Brief Bio

Janet Prvu Bettger, ScD, FAHA is an assistant professor and health services researcher at the Duke University School of Nursing and Duke Clinical Research Institute (DCRI), and a Senior Fellow of the Duke Center for the Study of Aging and Human Development. She serves as a Senior Scientist for the Duke Translational Nursing Institute (DTNI), a member of the Duke University Health System Evidence-based Practice Nursing Council, and was a co-investigator of Duke’s AHRQ funded Evidence-based Practice Center.

Dr. Bettger’s research is dedicated to improving health care quality and care coordination for older adults with chronic conditions, particularly stroke and those at risk for functional decline or rehospitalization. She is the principal investigator (PI) on a Patient-Centered Outcomes Research Institute (PCORI) grant to study the comparative effectiveness of rehabilitation services for survivors of an acute ischemic stroke. As a project PI for Duke’s NINR funded ADAPT Center she is studying cognitive status changes among stroke patients receiving acute rehabilitation. Related to these large database studies is the implementation research she leads on transitional care and interdisciplinary interventions to prevent adverse events.

Dr. Bettger received her BA from the University of Western Ontario, Canada and her MS from the University of Wisconsin–LaCrosse where she studied community reintegration for stroke and brain-injured patients transitioning from hospital to home. Her doctoral training in Rehabilitation Sciences, completed at Boston University, concluded with an investigation of patterns of functional recovery and factors affecting outcomes in patients transitioning home following acute rehabilitation. While working on her doctorate, she also worked in state government as the director of the Paul Coverdell National Acute Stroke Registry. Dr. Bettger completed post-doctoral training at the University of Pennsylvania with a NIH NRSA research fellowship in neurorehabilitation, a research fellowship at the NewCourtland Center for Transitions and Health, and a Switzer Fellowship funded by the National Institute on Disability and Rehabilitation Research to study the role of the environment on functional outcomes. She completed additional research training at Duke as a mentored scholar in comparative effectiveness research funded by AHRQ.

Academic Program Affiliations

PhD in Nursing Program
Doctor of Nursing Practice Program
Master of Science in Nursing Program

Education

ScD	Boston University
MS	University of Wisconsin - La Crosse
BA	University of Western Ontario

Professional Certifications

CTRS	Certified Therapeutic Recreation Specialist

Research Interests

Dr. Prvu Bettger's areas of research interest include quality of care, care coordination, access to care, transitions in care, organizational change and quality improvement, team-based care, integration of health and social service systems, comparative effectiveness, function and participation outcomes, stroke rehabilitation and recovery, social networks, and social environment.

Awards and Honors

• 2010 Associate Fellow, Center for Public Health Initiatives, University of Pennsylvania

• 2010 Fellow, American Heart Association/American Stroke Association (FAHA)

• 2008 Helen B. Spaulding Stroke Community Service Award, American Heart Association, Northeast Affiliate

• 2008 Switzer Research Fellow, (DoE - NIDRR)

• 2007 Provost Interdisciplinary Seminar Fund Award, University of Pennsylvania

• 2006 Best Poster Presentation, American Congress of Rehabilitation Medicine-American Society of Neurorehabilitation Joint Conference: Translating Research into Practice (Boston, MA)

• 2006 Inducted, Sigma Xi

• 2006 Research Fellow in Neurorehabilitation, Physical Medicine and Rehabilitation, University of Pennsylvania

• 2004 Fellowship, 5th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke (Washington, DC)

• 1999 Graduate Student Achievement Award, University of Wisconsin–La Crosse College of Health, Physical Education, Recreation and Teaching Education

• 1999 “Up & Coming” Professional of the Year, New England Therapeutic Recreation Association

• 1998 Inducted, Rho Phi Lambda Honor Society

• 1998 Peg Connolly Scholarship Award, American Therapeutic Recreation Association

• 1997 Professional Development Travel Awards (4), University of Wisconsin–La Crosse

Areas of Expertise

• Chronic Illness
• Gerontology
• Quality of Care / Patient Safety
• Translational Research

Areas of Interest

• Neurorehabilitation
• Stroke
• Public health
• Aging
• Health care quality
• Translating research into practice
• Health policy

Representative Publications

• 2013 -- Abbott, K., Prvu Bettger, J., Hampton, K, Kohler, H. P. The feasibility of measuring social networks among older adults in assisted living and dementia special care units. Dementia: The International Journal of Social Research and Practice. 2013, in press;

