[***(Go to Table of Contents)***](#top)

**2006**

**AHRQ National PBRN**

**Research Conference**

May 15-17, 2006

Bethesda Marriott

Bethesda, Maryland

Accreditation Provided by

> Indiana University School of Medicine
>
> The University of Wisconsin Milwaukee College of Nursing,\
> Continuing Education and Outreach Program

[]{#top .anchor}**[Table of Contents:]{.underline}**

> i.......... [Cover Page](#Cover)
>
> 1..........[Table of Contents](#top)
>
> [2..........](#top)[CME Information](#CME)
>
> 3..........[Welcome from AHRQ](#Welcome)
>
> 5..........[PBRN Resource Center
> Background](#the-pbrn-resource-center-top)
>
> 7..........[How to Register your PBRN](#PBRN_Registry)
>
> [9..........](#PBRN_Registry)[Meeting Agenda](#Agenda)
>
> 19.........[Plenary Speaker Bios](#Speaker_Bios)
>
> 25.........[Concurrent Session Abstracts](#ConcurrentSessions)
>
> 71.........[Poster Presentation Abstracts](#Posters)
>
> 97.........[List of Presenters (alphabetical order)](#Presenters)
>
> 99.........[Participant List](#Participants)
>
> 123......[Addendum Participant List](#Addendum_Participants)
>
> 131.......[General Information](#General_Information)
>
> 133......[.Personal Work plan Pages](#Workplans)
>
> 136.......[Presenter Disclosure Information](#Presenter_Disclosure)

[]{#CME .anchor}**Continuing Medical Education (CME) Information
[top](#top)**

+-----------------------------------------------------------------------+
| > **[Accreditation Statement]{.underline}** *(Physicians)*            |
| >                                                                     |
| > This activity has been planned and implemented in accordance with   |
| > the Essential Areas and policies of the Accreditation Council for   |
| > Continuing Medical Education (ACCME) through the joint sponsorship  |
| > of Indiana University School of Medicine and the U.S. Agency for    |
| > Healthcare Research and Quality (AHRQ).  The Indiana University     |
| > School of Medicine is accredited by the ACCME to provide continuing |
| > medical education for physicians.                                   |
| >                                                                     |
| > **[Credit]{.underline}**                                            |
| >                                                                     |
| > The Indiana University School of Medicine designates this           |
| > educational activity for a maximum of 14 *AMA PRA Category 1        |
| > Credits™*.  Physicians should only claim credit commensurate with   |
| > the extent of their participation in the activity.                  |
| >                                                                     |
| > **[Note]{.underline}**                                              |
| >                                                                     |
| > While it offers CME credits, this activity is not intended to       |
| > provide extensive training or certification in the field.           |
| >                                                                     |
| > **[Disclosure]{.underline}**                                        |
| >                                                                     |
| > In accordance with the Accreditation Council for Continuing Medical |
| > Education (ACCME) Standards for Commercial Support, educational     |
| > programs sponsored by Indiana University School of Medicine (IUSM)  |
| > must demonstrate balance, independence, objectivity, and scientific |
| > rigor.  All faculty, authors, editors, and planning committee       |
| > members participating in an IUSM-sponsored activity are required to |
| > disclose any relevant financial interest or other relationship with |
| > the manufacturer(s) of any commercial product(s) and/or provider(s) |
| > of commercial services that are discussed in an educational         |
| > activity.                                                           |
| >                                                                     |
| > **[Nursing Contact Hours]{.underline}**                             |
| >                                                                     |
| > The University of Wisconsin Milwaukee College of Nursing Continuing |
| > Education and Outreach Program will offer 17.1 contact hours for    |
| > this program. University of Wisconsin-Milwaukee College of Nursing  |
| > Continuing Education and Outreach Program is an approved provider   |
| > of continuing education by the Wisconsin Nurses Association         |
| > Continuing Education Approval Program Committee, an accredited      |
| > approver by the American Nurses Credentialing Center\'s Commission  |
| > on Accreditation. A certificate will be awarded to participants at  |
| > the completion of the conference.                                   |
+-----------------------------------------------------------------------+

