FOUNDER

Otho Sylvester Arnold Sprague was born in East Randolph, Vermont on May 13, 1839. Educated at Kimball Union Academy in Meridian, New Hampshire, he began his career as an employee of a general store in Vermont. Ultimately, he bought an interest in that store. After the outbreak of the Civil War, he enlisted and served in New Orleans. With failing health, he returned to Vermont. On recovery, he journeyed to Chicago to join his older brother, Albert. Together with Ezra Warner, Otho and Albert formed Sprague, Warner & Co., a firm that became the nation's largest wholesale grocer. Otho Sprague rose to civic leadership, prominence and wealth becoming one of the foremost builders of the Chicago's commercial interests. He was a founder and patron of The Art Institute and the Chicago Symphony Orchestra and member of numerous civic and business groups. He married Lucia Elvira Atwood. They had four children: Mary Sprague Miller, Lucy Sprague, Nancy A. Sprague and Albert A. Sprague II. Compelled by ill health to relinquish his business and civic responsibilities, Mr. Sprague moved to Pasadena, California, where he died of tuberculosis on February 21, 1909.

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HISTORIC OVERVIEW

Through Articles of Agreement dated January 15, 1906, and codicils thereto, Otho Sprague invested his brother, Albert, with the responsibility of implementing a philanthropic program. He stipulated that the assets he transferred to him be held, used and appropriated to some public charitable use in the City of Chicago administered either in the establishment of some new charity, or in carrying on the work of some existing charity. He further stipulated the funds be used for the investigation of the causes of disease and the prevention and relief of human suffering.

In addition to his brother, Mr. Sprague appointed Martin A. Ryerson, Charles L. Hutchinson, A.C. Bartlett, John P. Wilson, Byron L. Smith and his son, Albert A. Sprague II, to help in the management of such charity, thereby establishing an uninterrupted chain of self-perpetuating volunteer stewardship that continues through this day.

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CHARTERED IN 1910

On June 17,1910, Albert A. Sprague filed documents to create a new corporation, the Otho S.A. Sprague Memorial Institute. On June 30, 1910, he received a charter creating the Otho S.A. Sprague Memorial Institute and making it one of only 18 such foundations in the nation.

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INITIAL PROGRAMS

The Charter Trustees were influenced by a 1910 report from the Carnegie Foundation that declared "in respect to medical education, the City of Chicago is the plague of the country." With 14 of the nation's 158 medical schools, Chicago had 10 diploma mills and 4 schools of distinction. These four became the partners for the new Institute.

In April of 1911, Drs. Frank Billings (a president of the AMA), Ludvig Hektoen (researcher in cirrhosis of the liver) and James B. Herrick (discoverer of sickle cell anemia) presented a plan to The Institute's Trustees. They recommended using existing hospital facilities to do research, to support the visiting nurses, and to create several fellowships. Dr. H. Gideon Wells (a pioneer in chemical aspects of immunity) was engaged to be the Research Director of the new program at a salary of $2,000 per year. Rather than investing in new facilities, the Trustees determined that their new programs would support promising researchers working at credible institutions. The first programs were housed at the Presbyterian Hospital and Rush Medical College.

With an abundance of medical problems and no vaccines, antibiotics, or vitamins, the field was wide open. The Institute's early program of research focused on cancer, the effects of chemotherapy on tuberculosis, industrial diseases and the metabolism of carbohydrates affecting diabetes. Additional grants were made to Children's Memorial Hospital and to the Infant Welfare League, as well. These early researchers pioneered the use of insulin to control diabetes, performed lung surgeries to stem the effect of cigarettes on lung cancer, researched tuberculosis and studied environmental factors, like coal dust, for their impact on health. In 1913, mental diseases - specifically chemical treatments of dementia praecox (schizophrenia) and allied conditions were added to the research program.

By 1915, The Institute supported a staff of 20 working at the University of Chicago, Children's Memorial, Cook County Hospital, St. Luke's Hospital and Presbyterian Hospital-Rush Medical College. Within 10 years, the scientific staff and their families were provided with benefits and pensions, in addition to challenging research opportunities.

Institute records are full of publication titles, successful and failed research projects and anecdotes about the program. Among those highlighted from the early years were:

• Dr. Rollin T. Woodyatt became an international expert on diabetes and was actively involved in the trials of insulin.


• Maud Slye, an Institute researcher at the University of Chicago was hailed for her 38 years of work in breeding mice used in liver tumor and cancer research. She autopsied 150,000 mice during her career!


• Sprague Investigators, Dr. George and Gladys Dick began studying treatments for polio. During their effort, they discovered the cause of scarlet fever, a scourge of their time.


• Dr. Henry Helmholz became a renowned pediatrician and founded the Pediatric Section at the Mayo Clinic.


• Dr. Evarts Graham was among the first to note the relationship of lung cancer to cigarettes.


• Dr. Henry Corper became the area's foremost investigator of tuberculosis, a disease that he contracted, but continued to research.

