Translating Research into Practice (TRIP) Awards PBRN Grant Summaries
In late 2003, the Agency for Healthcare Research and Quality, in conjunction with the National Cancer Institute, solicited research proposals from primary care Practice-Based Research Networks. The purpose was to evaluate science-based strategies for translating evidence into sustainable improvements in clinical practice and outcomes, The solicitation also addressed the development, improvement, or validation of research dissemination methods applicable to cancer control in primary care practice. Funding was provided in two rounds, the first in 2004 and the second in 2005.
Project Title: QuitLink: A Leveraging Solution to Tobacco Counseling
Principal Investigator: Stephen F. Rothemich, M.D., M.S.
Organization: Virginia Ambulatory Care Outcomes Research Network
Grant Number: R21 HS014854
Project Period: 9/3/04-8/31/06
AHRQ Funding Amount: $449,827
Rothemich and colleagues found that patients at QuitLink intervention practices were more likely (p < 0.001) to report that they received intensive counseling to quit smoking and were more likely (p < 0.001) to be referred to a quit smoking hotline.
- Rothemich SF, Woolf SH, Johnson RE, et al. Promoting primary care smoking-cessation support with quitlines: The QuitLink Randomized Controlled Trial. Am J Prev Med 2010 Apr;38(4):367-74. PubMed PMID: 20307804
Project Title: Evaluating a Patient-Centered Diabetes Registry
Principal Investigator: Deborah S. Main, Ph.D.
Organization: Colorado Research Network, University of Colorado School of Medicine
Grant Number: R21 HS014871
Project Period: 9/30/04-9/30/07
AHRQ Funding Amount: $461,972
Main, et al., implemented a diabetes registry at six primary care practices and found that, overall, there was support for the registry at the patient and provider level.
No publication from this grant.
Project Title: Improving Diabetes Efforts Across Language and Literacy: Impact and Contextual Factors in a Safety Net System
Principal Investigator: Dean Schillinger, M.D.
Organization: Collaborative Research Network/Community Health Network of San Francisco
Grant Number: R21 HS014864
Project Period: 10/1/04-9/30/07
AHRQ Funding Amount: $432,808
In a randomized control trial to improve diabetes support, Schillinger and colleagues tested the effectiveness of two methods of self-management support: technologically oriented (automated telephone self-management [ATSM]) and interpersonally oriented (group medical visits). They found that ATSM resulted in high engagement among patients with limited English proficiency and low health literacy.
- Goldman LE, Handley M, Rundall TG, et al. Current and future directions in Medi-Cal chronic disease care management: a view from the top. Am J Manag Care 2007 May;13(5):263-68. PubMed PMID: 17488192
- Handley MA, Hammer H, Schillinger D. Navigating the terrain between research and practice: a Collaborative Research Network (CRN) case study in diabetes research. J Am Board Fam Med 2006 Jan-Feb;19(1):85-92. PubMed PMID: 16492010
- Handley MA, Shumway M, Schillinger D. Cost-effectiveness of automated telephone self-management support with nurse care management among patients with diabetes. Ann Fam Med 2008 Nov-Dec;6(6):512-8. PubMed PMID: 19001303
- Piette J, Schillinger D. Applying interactive health technologies for vulnerable populations. In King TE, Jr., Wheeler M, Fernandez A, et al. Medical management of vulnerable and underserved patients: principles, practice, and populations. New York: McGraw-Hill; 2006. pp. 131-40. No PubMed PMID
- Schillinger D. Literacy and health communication: reversing the "inverse care law."Am J Bioeth 2007;7:15-18. PubMed PMID: 18027291
- Schillinger D. An introduction to effectiveness, dissemination and implementation research. From the Series: CTSI Guides to Community-Engaged Research. San Francisco, CA: Clinical and Translational Science Institute; 2007. Available at: http://ctsi.ucsf.edu/documents/ce_rr&d_guide.pdf. No PubMed PMID.
- Schillinger D, Handley M, Wang F, et al. Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes: a three-arm practical clinical trial. Diabetes Care 2009 Apr;32(4):559-66. Epub 2009 Jan 8. PubMed PMID: 19131469
- Schillinger D, Hammer H, Wang F, et al.. Seeing in 3-D: examining the reach of diabetes self-management support strategies in a public health care system. Health Educ Behav 2008 Oct;35(5):664-82. Epub 2007 May 18. PubMed PMID: 17513690
- Sarkar U, Handley MA, Gupta R, et al. Use of an interactive, telephone-based self-management support program to identify adverse events among ambulatory diabetes patients. J Gen Intern Med 2008 Apr;23(4):459-65. PubMed PMID: 18373145
Project Title: An Evaluation of the WISE QI Program
Principal Investigator: Barcey T. Levy, M.D., Ph.D.
Organization: Iowa Research Network
Grant Number: R21 HS014859
Project Period: 4/1/06-12/22/09
AHRQ Funding Amount: $443,500
Levy, et al., tested the effectiveness of the WISE QI program to improve the health care of high-risk rural patients with type 2 diabetes and found that the program did not improve A1c levels or quality measures overall.
