Assessing Providers’ Interests and Research Experiences
JaxHERO PBRN - The purpose of this assessment is to understand the interests, needs and perspectives of clinicians/providers who will be invited to become members of the Jacksonville Health Equity Research Organization (JaxHERO). This information will be used to (1) shape the research agenda for JaxHERO as well as (2) assess research needs of faculty and to develop additional research training.
After being introduced to the purpose and overall structure of JaxHERO, providers will be invited to participate in an online survey that seeks to learn more about their interests and experience in research and need for additional research training. All healthcare providers (n=500) practicing at UF primary care clinics and the Duval County Health Department clinic staff will be invited to participate. Participation will involve completing an online survey that asks about experiences in research interests including types of projects, barriers, and benefits to research.
The specific objective of this study is to describe providers’ interests and experiences in participating in and conducting research. Specific aims are to:
- Determine provider’s previous research areas and roles on research projects
- Identify the providers’ areas of research interest
- Determine providers’ perceived benefits to participating in research in their department and in the JaxHERO networ
- Determine providers’ perceived barriers to participating in research
A Descriptive Analysis of Clinical Settings and Patient Populations
JaxHERO PBRN - The purpose of this project is to assess clinic and patient characteristics of potential participating clinics in a practice-based research network, titled the Jacksonville Health Equity Research Organization (JaxHERO). The specific objective of this study is to describe the clinic and patient characteristics of primary care clinical centers within the UF HSC/J system to understand the potential of JaxHERO to utilize research methods to improve local medical practice and disseminate evidence-based medical interventions within the Jacksonville Florida.
The specific objective of this study is to describe clinic and patient characteristics of the primary care clinical centers within the UF HSC/J system. Specific aims are to:
- Describe characteristics of each family practice, internal medicine and pediatric clinical center of UF HSC/J that will be included in the JaxHERO network
Describe characteristics of all patients visiting each of these clinical centers within the last two years (January 2010 – December 2011)
Adolescent Health Risk Assessment in Primary Care
Dr. Betsy Shenkman - The primary focus of this pilot study is to establish the feasibility of using HIT to conduct HRAs with adolescents in health care settings, including establishing the data collection procedures in diverse primary care practices. An additional focus of this pilot study is to examine the effects of using HIT on the number of completed HRAs relative to the number of adolescents seen during the study period per site, physician and staff report of satisfaction with conducting HRAs, and adolescent-report of experiences with the HRA and health care visit. Specific aims are to:
- Test the feasibility of using HIT in the form of iPads to gather HRA information from adolescents seen in a range of primary care settings. Feasibility will be assessed based on provider, office staff, and adolescent feedback about their satisfaction with and ease of participating in the intervention.
- Describe adolescent risk behaviors and whether those behaviors vary based on adolescent race/ethnicity, age, and gender.
- Examine whether the outcomes of interest vary
- based on the practice setting
- type of visit
- the adolescents’ sociodemographic characteristics (age, gender, race/ethnicity) and relative to two comparison health care settings not participating in the intervention.
The outcomes of interest are: number of completed HRAs relative to the number of adolescents seen during the study period, physician and staff report of satisfaction with conducting HRAs, physician report of counseling and referrals provided, and adolescent-report of experiences with the health care visit during which the HRA was conducted.
Academic and Community Partnerships for CBPR Research on Social Media and Digital Communication
William C. Livingood Jr., Ph.D. - This Academic-Community Partnership Conference Series grant proposal describes how a major academic health center (University of Florida/Shands-Jacksonville) will partner with a key community organization (Duval County Health Department) to utilize principles of community based participatory research (CBPR) to address major health disparity issues. Our initial focus on health disparity reduction will be on the use of techniques of outreach and information dissemination that are most effective with minority adolescents and young adults related to obesity in those populations.
Two groups of specific aims organized around two interrelated major goals:
- The development and implementation of a CBPR processes and infrastructure focused on health disparities in our community, and
- the use of community meetings, workshops, symposia and outreach to educate and involve the community in effective approaches for reducing health disparities associated with obesity in adolescent and young adults or precipitated by their lifestyles and behaviors.
The Relationship between Primary Care Medical Homes, Patient Engagement, and the Processes and Outcomes of Care among Individuals Living with Diabetes: A Proposal
Dr. Alyson Hall - This study seeks to understand how patient engagement mediates or affects the relationship between attributes of medical homes and outcomes of care among patients with diabetes. The project will assess whether specific attributes of medical homes are associated with levels of patient engagement, and then whether this level of engagement has any relationship to self-management (e.g. glucose testing), processes of care (receipt of Hemoglobin A1c), disease control/health outcomes (HgA1c level is appropriate) and patient satisfaction.