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WARTIME CHANGES AND TRANSITIONS

During World War I, Sprague researchers pursued wartime topics including the effects of toxic agents. In the post war years, The Institute turned to research in pathology, bacteriology, biochemistry, psychology and psychiatry. A special funding relationship with the University of Chicago spanned 23 years between the wars. With the advent of World War II, The Institute shifted focus and sponsored efforts reflecting the concerns of the day - neurologic and neuropsychologic, spatial and sensory research. These topics resulted from the traumas faced by soldiers and the need for enhanced weaponry. As part of the wartime effort, Institute teams sought to produce artificial blood - to no avail.

During the post-war years, the program again transitioned and the Board established block grants. The Institute pursued this strategy as federal funding of medical research began to swell, eclipsing the role of private philanthropy. Through guaranteed funding and seed grant research support, The Institute attempted to find a niche in a shifting research environment. The beneficiaries were Presbyterian-St. Luke's Hospital, the University of Chicago, Northwestern University and Children's Memorial Hospital. Funds were largely controlled by Deans, with concurrence of the Board's lay trustees. A variety of topics were supported ranging from cardiovascular research, organ transplant rejection, hormone influences, gastric disease, radiation treatments for cancer, pediatric anesthesia problems, kidney disease and dialysis research, and pediatric surgery techniques. The 1966 report of The Institute took a retrospective look at what had been accomplished. It catalogued an impressive list of scientific papers, enhanced bio-medical careers and a cumulative grant total of $6 million.

While The Institute pioneered in research, it also pioneered in philanthropy. As one of the nation's oldest foundations, in 1965 it was invited to membership in the newly created Council on Foundations. This relationship proved valuable to the Trustees, as they were forced to grapple with changing regulatory and fiscal issues affecting grantmakers over the next twenty years.

During the 1970s and '80s the Institute continued its policy of three year Term Grants to medical research institutions to support individual investigators and teachers. It also created Annual and Supplementary Grants. In 1975, in recognition of The Institute's longstanding support, Sprague Professors were appointed at the University of Chicago, Rush Presbyterian St. Luke's and Northwestern University. These named professorships continue to this day.

As the grants program continued along a predictable path, the Trustees became concerned with investment return. After considered debate, the portfolio was divided between two managers with counter-balancing investment styles, William Blair & Company and Harris Investment Management, Inc. This arrangement continues to the present time. In 2001, its effectiveness was tested by an independent consultant, who praised The Institute's approach and outcomes.

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FOCUS

Under the leadership of Vernon Armour, as financial issues were resolved, the Board turned its attention to programmatic and governance concerns. On May 23,1989, the Board retained James N. Alexander of Alexander Associates to review the administration and programs of The Institute. After delivering a report of his observations and recommendations, he was retained as a consultant to The Institute. In 1992, he assumed the administrative responsibilities for The Institute previously handled by Tom Macior of the Harris Bank.

The Institute's governance model also was changed to better utilize the expertise of volunteer Board members through more active committees. Proposal review and monitoring were vested in a Program & Grant Committee. With several new Directors, the Institute charged this group with identifying new program options. In 1992, Ada Mary Gugenheim, Chair of the Program & Grant Committee, Edward K. Chandler, Board Vice President and James Alexander devised a new model that balanced Research, Direct Service and Policy Studies. Recognizing that Institute funds were limited, the model encouraged support to smaller, more community-based initiatives, where impact and outcomes were more easily assessed. While relations continued with major medical centers, the projects supported were different. The Institute established a philosophy of enabling, rather than sustaining grants, which was more in keeping with its budget and catalytic role.

In 1994, Director, Charles Haffner, III wrote a letter expressing his concern that The Institute had reached a crossroad. He noted the complexity of managing a program of bio-medical research, the dissatisfaction with some of the grants to the three medical centers and the need to spend more time on task, if the program was to stay true to its mission. He called for study and change. While others recommended disbursing the endowment, or transferring it to another charity, he suggested the Board focus the program


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THE CHICAGO ASTHMA INITIATIVE

The Board heeded Mr. Haffner's recommendation and through a series of focus groups identified asthma as an under-funded, but significant, health problem for Chicago and other parts of the nation. As newly elected President, Mr. Haffner proposed a multi-year focus on asthma. In 1995, The Chicago Asthma Initiative was created. The centerpiece was The Chicago Asthma Consortium, www.chicagoasthma.org , a new entity designed by The Institute in collaboration with the American Lung Association of Metropolitan Chicago and the American College of Chest Physicians. The group quickly grew to a diverse membership of 300 individuals and 25 organizations interested in networking and attacking this chronic health condition. The CAC model has been adapted and replicated in numerous other communities around the nation. Approximately 200 such groups have been created across the United States.

