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) and is a Fellow of the American Heart Association.
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 and post-acute care services for survivors of an acute ischemic stroke and is the project PI on two NIH funded studies to examine outcomes after inpatient 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 is leading a multi-site transitional care health care quality collaborative in Ohio funded by the Centers of Disease Control and Prevention and the State of Ohio, and is a co-investigator on the RECOVER Trial in China, a randomized controlled trial of early supported discharge and transitional care in rural China.
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.
|MS||University of Wisconsin - La Crosse|
|BA||University of Western Ontario|
|CTRS||Certified Therapeutic Recreation Specialist|
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
2014 -- Salzer, M.S., Brusilovskiy, E., Prvu Bettger, J., Kottsieper, P. Measuring community participation of adults with psychiatric disabilities: reliability of two modes of data collection. Rehabilitation Nursing. 2014, in press;
2014 -- Pubmed # 24510493 Bushnell, C. D., Reeves, M. J., Zhao, X., Pan, W., Prvu-Bettger, J., Zimmer, L., Olson, D., Peterson, E. Sex differences in quality of life after ischemic stroke. Neurology. February 2014, Epub ahead of print;
2014 -- Pubmed # 24457296 Katzan, I. L., Spertus, J., Bettger, J. P., Bravata, D. M., Reeves, M. J., Smith, E. E., Bushnell, C., Higashida, R. T., Hinchey, J. A., Holloway, R. G., Howard, G., King, R. B., Krumholz, H. M., Lutz, B. J., Yeh, R. W., on behalf of the American Heart Association Stroke Council, Council on Quality of Care, Outcomes Research, Council on Cardiovascular, Stroke Nursing, Council on Cardiovascular Radiology, Intervention, Council on Cardiovascular Surgery, Anesthe, Risk Adjustment of Ischemic Stroke Outcomes for Comparing Hospital Performance: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. January 23, 2014;
2013 -- Pubmed # 23677444 Byrne, T., Prvu Bettger, J., Brusilovskiy, E., Wong, Y. I., Metraux, S., Salzer, M. S. Comparing neighborhoods of adults with serious mental illness and of the general population: research implications. Psychiatr Serv. August, 2013; 64(8); 782-8
2013 -- Buck, H. G., Akbar, J. A., Zhang, S. J., Prvu Bettger, J. A. Measuring comorbidity in cardiovascular research: A systematic review. Nursing Research and Practice. July, 2013; 2013 ID 563246, 11 pp.
2013 -- Pubmed # 24339099 Abbott, K. M., Bettger, J. P., Hampton, K. N., Kohler, H. The feasibility of measuring social networks among older adults in assisted living and dementia special care units. Dementia (London). July 8, 2013 (Online First);
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
2013 -- Prvu Bettger, J., Lupo, B., Nichols, K., Smith, K., Windes, E., Darden-Fluker, T. Hospital readmission among stroke patients who received post-hospital care: A systematic review. International Journal of Physical Medicine and Rehabilitation. 2013; 1(4); 137
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 -- Pubmed # 24422946 Williams, J. W., Jackson, G. L., Powers, B. J., Chatterjee, R., Bettger, J. P., 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). Evid Rep Technol Assess (Full Rep). July, 2012; 1-210
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(20); 1590-5
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.e7-11 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
Comparative effectiveness of rehabilitation services for survivors of an acute ischemic stroke
Patient-Centered Outcomes Research Institute (PCORI)
PCORI ID 130
Project Goals: This project’s purpose is to determine the best options for rehabilitation and the potential for recovery given stroke survivors’ needs.
RECOVER Trial (A randomized controlled trial on rehabilitation through caregiver-delivered nurse-organized service programs for disabled stroke patients in rural China)
China Medical Board
This project will develop, implement, and evaluate an evidence-based caregiver-delivered Early Supported Discharge (ESD) stroke rehabilitation program designed to improve the physical functioning of disabled stroke patients in rural China.
Administrative Data Linkage to Examine Outcomes after Inpatient Rehabilitation
Role: Project PI
This study will examine the degree to which patient and health-system characteristics are associated with the total number of days spent at home within 180 days of the index acute hospital admission (“home-time”) for the highest users of inpatient rehabilitation care.
ODH-Coverdell Acute Stroke Registry Program
Centers for Disease Control and Prevention/Ohio Department of Health
The aims of this project are to implement and evaluate multi-site transitional care intervention to prevent hospital readmissions for stroke survivors.
Cognitive Status Changes Among Stroke Patients Receiving Acute Rehabilitation
National Institutes of Health
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.
Post-stroke PERQ (Partnership Examining Rehabilitation Quality)
Duke University School of Nursing Small Grant Project
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
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
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.
Effectiveness of Post-acute Care for Elderly Stroke Survivors
Duke Mentored Comparative Effectiveness Research Scholar Program (AHRQ)
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.
Social Networks in Long-Term Care: Feasibility Pilot for Enhancing Existing Approaches to Measurement.
Institute on Aging, University of Pennsylvania
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.
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
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.
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
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.
Rehabilitation Research and Training Center on Participation and Community Living of Individuals with Psychiatric Disabilities
National Institute of Disability and Rehabilitation Research
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.
Health Related Quality of Life: Elders in Long-Term Care
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
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
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
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
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
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
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.
Give today and make an impact on the students and faculty of tomorrow.
Summer 2011 | Vol. 7 No. 2
Pushing the Boundaries