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AHRQ awards 13 grants for second phase of Translating Research Into Practice initiative

The Agency for Healthcare Research and Quality recently funded 13 new cooperative agreements to demonstrate and evaluate different strategies for translating research into practice and to ensure that improvements in quality continue. The overall aim of the program is to help accelerate the impact of research on practice and to improve the outcomes, quality, effectiveness, efficiency, and/or cost effectiveness of health care through partnerships between health care organizations and researchers. The new 3-year projects are described below.

An Internet Intervention to Increase Chlamydia Screening. Principal investigator: Jeroan Allison, M.D., University of Alabama, Birmingham. Total projected funding: $1,156,421. Project period: 9/30/00 - 9/29/03.

This project, undertaken in cooperation with U.S. Quality Algorithms (an Aetna subsidiary), involves a randomized trial in 220 primary care physician offices to test Internet-based learning modules for physicians. The modules are designed to increase screening of at-risk women and decrease incidence of pelvic inflammatory disease.

Improving Quality with Outpatient Decision Support. Principal investigator: David Bates, M.D., M.Sc., Brigham and Women's Hospital, Boston, MA. Total projected funding: $1,451,984. Project period: 9/30/00 - 8/30/03.

The researchers will test physician compliance with paper-based and electronic guidelines, reminders, and alerts for outpatient settings. Participants will be physicians at the Beth Israel and Massachusetts General Hospitals and their outpatient clinics. The reminders and alerts will target such areas as disease management, medication management, and ancillary test ordering.

Improving Utilization of Ischemic Stroke Research. Principal investigator: Catherine Borbas, Ph.D., Minneapolis Medical Research Institute, Minneapolis, MN. Total projected funding: $1,564,642. Project period: 9/30/00 - 8/31/03.

The researchers will assess the effectiveness of a model for accelerating the use of evidence-based treatment guidelines for acute ischemic stroke in 24 urban and rural hospitals in Minnesota. The investigators from Minneapolis Medical Research Institute, Harvard Medical School, and the University of Minnesota School of Nursing will test a hospital-based intervention to improve the quality of stroke care.

MCO Use of a Pediatric Asthma Management Program. Principal investigator: Michele M. Cloutier, M.D., University of Connecticut Health Center, Hartford. Total projected funding: $876,760. Project period: 9/11/00 - 8/31/03.

In this randomized controlled trial, the University of Connecticut will partner with ConnectiCare and the Connecticut Children's Medical Center to compare two asthma management programs in a large managed care organization in the Hartford area. A specially modified version of the Easy Breathing Program will be implemented by 66 providers in 18 communities and compared with the disease management program presently being used. Outcomes include guideline compliance, hospitalization rates, emergency room visits, prescription utilization, patient and provider satisfaction, and quality of life.

Better Pediatric Outcomes Through Chronic Care. Principal investigator: Judith Fifield, R.N., Ph.D., University of Connecticut Health Center, Hartford. Total projected funding: $1,437,769. Project period: 9/30/00 - 9/29/03.

This multi-site intervention project will use a family-focused educational intervention to reduce costs and improve outcomes among children with asthma. The study population will be poor, inner-city, minority children, ages 5-18, who are enrolled in a community health center-based Medicaid managed care organization.

Diabetes Education Multimedia for Vulnerable Populations. Principal investigator: Ben S. Gerber, M.D., University of Illinois, Chicago. Total projected funding: $1,148,955. Project period: 9/1/00 - 8/31/03.

This randomized controlled trial will compare usual care with patient education through the use of an interactive, multimedia computer program to improve diabetes-related knowledge, attitudes, self-efficacy and compliance with self-care recommendations. The study will take place at clinics serving predominately black and Hispanic patients throughout Chicago.

Implementing Adolescent Preventive Guidelines. Principal investigator: Charles E. Irwin, M.D., University of California, San Francisco. Total projected funding: $1,887,829. Project period: 9/30/00 - 8/31/03.

The researchers will analyze the value of implementing office-based clinical preventive services for adolescents. They will use an experimental design, consisting of training and tools, looking at the outcome of delivery of preventive services during routine well care visits.

Improving Pain Management in Nursing Homes. Principal investigator: Katherine R. Jones, Ph.D., University of Colorado Health Sciences Center, Denver. Total projected funding: $1,540,787. Project period: 9/1/00 - 8/31/03.

The researchers will attempt to develop and implement a culturally competent, evidence-based educational and behavioral intervention to improve the quality of pain assessment and management in 12 nursing homes. They will develop and implement competency-based educational materials, improve the quality of pain assessment and management procedures, improve knowledge and attitudes toward pain, analyze the influence and changes of organizational variables, and assess the cost-effectiveness of the intervention to nursing homes.

Translating Prevention Research into Practice. Principal investigator: Robert A. Levine, M.D., Meharry Medical College, Nashville, TN. Total projected funding: $1,989,273. Project period: 9/30/00 - 9/29/03.

As a collaboration between Meharry Medical College and the Center for Health Research at Tennessee State University, the researchers will conduct a randomized clinical trial comparing two methods of integrating preventive services in a group practice serving a low-income minority Medicaid population. Five of the six priority racial and ethnic health disparities will be addressed: infant mortality, cardiovascular disease, cancer screening, HIV/AIDS, and adult and pediatric immunizations.

Optimizing Antibiotic Use in Long-term Care. Principal investigator: Mark B. Loeb, M.D., MSc., McMaster University, Ontario, Canada. Total projected funding: $157,756. Project period: 9/30/00 - 8/31/02.

This study will determine if an evidence-based clinical algorithm for managing urinary tract infections in older adults in residential long-term care facilities can reduce the overall use of antibiotics in such facilities. This project is a collaboration between McMaster University, the University of Toronto, Queen's University, St. Joseph's Health Care System Research Network nursing homes, and nursing homes in the province of Ontario.

Primary and Secondary Prevention of Coronary Heart Disease and Stroke. Principal investigator: Steven M. Ornstein, M.D., Medical University of South Carolina, Charleston. Total projected funding: $1,092,326. Project period: 9/30/00 - 8/31/03.

The researchers will study the impact of a quality improvement model using academic detailing and electronic medical records on adherence to clinical practice guidelines for prevention of cardiovascular disease and stroke in primary care settings. Investigators from the Medical University of South Carolina's Center for Health Care Research will conduct the study in 22 affiliated Practice Partner Research Network (PPRNet) sites across the United States.

Developing an Asthma Management Model for Head Start. Principal investigator: Perla A. Vargas, Ph.D., Arkansas Children's Hospital, Little Rock. Total projected funding: $1,190,983. Project period: 9/26/00 - 8/31/03.

Using a randomized design, the researchers will develop an evidence-based asthma case management model for low-income minority children enrolled in 29 Head Start programs. The study will be conducted in cooperation with Pulaski County Head Start and the Arkansas Foundation for Medical Care. The researchers will measure such outcomes as asthma-related school absences, symptoms, quality of life, emergency department visits, and hospital use.

A Model for Use of the Urinary Incontinence (UI) Guideline in U.S. Nursing Homes. Principal investigator: Nancy M. Watson, Ph.D., R.N., University of Rochester, School of Nursing, Rochester, NY. Total projected funding: $1,257,133. Project period: 9/1/00 - 8/31/03.

The researchers will test the effectiveness of a model of care implemented by nurse practitioners in collaboration with nurses and physicians to translate the AHRQ UI guideline into practice in 10 New York nursing homes. The study will determine the feasibility of this model in reducing UI in nursing homes, preventing complications associated with UI, and improving the quality of life of nursing home residents and families.

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