The asthma initiative was true to the tradition of The Institute - investigating causes of disease and preventing human suffering. Early grants to the University of Chicago supported bench researchers pursuing the genetic and physiologic causes of the disease. At the same time, The Institute supported the development, by the American Red Cross of Greater Chicago, of education materials in English and Spanish. It helped asthma specialists at Children's Memorial and the Infant Welfare Society of Chicago work more effectively with community based primary care providers and peer educators. The connections between housing and asthma health resulted in a grant to Neighborhood Housing Services of Chicago to produce English and Spanish language materials outlining standards and techniques for asthma-friendly, but affordable, housing. www.nhschicago.org. The Institute supported epidemiological research on asthma triggers, medication compliance practices and worked with asthmatic teens to overcome the stigma many asthmatics face. Recognizing that asthma prevented many children from attending school, The Institute worked to change the medication policies of the Chicago Public Schools to permit asthma medications to be brought to class. (This policy is now mandated in all Illinois school districts). Direct Service Grants supported the adaptation and replication of peer education approaches to insure that African American and Hispanic residents, who are disproportionately affected by asthma, would understand how to obtain accurate diagnoses and how to follow their Asthma Management Plan. New asthma screening tools were produced, tested and refined. NHLBI guidelines were aggressively promoted to physicians and nurses. Problem Based Learning sessions were conducted by University of Illinois Medical School faculty to facilitate compliance with best practices by local doctors and nurses. Trainers trained through this program now continue the education process. While most efforts targeted children, a grant to Northwestern's Buehler Center on Aging assessed misdiagnosis and inadequate treatment of asthma in the elderly.

Recognizing that providers and patients must collaborate, The Institute supported two initiatives. The Chicago/Cook County Ambulatory Care Council's grant, titled: The Community-Provider-Patient Partnership to Improve Asthma Care was an ambitious four year initiative that targeted 5 underserved communities, 172 matched pair patients and 20 primary care provider settings. Its intensive effort resulted in significant changes in the way asthma was diagnosed and treated and in the way that patients could be empowered to manage this chronic condition. The project worked through District Health Councils organized in the City's most medically disadvantaged neighborhoods. It succeeded at multiple levels. The goals and methods utilized in the project have been summarized in a publication titled, A Guide to Operations: The Community-Provider-Patient Partnership to Improve Asthma Care, A Model for Chronic Care Improvement in Urban Neighborhoods. The publication is available through the Chicago/ Cook County Community Health Council 312.572.3463. In addition to significant funding from The Institute, the project received a $470,000 matching grant through the Robert Wood Johnson Foundation Local Initiative Funding Partners Program, as well as support from other Chicago-based philanthropies. In another Institute grant, providers were assessed and re-educated; patients were counseled and tracked; and outcomes were measured by The Advocate Health Care System. At the conclusion of the project, their healthcare network members reported that savings from their asthma project exceed $1.3 million, while patient health outcomes also improved significantly. The entire system received recognition as "Centers of Excellence."

The Hektoen Institute served as fiscal agent for a follow-on grant to the Asthma Partnership Project. The techniques tested and refined in that program have been applied to an expanded list of chronic conditions. As with the earlier grant, providers and patients were trained and empowered, best practices employed, and health outcomes closely monitored.

Two analytic tools were supported through the Chicago Asthma Initiative. One, The Chicago Asthma Atlas, www.chicagoasthmaatlas.org, utilized extant data from the State of Illinois, retail pharmacies and pharmaceutical companies to track patterns of asthma prevalence and compliance. The Institute also supported the Chicago Asthma Surveillance Initiative, CASI, www.chicago-casi.org to assess progress, collect new data from patients, physicians, nurses, emergency rooms and hospitals and convene stakeholders around special projects. While asthma has not been eliminated, researchers report positive trends in decreased use of Emergency Departments, fewer missed days of school and work, and better overall health. Comparisons to other Illinois Zip Codes also show positive trends, albeit in an environment where asthma continues to affect too many Chicagoans.

To share its approach and preliminary findings, The Institute published a Supplement to CHEST, the Journal of the American College of Chest Physicians, Volume 116/ Number 4/ October, 1999 Supplement to disseminate its model www.chestjournal.org. The Institute concluded its asthma funding through a grant to CASI for a conference and publication to be released in 2007 examining asthma health disparities

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NEW DIRECTIONS

As with Institute grants made nearly a century ago, the Chicago Asthma Initiative supported a diverse group of researchers, produced numerous scientific papers, enhanced careers and collaborations and pioneered new ways to relieve the suffering in Chicago. Many of The Institute's grantees already have been awarded significant federal and private foundation grants to sustain and advance their efforts. Asthma Patients and their families learned how to manage their condition. Communities learned about this chronic condition. Providers upgraded their skills in diagnosing and treating these Chicagoans. In addition to these very real outcomes, The Institute's Asthma Initiative has proven successful in challenging perceptions of what a mid-sized foundation can achieve.

With this sense of accomplishment, the Board recognized the need to transition to a new focus. In 2002, under the leadership of Dr. Whitney W. Addington, an expanded Board of Directors assessed community needs and reviewed programmatic options within its fiscal and administrative parameters.

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