> []{#Welcome .anchor}
>
> **Welcome Letter**: [top](#top)

+-----------------------------------------------------------------------+
| > Dear Colleagues:                                                    |
| >                                                                     |
| > Welcome to the second annual Primary Care Practice-Based Research   |
| > Network (PBRN) Conference, sponsored by the Agency for Healthcare   |
| > Research and Quality (AHRQ). This meeting is a part of AHRQ's       |
| > on-going support of the growth and development of primary care      |
| > PBRNs across the country. It offers you an opportunity to share     |
| > your work and experiences in practice-based research while also     |
| > learning from your colleagues in the field. Participants in this    |
| > year's conference include directors and coordinators of PBRNs;      |
| > network clinicians, researchers and staff; AHRQ's Federal and       |
| > foundation partners; and others interested in learning more about   |
| > research network efforts.                                           |
| >                                                                     |
| > The goals of the Primary Care PBRN Research Conference are to:      |
|                                                                       |
| -   Disseminate findings and lessons learned through PBRN research    |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   Enhance the growth and development of primary care PBRNs through  |
|                                                                       |
| > \-- Advancing the field of network research methodology             |
| >                                                                     |
| > \-- Sharing best practices for operating and managing PBRNs         |
| >                                                                     |
| > \-- Informing PBRNs about potential funding opportunities           |
|                                                                       |
| -   Promote communications/connections within the PBRN research       |
|     community                                                         |
|                                                                       |
| > We encourage you to take full advantage of the many opportunities   |
| > this conference offers, including research presentations,           |
| > participatory workshops, plenary sessions, poster presentations,    |
| > and a "Funders' Fair" featuring representatives from over a dozen   |
| > NIH institutes and other organizations ready to tell you about      |
| > potential sources of PBRN funding. At the same time, we recognize   |
| > that some of the most valuable time you spend at the conference     |
| > will be at receptions, lunches, and breaks where you can get to     |
| > know PBRN researchers from across the country who share your        |
| > interests.                                                          |
| >                                                                     |
| > On behalf of AHRQ, we welcome you to Washington D.C. and wish you a |
| > productive and enjoyable conference.                                |
| >                                                                     |
| > Sincerely,                                                          |
| >                                                                     |
| > Helen Burstin, MD, MPH, Director                                    |
| >                                                                     |
| > David Lanier, MD, Associate Director                                |
| >                                                                     |
| > David Meyers, MD, Co-Director, Primary Care Research                |
| >                                                                     |
| > Center for Primary Care, Prevention and Clinical Partnerships       |
|                                                                       |
| Agency for Healthcare Research and Quality                            |
+-----------------------------------------------------------------------+

