Mitigating the Public Health Impact of OA

Thurston Multidisciplinary Clinical Research Center

This summer the Thurston Arthritis Research Center became a Multidisciplinary Clinical Research Center (MCRC) charged with Mitigating the Public Health Impact of OA. This is designed to transform the face of osteoarthritis research on the UNC campus by serving as a hub for innovation, training and collaboration.


Since its funding in July 2013, this Multidisciplinary Clinical Research Center has launched two clinical research projects, a monthly speaker series, has provided writing group sessions where new investigators can develop grants related to the research mission of osteoarthritis and other rheumatic diseases and hosted a two-day event of presentations and discussions among researchers in biomechanics, physical therapy, orthopaedics, epidemiology, health behavior, and physical activity. On December 4th, members of the UNC Advisory Board and the External Advisory Board convened to plan the 2014 goals and benchmarks that will advance the next year’s work.


Executive Committee

JoanneJ.jpgJoanne M. Jordan, MD MPH is a practicing rheumatologist and epidemiologist. She is Joseph P. Archie, Jr. Eminent Professor in the Departments of Medicine and Orthopaedics in UNC’s School of Medicine (SOM) and Adjunct Professor in Epidemiology in the Gillings School of Global Public Health (SPH). She has been Principal Investigator of the Johnson County Osteoarthritis Project (JoCo OA) since its inception 22 years ago and Director of the Thurston Arthritis Research Center since 2007. Dr. Jordan serves as the Principal Investigator for the Multidisciplinary Clinical Research Center (MCRC) grant.


LeighC.jpgLeigh Callahan, PhD is an epidemiologist and musculoskeletal health outcomes researcher.  She is the Mary Link Briggs Distinguished Professor of Medicine, Professor of Social Medicine in the UNC School of Medicine and Adjunct Professor in Epidemiology in the Gillings School of Global Public Health. She has extensive experience in establishing research collaborations in communities across NC, serving in senior leadership roles in professional and nonprofit arthritis organizations, and in setting arthritis public health agendas.

Dr. Callahan serves as the Associate Director of the MCRC grant and Co-Director of the Methodology Core with Dr. Todd Schwartz.


Todd SchwartzTodd Schwartz, DrPH is a Research Assistant Professor in the Department of Biostatistics in the Gillings School of Global Public Health and has worked with investigators and students in arthritis and musculoskeletal epidemiology for almost 10 years. He is the Faculty Statistician to the Johnston County Osteoarthritis Project (JoCo OA) and many of its sub-studies, including those of Drs. Callahan, Nelson, and Golightly of the Thurston Arthritis Research Center.  Dr. Schwartz has expertise in categorical data analysis, longitudinal data analysis, linear models, linear mixed models, power and sample size, sampling weights and other topics in study design methodology and data analysis of particular relevance to the proposed projects and other funded projects likely to be supported by the MCRC. He is highly sought after for guest lectures across the UNC Health Affairs Schools in these areas, including the Biostatistics Seminar Series for NC TraCS, the North Carolina Translational & Clinical Sciences Institute (funded by the Clinical and Translational Science Award at UNC). Dr. Schwartz serves as a biostatistical reviewer for the journal Osteoarthritis and Cartilage.  He serves as the Co-Director of the Methodology Core.


Project Principal Investigators

Christine RiniChristine Rini, PhD, Principal Investigator of Project 1 Dr. Rini is Research Associate Professor at UNC in the Department of Health Behavior in the Gillings School of Global Public Health. She is a social/health psychologist conducting research on social, interpersonal, and intrapersonal resources that influence health-related psychological adjustment and behavior. Dr. Rini has substantial experience with longitudinal studies in various populations (e.g., cancer, pregnancy, osteoarthritis). She has also collaborated on or developed psychosocial and behavioral interventions. Most recently, she was awarded an R01 from NIAMS to translate a proven, in-person cognitive-behavioral coping skills intervention for delivery as a technologically-sophisticated, highly interactive web-based program that mimics key clinical features of in-person therapies among those with osteoarthritis.

Project 1: Clarifying critical processes linking partner support to insufficiently active osteoarthritis patients’ initiation and maintenance of increased lifestyle physical activity (LPA).

