By: Maggie Rotermund
ST. LOUIS – Sarah Gebauer, M.D., assistant professor of family and community medicine at Saint Louis University School of Medicine, was awarded a K23 grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases to use geospatial information science and electronic medical records to study how neighborhood walking can impact osteoarthritis.
The five-year grant totals $777,525 and will fund Gebauer’s research in knee osteoarthritis and how barriers to low-cost intervention can impact patients.
Nearly 14 million adults in the United States experience the pain and stiffness which come with knee osteoarthritis. Physicians often recommend walking as a low-cost treatment to alleviate symptoms.
“Walking around your own neighborhood is the easiest and most low-cost option for patients,” Gebauer said. “But there are so many things that stand in the way of that for many of the patients I see. If the infrastructure isn’t well-maintained or if the patient fears for their safety, they likely won’t get in enough exercise to help manage their symptoms.”
Gebauer will combine Geospatial Information Science (GISc) and qualitative methods in integrating Electronic Medical Record Data (EMR) to explore the influence of neighborhood on walking and painful conditions. She will explore the association between neighborhood factors, such as walkability, social capital, violent crime rates and prevalent cases of knee osteoarthritis, using a Veterans Affairs EMR data set.
The GISc modeling with varying measures of neighborhood walkability will follow veterans across the country in a retrospective cohort for 11 years. Gebauer will also conduct qualitative interviews with primary care providers and patients to help understand how patient or physician knowledge of neighborhood barriers and resources can enhance shared decision-making between doctors and patients and establish concordance around walking for knee OA treatment.
“With geospatial modeling, we can determine hot spots and be able to give providers information on appropriate interventions,” she said. “It’s not helpful to tell a patient to just go take a walk if they don’t have anywhere safe to walk.”
Gebauer said she hopes the longitudinal data will be able to inform public health actions, including helping communities target improvements to neighborhoods.
The project aims to provide innovative spatial survival models for chronic disease epidemiology, as well as a new understanding of shared decision-making for patients and their primary care physicians, which could then provide data for follow-up studies examining the integration of neighborhood characteristics to increase walking in knee osteoarthritis patients.
“Further studies could include replicating this study in civilian populations and different metropolitan areas, and studies which explore other musculoskeletal conditions that benefit from walking in the neighborhood,” Gebauer said.
K23 awards from the National Institutes for Health support the career development of those with clinical doctoral degrees, who have the potential to develop into productive, clinical investigators, and who have made a commitment to focus their research endeavors on patient-oriented research. The K23 provides support and protected time for patient-oriented research and training.
K23 awardees are encouraged to take advantage of mentors at their institutions. Gebauer is being mentored by Jeffrey Scherrer, Ph.D., professor of family and community medicine at SLU and senior director of research in SLU’s AHEAD Institute; Ness Sandoval, professor of sociology at SLU and acting director for diversity, education, and training at the Taylor Geospatial Institute; and Elizabeth Baker, Ph.D., professor of behavioral science and health education in the College for Public Health and Social Justice.
Gebauer is also receiving mentorship from faculty at the University of North Carolina, University of Arkansas, Texas A&M University and Washington University in St. Louis.
This study is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 1K23AR079035-01A1.