.

Findings from this study will enable us to further refine the tool as needed and make it psychometrically rigorous. In turn, this study will increase the rigor of wellness evaluation of MENTOR program participants, allowing us to make robust conclusions regarding program effectiveness by analyzing differences between pre- and post-intervention NWA scores. In the longer run, the NWA tool validation work may lead to its wider adoption across other studies, programs, and endorsement by national institutions.