### The PBRN Resource Center [top](#top)

+-----------------------------------------------------------------------+
| The PBRN Resource Center (PBRN RC) provides resources and assistance  |
| to clinical and health services research taking place in Primary Care |
| Practice Based Research Networks (PBRNs). This is accomplished        |
| through a network of primary care PBRNs registered with AHRQ. The     |
| PBRN RC provides support to registered PBRNs through a series of      |
| web-based seminars and the provision of technical research expertise  |
| to members. Registered PBRNs are also invited to participate in the   |
| Annual AHRQ PBRN Research Conference.                                 |
|                                                                       |
| To support primary care PBRNs throughout the United States, AHRQ      |
| established the PBRN Resource Center in 2002. The PBRN RC was         |
| initially created to provide support solely to PBRNs funded through   |
| AHRQ's PBRN initiative. AHRQ recently expanded their mission so that  |
| the PBRN RC now serves all registered PBRNs.                          |
|                                                                       |
| Registration with the PBRN RC allows PBRN researchers and staff       |
| members access to:                                                    |
|                                                                       |
| 1.  Technical expertise for collecting and managing data              |
|                                                                       |
| 2.  Methodological expertise and experience necessary for designing   |
|     research projects                                                 |
|                                                                       |
| 3.  Resources for operating a primary care PBRN such as communication |
|     strategies, project and network management, and member            |
|     recruitment and retention                                         |
|                                                                       |
| 4.  Health Information Technology support and resources               |
|                                                                       |
| 5.  Notification of funding and research opportunities                |
|                                                                       |
| 6.  Forums for discussing PBRN issues with colleagues and experts in  |
|     areas including quality improvement research within PBRNs         |
|                                                                       |
| The PBRN Resource Center's role with regard to these activities       |
| includes:                                                             |
|                                                                       |
| 1.  Assisting AHRQ with its Annual PBRN Research Conference           |
|                                                                       |
| 2.  Facilitating Peer Learning Group forums                           |
|                                                                       |
| 3.  Providing technical assistance with AHRQ's PBRN website as well   |
|     assistance with other communication mechanisms available to       |
|     registered PBRNs                                                  |
|                                                                       |
| 4.  Providing direct technical assistance to PBRNs in areas related   |
|     to managing a network and conducting primary care research        |
|                                                                       |
| 5.  Providing training in grant and peer-review journal writing       |
|                                                                       |
| 6.  Maintaining a database of PBRN research conducted with the U.S.   |
|                                                                       |
| The PBRN Resource Center is a collaborative effort between Indiana    |
| University and the National Opinion Research Center (NORC) at the     |
| University of Chicago.                                                |
|                                                                       |
| For additional information, please contact Brenda L. Hudson at        |
| [**brlhudso@iupui.edu**](mailto:brlhudso@iupui.edu) or by phone at    |
| (317)630-8364.                                                        |
+-----------------------------------------------------------------------+

[]{#PBRN_Registry .anchor}**PBRN REGISTRY [top](#top)**

+-----------------------------------------------------------------------+
| Recognizing the tremendous growth occurring around the country in     |
| Practice-Based Research Networks (PBRN), and their potential for the  |
| promotion of research and quality improvement in healthcare delivery, |
| the Agency for Healthcare Research Quality (AHRQ) would like to       |
| invite all interested primary care networks to register with the PBRN |
| Resource Center. **Registration is free!**                            |
|                                                                       |
| ***Why Register?***                                                   |
|                                                                       |
| Registered PBRNs receive a number of benefits including: notification |
| of AHRQ funding opportunities, the ability to participate in both     |
| general and topic-specific listservs and in the PBRN Resource Center  |
| sponsored web-based seminars (Peer Learning Groups). Additionally,    |
| members are invited to attend the annual AHRQ National PBRN Research  |
| Conference. Registration also offers your network access to technical |
| assistance from AHRQ and the PBRN Resource Center on operational and  |
| research topics relevant to Primary Care PBRNs.                       |
|                                                                       |
| ***Who can register?***                                               |
|                                                                       |
| All PBRNs that contain more than fifty percent of primary care        |
| clinicians (e.g. pediatrics, family medicine, general internal        |
| medicine, and geriatrics) are eligible to register including already  |
| established PBRNs or those in the process of organizing. Furthermore, |
| your network (or planned network) must consist of at least 15         |
| clinicians or clinician practices.                                    |
|                                                                       |
| ***How to Register?***                                                |
|                                                                       |
| Registration is easy. To receive a Username and Password for your     |
| network contact Brenda Hudson at <brlhudso@iupui.edu> or visit our    |
| website at <http://secure.ahrq.gov/survey/pbrn/surveys>.              |
|                                                                       |
| **The registry contains four sections, but only Section 1 must be     |
| completed to register a PBRN.**                                       |
+-----------------------------------------------------------------------+