This ancillary to JoCo OA, will study married or long term AA and Caucasian community-dwelling partners with OA who are insufficiently active according to current recommendations.  Guided by theory and evidence showing that partner support is a skills-based behavior that can facilitate or hinder behavior change, it will build on a novel foundation of knowledge about support-related behaviors of both people with OA and their partner’s influence whether those with OA increase and maintain LPA.  It will also identify teachable support skills and pathways through which partner support influences LPA and evaluate its potential to translate this new knowledge into a novel support skills training program.  Consistent with our public health approach, this project targets remedies that enlist the potentially powerful effects of spousal support and that can be applied to populations to slow onset or progression of OA through LPA. Such interventions promise to be highly cost-effective and their integration into people’s everyday lives enhances their potential for sustainability.


Stephen MarshallStephen Marshall, PhD, Principal Investigator of Project 2 Dr. Marshall is Director of the UNC Injury Prevention Research Center and  Professor of Epidemiology. He is the Principal Investigator for the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) longitudinal study that examines human movement as a risk factor for Anterior Cruciate Ligament injury on a large prospective cohort of military cadets. He maintains a long standing research interest in the later-life effects of sports injuries including the effects of musculoskeletal injuries on OA in professional football players and the potentiating effects of concussions on neuro-dementing illnesses such as Alzheimer’s syndrome. Project 2 is an ancillary study to the JUMP-ACL.  Like the parent study, the work is multidisciplinary in nature.  He will lead the team of experts in biomechanics, biomarkers, biostatistics, military medicine, sports medicine, rheumatology, and orthopaedic medicine.  He is well-versed in the complexities of designing and conducting prospective cohort studies and in creating military-civilian collaborations. 

Project 2:  Biomarkers & biomechanics associated with injury-mediated OA

An ancillary to JUMP-ACL, an ongoing prospective cohort of biomechanical risk factors for ACL injuries in military cadets and funded through 2016 by the Department of Defense (DoD) and NIAMS, this study will use existing data on incident knee injuries and the pre-injury biomechanics of human movement and biomarker data (using banked sera from the DoD Serum Repository) and self-reported and radiographic measures of OA.  The objective is to better understand the role of biomarkers and biomechanics in the causal process underlying injury-mediated OA.  Doing so is an important precursor to preventive measures aimed at mitigating the impact of OA at the population level by identifying contributory behavior patterns that may be modifiable to prevent joint injury.


Internal Advisory Board Members

Alice AmmermanAlice Ammerman, PhD: is a Professor in the Department of Nutrition at the UNC Gillings School of Global Public Health and the UNC School of Medicine. She is the Director of UNC’s Center for Health Promotion and Disease Prevention (HPDP), a CDC Prevention Research Center. She is the Principal Investigator for the Center of Excellence for Training and Research Translation (CTRT) that hosts a weeklong training course each year for CDC Program staff in obesity prevention. Her research activities focus on the design and testing of innovative clinical and community-based nutrition and physical activity intervention approaches for chronic disease risk reduction in primarily low income and minority populations. Dr. Ammerman has strong research and practice collaborations across the state addressing childhood obesity. Additional research interests focus on school nutrition policy associated with childhood obesity, sustainable agriculture as it relates to improved nutrition, and social entrepreneurship as a sustainable approach to addressing public health concerns.

Timothy CareyTimothy S. Carey, MD MPH: is the Sarah Graham Kenan Professor of Medicine, Director of the Cecil G. Sheps Center for Health Services Research, and a member of the leadership team of the UNC Clinical and Translational Science Award (CTSA). Dr. Carey serves as the Director of the Sheps Center’s National Research Service Award Fellowship Training Program and General Internal Medicine Faculty Development Program. For the past 9 years he has served as Co-Director of the joint Research Triangle Institute (RTI)-UNC Evidence-Based Practice Center and has also worked with the Drug Effectiveness Review Project (DERP). He is a senior health services researcher, with special expertise in the epidemiology and treatment of axial musculoskeletal disease, including acute and chronic neck and low back pain. Dr. Carey is the current chair of the federal Agency for Healthcare Research and Quality (AHRQ) Health Effectiveness and Outcomes Research study section. Dr. Carey will provide important linkages with the CTSA and the Sheps Center and their extensive networks in North Carolina to facilitate dissemination and translational activities to help with rapid transfer of findings to improve clinical and public health practice.

