|ST«!NY BR«#K Long Island WTC Health Program Stony Brook University Medical School Geography Nassau and Suffolk counties 1,200 square miles, suburban - Goal: Accessible and Convenient Options - 2 Clinical Centers on in each county I 9 Islandia, Suffolk County: Central hub for the Lonj Island Clinical Center of Excellence. Affiliated with Stony Brook Medical Center. • Garden City, Nassau County: Affiliated with Winthrop University Hospital. Brooklyn- New clinic to open at SUNY- Downstate Medical Center. |ST«!NY BR«#K Long Island Clinical Center of Excellence (Nassau and Suffolk) i-i» : 4*Sflf!" E **£WlL • Cohort size is 6,205 responders. By the end of Year 7, our retention rate was in the enrolled in Treatment Program - 2,900 active patients (seen past 12 months) and - 4,200 ever enrolled. 50% traditional 1 st responder. 50% non-traditional responder (construction and various trades). Growth of LI Clinic over 7 Years |ST«!NY BR«#K Collaborative Care Treatment Model ftffi E (internists, clinical social workers and specialists) and care across illness and health domains, for example, management of pulmonary disease that is comorbid with PTSD. Result: - Cost-effective - Comprehensive - Better management of complex cases - Increase adherence - Overcame barriers to treatment: • Provider Lack of Availability • Financial Barriers • Geographic Barriers Exposure, Probable PTSD, and Lower Respiratory Illness among World Trade Center Rescue, Recovery, and Clean-up Workers Luft et al. (in press). Psychological Medicine. • Physical illness and PTSD have been linked in various populations. 8,508 police and 12,333 non-traditional responders examined at the WTC Health Program PTSD and respiratory symptoms were correlated (r = 0.28). PTSD statistically mediated the association of WTC exposures with respiratory symptoms. The link between PTSD and respiratory symptoms is notable, supports integrated medical and psychiatric treatment for disaster responders. 'Burden of mental-physical comorbidity' E. Bromet, R. Kotov, B. Luft Identify mechanisms responsible for the comorbidity - Psychiatric: PTSD, anxiety, depression - Medical: lower respiratory symptoms, asthma, abnormal lung function, GERD, hypertension Telephone interviews with 5,000 patients from all of the clinics - Quality of life, health risk perceptions, and PTSD diagnosis Compare outcomes at Islandia, which provides integrated medical and psychiatric care, with other patients receiving "usual" care - Control for Visit 1 demographic and illness characteristics "Enhanced smoking cessation intervention" R. Kotov, E. Bromet, B. Luft Key risk factors to pulmonary problems: smoking & PTSD PTSD makes quitting more difficult, enhanced treatment (smoking cessation + psychotherapy) is needed Study will compare, in a randomized clinical trial, the effect of enhanced treatment vs. standard treatment on 1 . Abstinence from tobacco 2. PTSD symptoms 3. Respiratory symptoms 100 smokers with PTSD symptoms will be randomized Develop a powerful new intervention for a difficult to treat group of WTC responders WTC Oral History Project E about their personal experiences and its impact 10 years later. Purpose: - Document the human perspective of the WTC disaster. - Focus on personal stories from the Responder perspective. — Wiahliaht thpir motivations valnp.s QtniaalpQ anH rp.sili p.nr.v - Expand our knowledge about the disaster beyond the medical effects. - Develop a resource for future generations to learn about 9/11. Library of Congress will provide a permanent home in the American Folklife Center.