> []{#Agenda .anchor}THE 2006 AHRQ NATIONAL PBRN RESEARCH CONFERENCE,
> MAY 15 -- 17, 2006

#  BETHESDA MARRIOT, 5151 POOKS HILL ROAD, BETHESDA MARYLAND

# *Monday, May 15, 2006* [top](#top) CONFERENCE AGENDA 

+--------+--------------+---+-----+-----+-----------+---+------------------+
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|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| *      |              |   |     | *   |           |   |                  |
| *[Peer |              |   |     | *[1 |           |   |                  |
| Le     |              |   |     | :00 |           |   |                  |
| arning |              |   |     | P   |           |   |                  |
| Group  |              |   |     | .M. |           |   |                  |
| Wo     |              |   |     | --  |           |   |                  |
| rkshop |              |   |     | 4   |           |   |                  |
| s\*]{. |              |   |     | :45 |           |   |                  |
| smallc |              |   |     | P   |           |   |                  |
| aps}** |              |   |     | .M. |           |   |                  |
|        |              |   |     | ]{. |           |   |                  |
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|        |              |   |     | llc |           |   |                  |
|        |              |   |     | aps |           |   |                  |
|        |              |   |     | }** |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **     |              |   |     | > * |           |   |                  |
| [[PBRN |              |   |     | *Ma |           |   |                  |
| Ope    |              |   |     | nag |           |   |                  |
| ration |              |   |     | ing |           |   |                  |
| s]{.un |              |   |     | >   |           |   |                  |
| derlin |              |   |     |  Mu |           |   |                  |
| e}:]{. |              |   |     | lti |           |   |                  |
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|        |              |   |     | Pro |           |   |                  |
|        |              |   |     | jec |           |   |                  |
|        |              |   |     | ts: |           |   |                  |
|        |              |   |     | >   |           |   |                  |
|        |              |   |     | Mas |           |   |                  |
|        |              |   |     | ter |           |   |                  |
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|        |              |   |     | >   |           |   |                  |
|        |              |   |     | the |           |   |                  |
|        |              |   |     | >   |           |   |                  |
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|        |              |   |     | >   |           |   |                  |
|        |              |   |     |  of |           |   |                  |
|        |              |   |     | > " |           |   |                  |
|        |              |   |     | Jug |           |   |                  |
|        |              |   |     | gli |           |   |                  |
|        |              |   |     | ng" |           |   |                  |
|        |              |   |     | >   |           |   |                  |
|        |              |   |     |  in |           |   |                  |
|        |              |   |     | > 3 |           |   |                  |
|        |              |   |     | > E |           |   |                  |
|        |              |   |     | asy |           |   |                  |
|        |              |   |     | > H |           |   |                  |
|        |              |   |     | our |           |   |                  |
|        |              |   |     | s** |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **     |              |   |     | >   |           |   |                  |
| [[PBRN |              |   |     |  ** |           |   |                  |
| Method |              |   |     | Exp |           |   |                  |
| s]{.un |              |   |     | and |           |   |                  |
| derlin |              |   |     | ing |           |   |                  |
| e}:]{. |              |   |     | > y |           |   |                  |
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| aps}** |              |   |     | > M |           |   |                  |
|        |              |   |     | eth |           |   |                  |
|        |              |   |     | ods |           |   |                  |
|        |              |   |     | >   |           |   |                  |
|        |              |   |     |  Sk |           |   |                  |
|        |              |   |     | ill |           |   |                  |
|        |              |   |     | >   |           |   |                  |
|        |              |   |     |  Se |           |   |                  |
|        |              |   |     | t** |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **[[Q  |              |   |     | >   |           |   |                  |
| uality |              |   |     |  ** |           |   |                  |
| Impro  |              |   |     | Mov |           |   |                  |
| vement |              |   |     | ing |           |   |                  |
| in     |              |   |     | >   |           |   |                  |
| PBRN   |              |   |     | Bey |           |   |                  |
| s]{.un |              |   |     | ond |           |   |                  |
| derlin |              |   |     | > P |           |   |                  |
| e}:]{. |              |   |     | eer |           |   |                  |