Giselle Corbie-SmithGiselle Corbie-Smith, MD MSc: is Professor of Medicine and Social Medicine, Director of the Program on Health Disparities at the UNC Cecil G. Sheps Center for Health Services Research, and Director of the Community Academic Resources for Engaged Scholarship (CARE) Services of the NC Translational and Clinical Sciences Institute, the home of UNC’s CTSA grant. Her empirical work has employed both qualitative and quantitative methods and has focused on the methodological, ethical, and practical issues faced by mandated inclusion of minorities in research and the need for this research to address racial disparities in health. Dr. Corbie-Smith is accomplished in drawing communities, faculty, and health care providers into working partnerships in clinical and translational research. This engagement ultimately transforms the way that academic investigators and community members interact while boosting public trust in research. Her experience in translational activities will be important to the Thurston MCRC and to the Methodology Core.


Kevin GuskiewiczKevin Guskiewicz, PhD: is the Kenan Distinguished Professor and Co-Director of the Matthew Geller Sport-Related Traumatic Brain Injury Research Center. He is the Director of the Center for the Study of Retired Athletes in the Department of Exercise and Sport Science at UNC Chapel Hill. He is the Senior Associate Dean for the Natural Sciences in the College of Arts and Sciences. Dr. Guskiewicz holds joint appointments in the Department of Orthopaedics, UNC Injury Prevention Research Center and the Doctoral Program in Human Movement Science. A 2011 recipient of the highly prestigious John D. and Catherine T. MacArthur Foundation fellowship, he has collaborated with Drs. Steven Marshall, Leigh Callahan, and Yvonne Golightly from our group for many years and participated in the training of several of our graduate and post-doctoral students. Dr. Guskiewicz has extensive experience with post-injury effects on the musculoskeletal system and is a recognized expert in posttraumatic brain injury in athletes.

William MaixnerWilliam Maixner, DDS, PhD: is the Mary Lily Kenan Flagler Bingham Distinguished Professor of Dentistry in the UNC School of Dentistry (SOD) and Professor in the School of Medicine’s Department of Pharmacology. He is the Director of UNC’s Regional Center for Neurosensory Disorders and Co-Director of the Orofacial Pain Management Program at the University of North Carolina in Chapel Hill. Dr. Maixner’s translational pain research program focuses on identifying the pathophysiological processes that underlie pain perception, persistent pain conditions, and related disorders. His current research focuses on genetic, environmental, biological, and psychological risk factors and markers that contribute to the onset and maintenance of chronic pain conditions. A long-term goal of his program is to translate new discoveries into clinical practices that improve the ability to diagnose and treat patients experiencing chronic pain with an emphasis on temporomandibular joint disorders, fibromyalgia, and osteoarthritis.


Bryce ReeveBryce Reeve, PhD: is an Associate Professor in the Department of Health Policy and Management in the UNC Gillings School of Global Public Health. Dr. Reeve is a psychometrician and outcomes researcher. He has extensive research experience in patient-reported outcomes, health-related quality of life, psychometrics, and questionnaire design. He is the Principal Investigator of the Coordinating Center for the National Cancer Institute (NCI) funded network to develop the pediatric version of the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE).  The goal of this project is to design a valid and reliable self-report measure of subjective symptoms that will improve our understanding of the impact of cancer and its treatment on the lives of children and adolescents.   Dr. Reeve currently serves as President of the International Society for Quality of Life Research (ISOQOL).  He also serves on NCI’s Symptom Management and Health-Related Quality of Life Steering Committee and ALLIANCE’s Health Outcomes Committee. 


External Advisory Board Members

Constance ChuConstance Chu, MD: Dr. Chu is Professor of Sports Medicine and Arthroscopy and Vice Chair, Research, Orthopaedic Surgery, at Stanford University. She also is Chief of Sports Medicine and Director of the Joint Preservation Center at the VA Palo Alto.  Dr. Chu is a clinician-scientist with a focus on basic and translational studies in cartilage degeneration, regeneration, and imaging. A distinguished cadet and a graduate of the US Military Academy at West Point, Dr. Chu is very familiar with the military structure and the issues and investigators involved in Dr. Marshall’s study on post-injury OA. She recently chaired the American Orthopaedic Society for Sports Medicine (AOSSM) Post-injury Conference II, with a U13 from NIAMS.


