Oral

One of the most significant challenges of clinical health services research is the successful translation and application of rigorous research to “real-world” practice and community settings from the evidentiary gold standard of randomized controlled trials (RCT) and tertiary-setting interventions. Although clinical RCT findings may present primary care opportunities to improve the public’s health, the realities of community-based practice often diminish dissemination and adoption. Practitioners and patients report that adopting primary care research findings is at its best difficult and frustrating, and at its worst, victim blaming due to “failure to comply/adhere” labels in particularly vulnerable populations. Moreover, the dearth of research training, skills, infrastructure and practical care-coordination research tools tends to thwart community-based primary care practitioners’ ability to conduct the necessary research. This session, Practice-Based Research Networks in Primary Care and Public Health, presents several specific, yet systems-based, building blocks of potential solutions to this dilemma. Spurred on by the PPACA, the transformation of primary care systems to medical homes and accountable care organizations (ACOs) has accelerated the need for implementable, evidence-based primary care practices, care-management plans, and systems-based tools. These must be applicable to “safety-net providers,” community-health centers, public hospital clinics, and public health departments providing primary-care, preventive services, and coordinating chronic-condition management care to underserved populations. In the first presentation, the NIH-funded Harvard Clinical and Translational Science Award (CTSA) employed a community-based participatory approach to build research capacity within safety-net institutions. In the second presentation, the NCHIT-Funded Beacon Community of the Inland Northwest, developed and implemented an inventory tool to: assess care coordination readiness and ambulatory care clinic readiness for care coordination. This project utilizes information-enhanced care coordination to improve preventive health services and patient outcomes in adults with Type 2 diabetes. Next, the novel use GIS coordinate mapping derived from primary care practice administrative data identifies gaps in breast cancer screening. This detailed geographic approach empowers health systems to identify communities at high risk for poor outcomes. Finally, the Stroke and Heart Attack Prevention Program (SHAPP) investigates patients' experiences and attitudes about hypertension management in an effort to improve hypertension management adherence. The confluence of potential increased access to care, emphasis on prevention and the requirement of value for dollars invested in research could further develop, diffuse, enhance and harmonize research entities, data systems, and electronic health records; ultimately, these have potential to enable stakeholders to identify care/attention/resources priorities, produce novel interventions, and iteratively provide outcomes feedback.

Session Objectives: 1-Identify three facilitators (key elements) and three barriers to conducting primary care practice-based research in underserved and/or vulnerable populations. 2-Describe the potential use of tools such as: geographic information system (GIS) data in identifying areas with poor quality health outcomes or the Care Coordination Readiness Assessment for Diabetes control (and other) programs. 3- List and describe 3 opportunities for improving or enhancing practice-based primary care research in public health.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH) , Masters Certified Health Education Specialist (MCHES)