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|        |              |   |     | iew |           |   |                  |
|        |              |   |     | >   |           |   |                  |
|        |              |   |     |  Pu |           |   |                  |
|        |              |   |     | bli |           |   |                  |
|        |              |   |     | cat |           |   |                  |
|        |              |   |     | ion |           |   |                  |
|        |              |   |     | s - |           |   |                  |
|        |              |   |     | > D |           |   |                  |
|        |              |   |     | iss |           |   |                  |
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|        |              |   |     | nat |           |   |                  |
|        |              |   |     | ing |           |   |                  |
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|        |              |   |     | our |           |   |                  |
|        |              |   |     | >   |           |   |                  |
|        |              |   |     |  QI |           |   |                  |
|        |              |   |     | > R |           |   |                  |
|        |              |   |     | ese |           |   |                  |
|        |              |   |     | arc |           |   |                  |
|        |              |   |     | h** |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **[[IT |              |   |     | >   |           |   |                  |
| & HIT  |              |   |     |  ** |           |   |                  |
| in     |              |   |     | Hea |           |   |                  |
| PBRN   |              |   |     | lth |           |   |                  |
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|        |              |   |     | >   |           |   |                  |
|        |              |   |     |  Re |           |   |                  |
|        |              |   |     | sea |           |   |                  |
|        |              |   |     | rch |           |   |                  |
|        |              |   |     | >   |           |   |                  |
|        |              |   |     | Set |           |   |                  |
|        |              |   |     | tin |           |   |                  |
|        |              |   |     | g** |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| *\*A   |              |   |     |     |           |   |                  |
| descr  |              |   |     |     |           |   |                  |
| iption |              |   |     |     |           |   |                  |
| of the |              |   |     |     |           |   |                  |
| wor    |              |   |     |     |           |   |                  |
| kshops |              |   |     |     |           |   |                  |
| and    |              |   |     |     |           |   |                  |
| the    |              |   |     |     |           |   |                  |
| pres   |              |   |     |     |           |   |                  |
| enters |              |   |     |     |           |   |                  |
| is     |              |   |     |     |           |   |                  |
| ava    |              |   |     |     |           |   |                  |
| ilable |              |   |     |     |           |   |                  |
| at the |              |   |     |     |           |   |                  |
| end of |              |   |     |     |           |   |                  |
| the    |              |   |     |     |           |   |                  |
| ag     |              |   |     |     |           |   |                  |
| enda.* |              |   |     |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
|        | **PBRN**     | * |     |     | **Quality |   | **IT/HIT in      |
|        |              | * |     |     | Impr      |   | PBRNs**          |
|        | **           | P |     |     | ovement** |   |                  |
|        | Operations** | B |     |     |           |   | ***(Pooks        |
|        |              | R |     |     | ***(Cong  |   | Hil              |
|        | ***(C        | N |     |     | ressional |   | l/Kensington)*** |
|        | ongressional | * |     |     | Salon     |   |                  |
|        | Salon 1)***  | * |     |     | 3)***     |   |                  |
|        |              |   |     |     |           |   |                  |
|        |              | * |     |     |           |   |                  |
|        |              | * |     |     |           |   |                  |
|        |              | M |     |     |           |   |                  |
|        |              | e |     |     |           |   |                  |
|        |              | t |     |     |           |   |                  |
|        |              | h |     |     |           |   |                  |
|        |              | o |     |     |           |   |                  |
|        |              | d |     |     |           |   |                  |
|        |              | s |     |     |           |   |                  |
|        |              | * |     |     |           |   |                  |
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|        |              | ( |     |     |           |   |                  |
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|        |              | o |     |     |           |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | 2 |     |     |           |   |                  |
|        |              | ) |     |     |           |   |                  |
|        |              | * |     |     |           |   |                  |