Marian HannanMarian Hannan, DSc MPH: Dr. Hannan will chair the External Advisory Board. She is an Associate Professor at the Institute for Aging Research at Hebrew Senior Life, a teaching affiliate of the Beth Israel-Deaconess Medical Center and Harvard Medical School in Boston. She is Co-Director of Musculoskeletal Research at Hebrew Senior Life and an experienced epidemiologist with research expertise in musculoskeletal epidemiology, foot disorders, genetic analysis interpretation, and arthritis. A former President of the Association of Rheumatology Health Professionals, Dr. Hannan has served in many high-visibility leadership roles in arthritis, including her current role as the Editor-in-Chief of Arthritis Care and Research. Dr. Hannan has directed many of the musculoskeletal studies at the Framingham Study for over 18 years, and since 2002 has been the Principal Investigator on the Framingham Foot Study.


Elena LosinaElena Losina, PhD, MSc: Dr. Losina is Co-Director of the Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) at Brigham and Women's Hospital and Associate Professor of Orthopedic Surgery at Harvard Medical School, as well as Associate Professor of Biostatistics, Boston University School of Public Health. Her work’s focus is to bring rigorous research methods to bear on pressing clinical and policy questions in two spheres – osteoarthritis (OA) and HIV.  In the musculoskeletal area, she serves as the principal investigator of a multidisciplinary team that has developed the OA Policy Model ¾ a computer simulation model of prevention, natural history and treatment for knee OA. Dr. Losina is the Analytic Core Director of a multidisciplinary, international project assessing the prognostic value of serum and imaging biomarkers in knee osteoarthritis. For more than a decade she has served as Principal Investigator of the Methodology Core of the NIAMS-funded P60 Multidisciplinary Clinical Research Center at Brigham & Women’s Hospital.

Stephen MessierStephen Messier, PhD is Professor in Health and Exercise Science and Adjunct Professor in the Department of Internal Medicine, Section on Gerontology and Geriatric Medicine at the Wake Forest University Baptist Medical Center. He is a biomechanist with expertise in osteoarthritis gait analysis and over 20 years’ experience directing large scale translational clinical trials involving non-pharmacologic interventions in older adults with knee osteoarthritis. Dr. Messier has collaborated in research and in training with Dr. Jordan, including the Osteoarthritis Research Society International (OARSI) FDA Initiative, co-authoring with her the white paper on design of clinical trials to prevent OA, and on the OARSI World Congress Program Committee. He has served on multiple grant review study sections for NIAMS and most relevant to this proposal, on the CDC Disease, Disability, and Injury Prevention and Control Special Emphasis Panel in 2008 and the Arthritis Foundation Technology/Biomechanics Study Section since 2006.


Kate T. QueenKate T. Queen, MD is a board-certified, practicing rheumatologist with Mountain Medical Associates in Clyde, North Carolina.  Dr. Queen serves in three distinct leadership roles with Haywood Regional Medical Center as the current Medical Director for Rehabilitation Service, for the Osteoporosis Center and for the Haywood Health and Fitness Center. She is a past member of the Thurston Arthritis Research Center Board of Advisers. She has maintained research relationships with Thurston investigators for over 15 years. Past research projects with UNC have included osteoporosis prevention, genetics of generalized osteoarthritis, physical activity and health literacy.


Howard TennenHoward Tennen, PhD is the Board of Trustees Distinguished Professor at the University of Connecticut School of Medicine. His research addresses the dynamics of stress, coping and health behavior. Most recently, his work has also focused on the study of gene-environment interactions as they emerge in the context of daily stress. Dr. Tennen’s research has examined areas highly relevant to this MCRC, including the study of psychological processes and health behaviors related to chronic pain, including rheumatoid arthritis and fibromyalgia, alcohol use, and asthma. Several of these studies were intervention trials.