• 2013 -- Bryne, T., Brusilovskiy, E., Prvu-Bettger, J., Metraux, S., Wong, Y. L. I., Salzer, M. Comparing neighborhood characteristics of adults with serious mental illness and members of the general population in Philadelphia: Implications for research on determinants of community integration. Psychiatric Services. 2013, in press;

• 2013 -- Jackson, G. L., Powers, B. J., Chatterjee, R., Bettger, J. Prvu, Kemper, A. R., Hasselblad, V., Dolor, R. J., Irvine, R. J., Heidenfelder, B. L., Kendrick, A. S., Gray, R., Williams Jr., J. W., Jr. The patient-centered medical home: A systematic review. Annals of Internal Medicine. February 5, 2013; 158(3); 169-178

• 2013 -- Pubmed # 22858797 Prvu Bettger, J. A., Kaltenbach, L., Reeves, M. J., Smith, E. E., Fonarow, G. C., Schwamm, L. H., Peterson, E. D. Assessing stroke patients for rehabilitation during the acute hospitalization: findings from the get with the guidelines-stroke program. Arch Phys Med Rehabil. January, 2013; 94(1); 38-45

• 2012 -- Pubmed # 22292979 Abbott, K. M., Bettger, J. P., Hanlon, A., Hirschman, K. B. Factors associated with health discussion network size and composition among elderly recipients of long-term services and supports. Health Commun. November, 2012; 27(8); 784-93

• 2012 -- Pubmed # 22929378 Abbott, K. M., Bettger, J. P., Hampton, K., Kohler, H. Exploring the use of social network analysis to measure social integration among older adults in assisted living. Fam Community Health. October, 2012; 35(4); 322-33

• 2012 -- Pubmed # 22929373 Bettger, J. P. Foreword: the social environment supporting elder health: an exploration of social ties, networks, and resources. Fam Community Health. October, 2012; 35(4); 274-5

• 2012 -- Pubmed # 23095974 Bettger, J. P., Granger, B. B. Engaging research partners to advance clinical inquiry. AACN Adv Crit Care. October 1, 2012; 23(4); 471-6

• 2012 -- Pubmed # 22949273 Bettger, J. P. Clinical inquiry in stroke: using different perspectives to guide future research. Rehabil Nurs. September-October, 2012; 37(5); 213-4

• 2012 -- Pubmed # 22986378 Prvu Bettger, J., Alexander, K. P., Dolor, R. J., Olson, D. M., Kendrick, A. S., Wing, L., Coeytaux, R. R., Graffagnino, C., Duncan, P. W. Transitional care after hospitalization for acute stroke or myocardial infarction: a systematic review. Ann Intern Med. September, 2012; 157(6); 407-16

• 2012 -- Pubmed # 22902975 Bettger, J. P., Sochalski, J. A., Foust, J. B., Zubritsky, C. D., Hirschman, K. B., Abbott, K. M., Naylor, M. D. Measuring nursing care time and tasks in long-term services and supports: one size does not fit all. J Nurs Res. September, 2012; 20(3); 159-68

• 2012 -- Williams, J.W., Jackson, G.L., Powers, B., Chatterjee, R., Prvu Bettger, J., Kemper, A.R., Hasselblad,V., Dolor, R.J., Irvine, R.J., Heidenfelder, B.L., Kendrick, A.S., Gray, R. Closing the Quality Gap: Revisiting the State of the Science, Vol. 2: The Patient-Centered Medical Home. Evidence Report/Technology Assessment No. 208.2 July, 2012;

• 2012 -- Pubmed # 22551730 Skolarus, L. E., Meurer, W. J., Burke, J. F., Prvu Bettger, J., Lisabeth, L. D. Effect of insurance status on postacute care among working age stroke survivors. Neurology. May, 2012; 78

• 2012 -- Pubmed # 22305129 Metraux, S., Brusilovskiy, E., Prvu-Bettger, J. A., Irene Wong, Y., Salzer, M. S. Geographic access to and availability of community resources for persons diagnosed with severe mental illness in Philadelphia, USA. Health Place. May, 2012; 18(3); 621-9

• 2012 -- Pubmed # 22514061 Buck, H. G., Meghani, S., Bettger, J. P., Byun, E., Fachko, M. J., O'Connor, M., Tocchi, C., Naylor, M. The use of comorbidities among adults experiencing care transitions: a systematic review and evolutionary analysis of empirical literature. Chronic Illn. April, 2012; 20(3); 159-168

• 2012 -- Pubmed # 22339774 Granger, B. B., Prvu-Bettger, J., Aucoin, J., Fuchs, M. A., Mitchell, P. H., Holditch-Davis, D., Roth, D., Califf, R. M., Gilliss, C. L. An academic-health service partnership in nursing: lessons from the field. J Nurs Scholarsh. March, 2012; 44(1); 71-9

• 2012 -- Prvu Bettger, J. A. Care coordination (Chapter 47). In Concepts for Nursing Practice, edited by Giddens, J. F. March, 2012; St. Louis, MO: Elsevier Mosby.

