Clinical and Epidemiological Science

Dr Joanne Jordan
Joanne Jordan, MD, MPH; Director of the Thurston Arthritis Research Center
Some might say pursuing research in the health arena is a bit like the question about the “chicken or the egg.”  Is it more important to study the causes and impacts of disease, or to instead pursue the development of innovative new treatments?  

The philosophy of the Thurston Arthritis Research Center is that not only are both approaches equally important, but they are strongest when they function collaboratively so that each sheds light upon the other.  This means the Center’s clinicians and researchers who are treating patients each day work collaboratively with their epidemiology-focused colleagues, who are actively exploring how rheumatologic diseases and allergies emerge, impact patient populations, and can be better managed by individuals as well as communities.  The full clinical and epidemiologic expertise from some of the country’s leading MDs, PhDs, PTs, and affiliated experts is brought to bear via an integrated approach that is based on a foundation of innovative thinking and problem solving.   

Examples of some of our main research focus areas include:

  • Population based studies of osteoarthritis and disability  
    Large, ongoing population-based study – known as The Johnston County Osteoarthritis Project – initiated over 25 years ago.  It has generated more than 30 supplemental and ancillary trials focused on numerous factors influencing the development, management, and impact of osteoarthritis.  For more information, contact: Joanne Jordan, MD, MPH.   
  • Social determinants and health outcomes  
    Observational research measuring associations of factors such as age, gender, education, ethnicity and place of residence with a range of health outcomes including disability, pain and psychosocial factors in patients with osteoarthritis and rheumatoid arthritis.  For more information, contact: Leigh Callahan, PhD.
  • measuring foot arch
    Measuring foot arch
    Community-based physical activity and weight loss intervention trials  
    Evaluating and establishing the evidence-base for physical activity interventions that can be implemented in the community setting, e.g., Walk With Ease, Camine con Gusto (the Spanish language version of Walk With Ease), Active Living Everyday, WE-CANFor more information, contact: Leigh Callahan, PhD. 
  • Comparative Effectiveness Trials  
    Comparing traditional physical therapy to internet-based exercise programs and STAART (Pain Coping Skills Training for African Americans with Osteoarthritis).  For more information, contact Kelli Allen, PhD. 
  • Injury prevention  
    Injury and musculoskeletal epidemiology research focused on identifying modifiable risk factors for osteoarthritis.  For more information, contact: Yvonne Golightly, PT, PhD.
  • Health impact of variances in anatomic and biomechanical factors  
    Research program investigating the association between factors such as leg length inequality, arch of the foot, foot type, and similar measures, as related to development of lower limb osteoarthritis.  For more information, contact: Yvonne Golightly, PT, PhD, and Amanda Nelson, MD.  
  • Novel approaches to the use of imaging technologies in osteoarthritis  
    Use of innovative methods to analyze relationships between imaging (ultrasound, x-ray) features such as joint shape and osteoarthritis risk.  For more information, contact: Amanda Nelson, MD.
  • HLUPTRheum450.jpg
    Health Literacy Toolkit
    Health literacy 
    Development of a “Health Literacy Universal Precautions Toolkit” designed to help clinical practice settings in working with individuals with all levels of health literacy.  For more information, contact: Leigh Callahan, PhD.
  • Mortality and osteoarthritis  
    Studies evaluating the role of knee and hip osteoarthritis (alone and in combination with co-morbid conditions) and mortality.  For more information, contact: Leigh Callahan, PhD, or Rebecca J. Cleveland.
  • Food allergies including alpha-gal meat allergy  
    Clinical and laboratory-based exploration of ways to better identify and manage symptoms of this often undiagnosed, and rapidly growing allergy.  For more information, contact: Maya Jerath, MD, PhD.


Pioneering Population-Based Research -- The Johnston County Osteoarthritis Project

johnston county project
Research performed in Johnston County, NC has been the source of over 60 supplementary and ancillary studies.

Brief History 

Over a span of 25 years, the Johnston County Osteoarthritis Project in Smithfield, NC has established itself as one of the premier longitudinal research studies world-wide regarding the determinants and societal implications of osteoarthritis.  It is internationally-recognized as the flagship study of the UNC Thurston Arthritis Research Center, and was the first study in the US to examine urban and rural differences in medically defined arthritis.

This innovative and multi-faceted population based study has collected a vast repository of genetic, behavioral and clinical data to address the complexities surrounding the causes, social and psychological impact, and optimal treatment approaches for people with hand, knee, hip and spine osteoarthritis.  Numerous collaborative studies to date have been successfully executed, creating new analytical data sets spanning 7,500 participants. These data sets serve as an invaluable library for secondary analyses that have, in turn, produced hundreds of publications across diverse disciplines, including health services, orthopedics, exercise & sport science, and physical therapy – to name a few.  The efficiency of data access built into the program creates an optimal research environment that enables bench-to-bedside implementation. 

As a leader in the scientific community for advancing knowledge about osteoarthritis, the project is recognized as an outstanding training ground for young scientists.  

Expansion and enrollment

Recent research has shown that osteoarthritis onset is appearing in much younger age groups than previously observed.  In response to this trend, the Johnston County Project will be expanding to include a younger age group in its cohort, starting at age 35, with an overall participant goal of 3,500 across all study groups for this population-based research.