The study focuses on adults living with Type2 diabetes who are seen at 4 primary care practices that have implemented aspects of the medical home model. We propose employing a mixed-methods approach that utilizes in-depth interviews with clinic personnel and patient surveys to address aim one; and cross-sectional analysis of combined patient survey and practice electronic medical records/administrative data to address aims two and three. Specific aims are to:
- examine whether there are differences in patient scoring of aspects of the medical home, as measured by the Ambulatory Care Experiences Survey (ACES), across practices that have adopted various organizational elements of the medical home model
- examine the association between patient scoring of aspects of the medical home and the degree of patient engagement as measured by the Patient Activation Measure (PAM)
- examine whether the relationship between patients’ assessment of the medical home and patient satisfaction, health outcomes, health behaviors, and processes of care can be explained or mediated by their level of patient engagement as measured by the PAM
The study focuses on adults living with Type2 diabetes who are seen at four primary care practices
The Effect of PCMH Model Certification within a Primary Care Network
Nipa R. Shah, M.D. - The primary focus of this research is to examine the association between patient centered-medical home (PCMH) status and patient health outcomes and satisfaction within an academic, multi-disciplinary primary care network.
The overall goal of this research is to learn more about whether implementing a registry (key attribute within the PCMH model) is significantly associated with patients’ health outcomes and satisfaction within an academic, multi-disciplinary primary care network. Specific aims are to:
- Determine the PCMH status of each primary care practice as defined by having a diabetes registry
- Measure health outcomes and satisfaction of patients from primary care centers within the network
- Test the association between PCMH status and patients’ health outcomes and satisfaction.
The source population consists of the University of Florida’s Family Medicine/Family Practice primary care health centers that consist of at least 79 healthcare providers and more than 150 clinical support staff providing services to a diverse population22 located throughout Jacksonville (Duval County), FL.
Promoting Customized Culturally Sensitive Health Care Using Health Information Technology
The broad long-term objective of the proposed pilot study is to launch a demonstration research project that (a) shows how electronic medical records (EMRs) and iPads (i.e. health information technology [HIT]) can be used to promote health care providers’ engagement in novel customized patient-centered culturally sensitive health care [PC-CSHC] by providers in clinical encounters with culturally diverse patients at diverse outpatient clinics , and (b) provides empirical evidence that such use of HIT improves these patients’ perceived health care quality and related treatment adherence and health outcomes. Specific aims are to:
- Determine the feasibility of having new patients use iPads and providers use EMRs to promote customized PC-CSHC by providers at 6 urban outpatient primary care clinics that serve culturally diverse patients, including racial/ethnic minority patients and low-income patients
- Explore any significant group (intervention [IG] versus control [CG]), race, gender, or age differences in the impact of this use of HIT on patients’ perceived health care quality (i.e., perceived provider cultural sensitivity, trust in provider, control in patient-provider interactions, and satisfaction with provider)
- Explore theory-based paths among the sensitivity, trust, control, and satisfaction variables, and any racial differences in these paths, and (d) assess any patient versus provider differences in perceived usefulness and practicality of and needed changes in the HIT tools and methods.
Colorectal Cancer Screening in a Primary Care Center
Subashini V. Anand, M.D. - The purpose of this study is to increase screening to increase the diagnosis of colon cancer and reduce the number of “missed” cases by identifying individuals aged > 50 to determine screening status, demographic factors, and risk factors for current patients. Patients will then be asked to complete a survey regarding their screening status, family and personal risk factors, and barriers to screening. Those with at least two or more risk factors will be invited to take part in an educational intervention.
They will then be re-assessed regarding their knowledge and willingness to be screened. Outcomes will include 1) screening (Y/N) of eligible patients, 2) change in knowledge towards screening, 3) change in attitudes towards screening, 4) reduction in barriers to screening. Specific aims are to:
- Determine how many individuals, aged 50 years and older was screened for colorectal cancer
- Test whether demographic factors of screened patients compared with non-screened patients significantly differ
- Determine whether an evidence-based intervention process improves screening for colorectal cancer compared with standard of care.
The priority population consists of all persons aged > 50 years visiting Anchor Plaza Family Practice between January 1 2009 to December 31 2011.