• 2012 -- Pubmed # 21450235 Hirschman, K. B., Abbott, K. M., Hanlon, A. L., Prvu Bettger, J., Naylor, M. D. What factors are associated with having an advance directive among older adults who are new to long term care services? J Am Med Dir Assoc. January, 2012; 13(1); 82.e7-82.e11 PMCID: PMC3134595

• 2011 -- Pubmed # 23126647 Furlan, A. D., Olson, D. M., Bettger, J. P., Alexander, K. P., Kendrick, A. S., Irvine, J. R., Wing, L., Coeytaux, R. R., Dolor, R. J., Duncan, P. W., Graffagnino, C. Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention. Evid Rep Technol Assess (Full Rep). October 1, 2011; 1-197

• 2011 -- Olson, D. W., Prvu Bettger, J., Alexander, K. P., Kendrick, A. S., Irvine, J. R., Wing, L., Coeytaux, R. R., Dolor, R. J., Duncan, P. W., Graffagnino, C. Transition of Care for Acute Stroke and Myocardial Infarction Patients: From Hospitalization to Rehabilitation, Recovery, and Secondary Prevention (AHRQ Evidence Report No. 202). AHRQ Publication No. 11(12)-E011-EF. October, 2011;

• 2010 -- Naylor, M. D., Coburn, K. D., Kurtzman, E. T., Prvu Bettger, J. A.,, Buck, H., Van Cleave, J., Cott. C. inter-professional team-based primary care for chronically ill adults: State of the science. [White Paper commissioned by the American Board of Internal Medicine (ABIM) Foundation]. 2010;

• 2009 -- Pubmed # 18997471 Prvu-Bettger, J. A., Bates, B. E., Bidelspach, D. E., Stineman, M. G. Short- and long-term prognosis among veterans with neurological disorders and subsequent lower-extremity amputation. Neuroepidemiology. December, 2009; 32(1); 4-10 PMCID: PMC2790599

• 2009 -- Pubmed # 19528388 Stineman, M. G., Kurichi, J. E., Kwong, P. L., Maislin, G., Reker, D. M., Vogel, W. B., Prvu-Bettger, J. A., Bidelspach, D. E., Bates, B. E. Survival analysis in amputees based on physical independence grade achievement. Arch Surg. June, 2009; 144(6); 543-51; discussion 552 PMCID: PMC2869628

• 2009 -- Pubmed # 19238103 Kurichi, J. E., Small, D. S., Bates, B. E., Prvu-Bettger, J. A., Kwong, P. L., Vogel, W. B., Bidelspach, D. E., Stineman, M. G. Possible incremental benefits of specialized rehabilitation bed units among veterans after lower extremity amputation. Med Care. April, 2009; 47(4); 457-65 PMCID: PMC2865891

• 2008 -- Pubmed # 18929014 Stineman, M. G., Kwong, P. L., Kurichi, J. E., Prvu-Bettger, J. A., Vogel, W. B., Maislin, G., Bates, B. E., Reker, D. M. The effectiveness of inpatient rehabilitation in the acute postoperative phase of care after transtibial or transfemoral amputation: study of an integrated health care delivery system. Arch Phys Med Rehabil. October, 2008; 89(10); 1863-72 PMCID: PMC2880880

• 2008 -- Pubmed # 18791405 Smith, E. E., Dreyer, P., Prvu-Bettger, J., Abdullah, A. R., Palmeri, G., Goyette, L., McElligott, C., Schwamm, L. H. Stroke center designation can be achieved by small hospitals: the Massachusetts experience. Crit Pathw Cardiol. September, 2008; 7(3); 173-7

• 2008 -- Pubmed # 18586128 Prvu Bettger, J. A., Coster, W. J., Latham, N. K., Keysor, J. J. Analyzing change in recovery patterns in the year after acute hospitalization. Arch Phys Med Rehabil. July, 2008; 89(7); 1267-75

• 2007 -- Pubmed # 17964900 Prvu Bettger, J. A., Stineman, M. G. Effectiveness of multidisciplinary rehabilitation services in postacute care: state-of-the-science. A review. Arch Phys Med Rehabil. November, 2007; 88(11); 1526-34

