Hermes Florez

Closing out the federal fiscal year with another major award, the Miller School of Medicine has received a total of 108 grants worth $58.8 million from the federal government’s infusion of research funds to stimulate the economy and accelerate promising medical breakthroughs.

The $2.9 million grant that Hermes Florez, associate professor of medicine and epidemiology and public health, received in FY 2009-10’s waning weeks to test novel strategies for managing and preventing diabetes is the second largest grant awarded to the Miller School under the American Recovery and Reinvestment Act (ARRA) that President Obama pushed through Congress in February 2009 to mend the economy.

“The Miller School of Medicine has expanded its research portfolio remarkably,’’ noted Miller School Dean Pascal J. Goldschmidt “With the creation of new technology platforms, the Hussman Institute for Human Genomics, Interdisciplinary Stem Cell Institute, and Biomedical Nanoscience Institute, we have revved up collaborations across all laboratories and pillar centers, such as the Bascom Palmer Eye Institute, The Miami Project to Cure Paralysis, Sylvester Comprehensive Cancer Center, Batchelor Children’s Research Institute, the Diabetes Research Institute, the Gordon Center for Research in Medical Education, and the Geriatric Research, Education and Clinical Center, to name just a few. The result is awesome work such as that described in the funded award to Dr. Florez of the Geriatric Center—work that will benefit immensely our patients and fellow humans.’’

Florez’s two-year grant is a fitting bookend to the Miller School’s largest ARRA award, which Lisa Metsch, professor of epidemiology and public health, received to study the effectiveness of HIV prevention counseling at the onset of the stimulus distributions more than a year ago. She and the San Francisco Department of Health were awarded $12.3 million over two years to study the effectiveness of HIV prevention counseling by following 5,000 patients at nine clinics in Washington, D.C., and six states for sexually transmitted diseases, a population at high risk for HIV.

Racing against tight deadlines, Miller School faculty applied for 499 of the total 633 ARRA grants sought by the University, and received 108–or 70 percent–of the 155 grants worth $102.9 million that UM was awarded overall, an effort Richard Bookman, vice provost for research, deemed extraordinary.

“The results of that effort are clear: it worked and the Miller School’s success, in a highly competitive environment with many thousands of competing proposals, is yet another indicator of the success of UM’s investment in research excellence,’’ Bookman said.

Florez, clinical director in the Geriatric Research, Education, and Clinical Center (GRECC) at the Miami Veterans Affairs Healthcare System, said his grant will build on the lessons learned from the Miller School’s previous diabetes prevention research and the Veterans Affairs Diabetes Trial.

Specifically, he and his team of GRECC and UM investigators will test the use of peer counselors and technology to implement the findings of the Diabetes Prevention Program. Conducted at the Diabetes Research Institute, the prevention study showed that older pre-diabetics who adopted exercise routines and healthier diets experienced a 71 percent risk reduction over a three-year period. The long-term follow-up recently showed a four-year delay over a decade in the onset of the disease.

But, Florez said, the cost of providing the case managers, exercise physiologists, nutritionists, and nurses who helped study participants make those lifestyle changes is too high to implement the strategy on a broad scale. As a result, he sought his grant to train peer counselors – patients who already have succeeded at delaying or reducing their diabetes through exercise and diet – to help others 60 and older do the same by, for example, leading exercise classes or sharing prevention messages, as done in the Miami VA Healthcare System with the MOVE! weight management and Enhance Fitness programs.

“It’s empowering,’’ Florez said. “Patients will have an important ally in a peer.’’

He’ll also test a hypothesis that peer-led care alone, or facilitated by technology, is superior to more traditional methods of disseminating information on the management of diabetes, as shown in the Veterans Affairs Diabetes Trial and other major clinical trials. For instance, peer counselors may send daily tips for eating wisely via cell phones.

“This grant is meant to benefit older adults in South Florida at and outside the VA in the Healthy Aging Regional Collaborative, but the beauty of it is, if it works, it can be replicated nationwide,’’ Florez said. “And it can be expanded to other chronic diseases. We could use it for high blood pressure and the prevention of stroke and heart attack.’’