In process of writing publication.
Project Title: Delivery of Preventive Services in Primary Care
Principal Investigator: James W. Mold, M.D., M.P.H.
Organization: Oklahoma Physicians Resource/Research Network
Grant Number: R21 HS014850
Project Period: 9/30/04-9/29/06
AHRQ Funding Amount: $439,500
Mold and colleagues found that practices in the intervention (which included performance feedback and benchmarking, practice facilitation, and information technology support) were more likely to implement evidence-based strategies (p = 0.003), and rates of mammography screening increased (p = 0.02).
- Nagykaldi Z, Mold JW. The role of health information technology in the translation of research into practice: an Oklahoma Physicians Resource/Research Network (OKPRN) study. J Am Board Fam Med 2007 Mar-Apr;20(2):188-95. PubMed PMID: 17341756
- Mold JW, Aspy CA, Nagykaldi Z; Oklahoma Physicians Resource/Research Network. Implementation of evidence-based preventive services delivery processes in primary care: an Oklahoma Physicians Resource/Research Network (OKPRN) study. J Am Board Fam Med 2008 Jul-Aug;21(4):334-44. PubMed PMID: 18612060
Project Title: Improving Geriatric Medication Safety in Underserved Practices
Principal Investigator: Gurdev Singh, Ph.D.
Organization: Patient Safety Research Center, State University of New York at Buffalo
Grant Number: R21 HS014867
Project Period: 12/1/05-11/30/07
AHRQ Funding Amount: $467,455
Singh, et al., found that practices that received the Team Resource Management approach along with assistance from a practice enhancement associate showed a statistically significant reduction (p = 0.042) in the rates of preventable adverse drug events.
- Singh R, McLean-Plunckett EA, Kee R, et al.. Experience with a trigger tool for identifying adverse drug events among older adults in ambulatory primary care. Qual Saf Health Care 2009 Jun;18(3):199-204. PubMed PMID: 19468002
Project Title: Electronic Health Record-Based Decision Support To Improve Outpatient Asthma Care: A Cluster Randomized Trial
Principal Investigator: Louis M. Bell, M.D.
Organization: Pediatric Research Consortium, Children’s Hospital of Philadelphia
Grant Number: R21 HS014873
Project Period: 12/12/05-8/31/08
AHRQ Funding Amount: $487,303
Bell, et al., conducted a prospective cluster-randomized trial for adherence to National Asthma Education Prevention Program guidelines. They found that the use of computerized decision support alerts within an electronic health record significantly improved prescriptions for controller medications (p = 0.006) and use of spirometry (p = 0.004) in urban practices. It also significantly improved filing of an up-to-date asthma care plan (p = 0.03) and performing spirometry (p = 0.003) in suburban sites.
- Bell LM, Grundmeier R, Localio R, et al. Electronic health record-based decision support to improve asthma care: a cluster-randomized trial. Pediatrics 2010 Mar;125(4):e770-7. Epub 2010 March 15. PMID: 20231191
Project Title: Treatment of Children With Obesity in Primary Care
Principal Investigator: Ellen R. Wald, M.D.
Organization: Wisconsin Research & Education Network
Grant Number: R21 HS014862
Project Period: 11/1/05-10/31/09
AHRQ Funding Amount: $430,500
Wald and colleagues conducted a randomized controlled trial of obese children in primary care. The intervention was a behavioral management program that included a self-monitoring component of food intake, physical activity, and sedentary behavior. They found that children in the intervention group had a mean weight loss of 2.08 lbs that was significant (p < 0.01) compared to the control group, which had a mean weight gain of 3.3 lb.
- Wald ER, Ewing L, Cluss P, et al. Establishing a family-based intervention for overweight children in pediatric practice. Ann Fam Med 2005 Jul-Aug;3 (Suppl 2):S45-47. PubMed PMID: 16049086
Project Title: Using the Telephone To Improve Care in Childhood Asthma
Principal Investigator: Jane Garbutt, M.B.Ch.B.
Organization: Washington University Pediatric/Adolescent Ambulatory Research Consortium
Grant Number: R21 HS015378
Project Period: 9/30/04-2/29/08
AHRQ Funding Amount: $440,195
Garbutt and colleagues conducted a randomized controlled trial to ascertain if a telephone asthma program reduced impairment and emergent events. They found statistically significant increases in quality of life scores (p = 0.002) and a reduction in children with poorly controlled asthma (p = 0.029) but did not find any difference between the intervention and control group with respect to emergent events.
- Bloomberg GR, Banister C, Sterkel R, et al. Socioeconomic, family, and pediatric practice factors that affect level of asthma control. Pediatrics 2009;123:829-35. PMID: 19255010.
- Garbutt, J, Bloomberg, G, Banister, et al. What constitutes maintenance asthma care? The pediatrician's perspective. Ambul Pediatr 2007;7:308-12. PubMed PMID: 17660103
- Sterkel R, Banister C, Bruns J, et al. Collaboration with pediatric call centers for patient recruitment. Arch Pediatr Adolesc Med 2009;163:588-9. PubMed PMID:19487619