• 2006 -- Pubmed # 17141635 Keysor, J. J., Jette, A. M., Coster, W., Bettger, J. P., Haley, S. M. Association of environmental factors with levels of home and community participation in an adult rehabilitation cohort. Arch Phys Med Rehabil. December, 2006; 87(12); 1566-75

• 2006 -- Prvu Bettger, J. A., Schwamm, L. H. Implementation of JCAHO and state-based designation of specialized centers for acute ischemic stroke care. Stroke: Clinical Updates. Nov.-Dec., 2006; 16(6); 1-7

• 2005 -- Prvu Bettger, J. A. Massachusetts Department of Health statewide stroke prevention and control. National Association of Chronic Disease Directors, State Success Stories, Massachusetts. 2005;

• 2005 -- Croft, J. B., Prvu, J., Lawton, L., Howard, T., Boisseau, B., Carte, A., Hayashi, T., Lembach, J., Griffies, A., Penman, A., Smith, J. Scientific capacity (Chapter 1) In National Stroke Association Stroke Program Implementation Guide, edited by 2005; pp. 1-35. Centennial, CO: National Stroke Association.

• 2001 -- Prvu, J., Schwamm, L. H. Focus on Operation Stroke. Massachusetts Peer Review Organization Quality Improvement Newsletter. Summer, 2001; 7(2); 1

• 1999 -- Prvu, J. A., Navar, N., Yaffe, R. The effects of leisure education on leisure satisfaction, leisure participation, and self-confidence for individuals with brain injuries. (Abstract) Microform Publications of Human Movement Studies. October, 1999; 12(2); 35

• 1999 -- Prvu, J., Gushiken, T. T. Accessing therapeutic recreation over the internet: Bringing accessibility to the net. Parks & Recreation. May, 1999; 34(5); 22

Grant Funding (selected)

• Comparative effectiveness of rehabilitation services for survivors of an acute ischemic stroke  
  Patient-Centered Outcomes Research Institute (PCORI)
  PCORI ID 130
  03/2013-02/2016
  Project Goals: This project’s purpose is to determine the best options for rehabilitation and the potential for recovery given stroke survivors’ needs.

• Cognitive Status Changes Among Stroke Patients Receiving Acute Rehabilitation  
  National Institutes of Health
  1P30-NR014139-01
  09/2012-06/2017
  Role: Project PI
  P30 Grant Title: Center for Adaptive Leadership in Symptom Science. Project description within the center: Cognitive Status Changes Among Stroke Patients Receiving Acute Rehabilitation. Project goals: To explore the trajectory of cognitive status among acute stroke patients, the association of patient sociodemographic and clinical characteristics, the mediating effects of stroke sequelae, and the independent predictors of length of stay. Center: The proposed Center of Excellence (P30), “Adaptive Leadership for Cognitive/Affective Symptom Science (ADAPT)” at Duke University School of Nursing will promote biobehavioral research to advance symptom science using a new lens—the Adaptive Leadership (AL) framework—to conceptualize and study cognitive/affective symptoms, and/or intervene in ways that promote patients’ and their family caregivers’ adaptive abilities.

• Effectiveness of Post-acute Care for Elderly Stroke Survivors  
  Duke Mentored Comparative Effectiveness Research Scholar Program (AHRQ)
  K12-HS019479
  09/2010-09/2013
  Role: K-12 Mentored Scholar
  K12 grant title: Training in Comparative Effectiveness Research. This is an institutional training grant to Duke University in support of developing scholars in comparative effectiveness research. Specific project: effectiveness of post-acute care for elderly stroke survivors.

• Post-stroke PERQ (Partnership Examining Rehabilitation Quality)  
  Duke University School of Nursing Small Grant Project
  05/2012-04/2013
  Role: Principal Investigator (effort under K award)
  The aim of this project is to study the relationship between stroke patient characteristics and physical function and self-care at discharge from inpatient rehabilitation.

• Stroke Rehabilitation Outcomes Evaluation  
  Cannon Research Center, Carolinas Medical Center
  04/2012-03/2013
  Role: Co-PI (effort under K award)
  The aims of this project are to identify the person-level sociodemographic and clinical characteristics associated with stroke patient outcomes at discharge and at 3-months.

• Closing the Quality Gap Series: The Medical Home  
  Agency for Healthcare Research and Quality (AHRQ)
  HHSA 290-2007-10066-I, T.O.9
  09/2011-07/2012
  Role: Co-Investigator
  The aim of this project is to systematically review the evidence for patient centered medical homes designed to support the health and wellness for community-dwelling children and adults. The results of the review will be integrated into the AHRQ Closing the Quality Gap Series for advancing evidence-based primary care.

