Emergency Medicine Public Health Research Funded by Federal Agencies: Progress and Priorities

Abstract

The emergency department (ED) visit provides an opportunity to impact the health of the public throughout the entire spectrum of care, from prevention to treatment. As the federal government has a vested interest in funding research and providing programmatic opportunities that promote the health of the public, emergency medicine (EM) is prime to develop a research agenda to advance the field. EM researchers need to be aware of federal funding opportunities, which entails an understanding of the organizational structure of the federal agencies that fund medical research, and the rules and regulations governing applications for grants. Additionally, there are numerous funding streams outside of the National Institutes of Health (NIH; the primary federal health research agency). EM researchers should seek funding from agencies according to each agency's mission and aims. Finally, while funds from the Department of Health and Human Services (HHS) are an important source of support for EM research, we need to look beyond traditional sources and appeal to other agencies with a vested interest in promoting public health in EDs. EM requires a broad skill set from a multitude of medical disciplines, and conducting research in the field will require looking for funding opportunities in a variety of traditional and not so traditional places within and without the federal government. The following is the discussion of a moderated session at the 2009 Academic Emergency Medicine consensus conference that included panel discussants from the National Institutes of Mental Health, Drug Abuse, and Alcoholism and Alcohol Abuse and the Centers for Disease Control and Prevention (CDC). Further information is also provided to discuss those agencies and centers not represented. ACADEMIC EMERGENCY MEDICINE 2009; 16:1065-1071 ª 2009 by the Society for Academic Emergency MedicineKeywords: federal funding, public health, emergency medicine, emergency departments T he Institute of Medicine's (IOM) seminal report on the Future of Emergency Care in the United States Health Care System 1 was the culmination of an extensive investigation into the status of emergency medicine (EM) and services. Hospital emergency departments (EDs) were described as broken systems, overcrowded, inefficient, and ineffective because the demand for care far exceeds the capacity in EDs. The IOM emergency care committee chair testified before Congress and described the need to enhance emergency care research. 2 The committee determined that public health was negatively affected by the current state of emergency care. Specifically, the panel of EM experts recommended that federal agencies target additional research funding for prehospital emergency care services and for needs and gaps in emergency care. 2Not only are EM providers availing themselves of federal research funds in acute critical care, but also EM researchers have increasing opportunities to ameliorate a host of other health issues that directly or indirectly affect public health. To this end, bot...

Development of a scale to measure practitioner adherence to a brief intervention in the emergency department

“…Further, emergency department practitioners can be successfully trained to implement BI in “real-world” medical settings in approximately 2 hours (D'Onofrio, Pantalon, Degutis, Fiellin & O'Connor, 2005). BI also has promise for illicit drug abuse (Bernstein, Edwards, Dorfman, Heeren, Bliss & Bernstein, 2009; D'Onofrio & Degutis, 2010; Madras, Compton, Abula, Stegbauer, Stein, & Clark, 2009) and several national agencies have endorsed BI for use in emergency care settings to address problematic public health behaviors (D'Onofrio, Goldstein, Denisco, Hingson, Heffelfinger & Post, 2009). …”

Survey of an Australian general emergency department: estimated prevalence of mental health disorders

“…The public health approach starts by defining the scope of the problem (D'Onofrio et al . ). However, no comprehensive Australian data are available describing the presence of mental health disorders in people presenting to ED; existence of a mental health disorder is usually only recorded if it is investigated as part of the presenting clinical history.…”

“…A visit to the emergency department (ED) ‘provides an opportunity to impact the health of the public… from prevention to treatment’ (D'Onofrio et al . ) and EDs should show leadership in promoting the public's health through research initiatives that address surveillance, screening, and intervention for a range of issues, including mental health disorders (Woolard et al . ).…”

“…. from prevention to treatment' (D'Onofrio et al 2009) and EDs should show leadership in promoting the public's health through research initiatives that address surveillance, screening, and intervention for a range of issues, including mental health disorders (Woolard et al 2009). The public health approach starts by defining the scope of the problem (D'Onofrio et al 2009).…”

“…from prevention to treatment' (D'Onofrio et al 2009) and EDs should show leadership in promoting the public's health through research initiatives that address surveillance, screening, and intervention for a range of issues, including mental health disorders (Woolard et al 2009). The public health approach starts by defining the scope of the problem (D'Onofrio et al 2009). However, no comprehensive Australian data are available describing the presence of mental health disorders in people presenting to ED; existence of a mental health disorder is usually only recorded if it is investigated as part of the presenting clinical history.…”