• Social Networks in Long-Term Care: Feasibility Pilot for Enhancing Existing Approaches to Measurement.  
  Institute on Aging, University of Pennsylvania
  07/2010-06/2011
  Role: Co-Investigator
  The proposed pilot study is designed to evaluate the feasibility of recruiting, consenting, enrolling and interviewing long-term care providers, elders in long-term care of different genders, race, ethnicity, and levels of cognitive impairment, and elders’ caregivers.

• Social Networks in Long-Term Care: Pilot Testing Novel Approaches to Measurement  
  Francis E. Parker Memorial Home, Inc.
  07/2010-06/2011
  Role: Co-PI
  The proposed pilot study is designed to evaluate the feasibility of a sociocentric approach to data collection and social network analyses for elders in long-term care.

• Transitions of Care for Acute Stroke and Myocardial Infarction Patients from Hospitalization to Rehabilitation, Recovery and Secondary Prevention  
  Agency for Healthcare Research and Quality (AHRQ)
  HHSA 290-2007-10066-I EPC3 T.O.#7
  05/2010-07/2011
  Role: Co-investigator
  Project goal: The aim of this 12-month project is to systematically review the evidence for transitional services and programs that improve the post-hospitalization quality of care for patients who have suffered heart attacks and strokes. The results of the review will be directed to CDC for use in guiding development of a post-acute stroke quality of care program.

• Rehabilitation Research and Training Center on Participation and Community Living of Individuals with Psychiatric Disabilities  
  Department of Education National Institute of Disability and Rehabilitation Research
  H133B080029
  10/2008-09/2013
  Role: Co-investigator (2008-2010)
  The research of this center focuses on enhancing the capacity of individuals and systems to maximize participation and community living through the advancement of theory, measures, methods, and intervention knowledge.

• Physical and Social Environmental Factors that Influence Health and Participation Outcomes for Chronically-Ill Adults  
  Department of Education, National Institute on Disability and Rehabilitation Research
  H133F080014
  07/2008-06/2009
  Role: Principal Investigator
  The primary purpose of this study was to examine contextual factors of the social and physical neighborhood environment as potential contributors to health and participation outcomes among older adults with chronic conditions who are living in the community with or without disabilities, or represent an underserved population.

• Health Related Quality of Life: Elders in Long-Term Care  
  NIH/NIA, NINR
  5R01AG025524
  09/2006-05/2011
  Role: Research Associate
  This is a longitudinal, prospective, descriptive study to assess changes in the multiple domains of health related quality of life among elders new to long term care.

• Research Training in Neurological Rehabilitation  
  NIH/NICHD
  5T32HD007425
  07/1992-04/2012
  Role: NRSA Postdoctoral Research Fellow for 2006-2007
  This institutional training grant to the University of Pennsylvania School of Medicine, Department of Physical Medicine and Rehabilitation, supported postdoctoral research training in neurorehabilitation.

• Cardiovascular Health Program Stroke Registry Supplement (Paul Coverdell National Acute Stroke Registry)  
  Centers for Disease Control and Prevention
  4U50CCU121351
  06/2003-06/2007
  Role: Project Director, Consultant
  This project established a statewide acute care data registry of all patients treated for acute stroke in all Massachusetts hospitals. The data was used to support a 69 hospital quality improvement project.

• Rehabilitation for Self-Management of Parkinson’s Disease  
  NIH/NINDS
  3R01AG021152
  06/2003-05/2006
  Role: Graduate Research Associate
  The overall goal of the proposed research is to determine whether rehabilitation that focuses on self-management of health helps to improve the day-to-day functioning and quality of life of community-living clients with Parkinson's disease (PD), beyond the effects of medical treatment alone.

• State Cardiovascular Health Programs  
  Centers for Disease Control and Prevention
  CDC: 5U50CCU121351
  06/2002-06/2007
  Role: Project Manager, Coordinator of Stroke Initiatives
  This was a capacity building grant to develop a statewide plan for heart disease and stroke prevention and control.

• Boston Operation Stroke Study of Pre-hospital and Hospital Stroke Care  
  Blue Cross Blue Shield of Massachusetts
  07/2000-06/2002
  Role: Project Director
  This study examined the feasibility of prospectively collecting data on clinical processes and stroke patients from stroke onset in the community through hospital discharge.

• Leisure Education and Counseling, Leisure Lifestyle Center  
  Department of Education Rehabilitation Services Administration
  H128 700002
  10/1997-09/2001
  Role: Research Assistant
  The center was designed to incorporate clinical experience into the Therapeutic Recreation curriculum while providing a valuable service to clients in the community by providing individualized leisure assessments and leisure guidance.