|        |              | * |     |     |           |   |                  |
|        |              | * |     |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **1:00 | U            | E |     |     | Comm      |   | What PBRNs       |
| PM --  | nderstanding | x |     |     | unicating |   | Should Know      |
| 2:00   | the Art of   | p |     |     | with      |   | about Health     |
| PM**   | Project      | l |     |     | Policy    |   | Informatics      |
|        | Management   | o |     |     | Makers    |   |                  |
|        | and its      | r |     |     | and       |   |                  |
|        | Methodology  | i |     |     | Payers    |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | g |     |     |           |   |                  |
|        |              | t |     |     |           |   |                  |
|        |              | h |     |     |           |   |                  |
|        |              | e |     |     |           |   |                  |
|        |              | F |     |     |           |   |                  |
|        |              | u |     |     |           |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | d |     |     |           |   |                  |
|        |              | a |     |     |           |   |                  |
|        |              | m |     |     |           |   |                  |
|        |              | e |     |     |           |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | t |     |     |           |   |                  |
|        |              | a |     |     |           |   |                  |
|        |              | l |     |     |           |   |                  |
|        |              | s |     |     |           |   |                  |
|        |              | o |     |     |           |   |                  |
|        |              | f |     |     |           |   |                  |
|        |              | M |     |     |           |   |                  |
|        |              | o |     |     |           |   |                  |
|        |              | t |     |     |           |   |                  |
|        |              | i |     |     |           |   |                  |
|        |              | v |     |     |           |   |                  |
|        |              | a |     |     |           |   |                  |
|        |              | t |     |     |           |   |                  |
|        |              | i |     |     |           |   |                  |
|        |              | o |     |     |           |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | a |     |     |           |   |                  |
|        |              | l |     |     |           |   |                  |
|        |              | I |     |     |           |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | t |     |     |           |   |                  |
|        |              | e |     |     |           |   |                  |
|        |              | r |     |     |           |   |                  |
|        |              | v |     |     |           |   |                  |
|        |              | i |     |     |           |   |                  |
|        |              | e |     |     |           |   |                  |
|        |              | w |     |     |           |   |                  |
|        |              | i |     |     |           |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | g |     |     |           |   |                  |
|        |              | i |     |     |           |   |                  |
|        |              | n |     |     |           |   |                  |
|        |              | P |     |     |           |   |                  |
|        |              | r |     |     |           |   |                  |
|        |              | i |     |     |           |   |                  |
|        |              | m |     |     |           |   |                  |
|        |              | a |     |     |           |   |                  |
|        |              | r |     |     |           |   |                  |
|        |              | y |     |     |           |   |                  |
|        |              | C |     |     |           |   |                  |
|        |              | a |     |     |           |   |                  |
|        |              | r |     |     |           |   |                  |
|        |              | e |     |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| ***15  |              |   |     |     |           |   |                  |
| minute |              |   |     |     |           |   |                  |
| break  |              |   |     |     |           |   |                  |
| (C     |              |   |     |     |           |   |                  |
| ongres |              |   |     |     |           |   |                  |
| sional |              |   |     |     |           |   |                  |
| Foy    |              |   |     |     |           |   |                  |
| er)*** |              |   |     |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **2:15 | Project      |   | U   |     | Comm      |   | Strategies for   |
| PM --  | Management:  |   | nde |     | unicating |   | Identifying      |
| 3:15   | Assessing    |   | rst |     | with      |   | Eligible         |
| PM**   | the          |   | and |     | Policy    |   | Patients         |
|        | Situation    |   | ing |     | Makers    |   |                  |
|        |              |   | M   |     | and       |   |                  |
|        |              |   | ult |     | Payers -  |   |                  |
|        |              |   | ile |     | Open      |   |                  |
|        |              |   | vel |     | Forum     |   |                  |
|        |              |   | Mo  |     | with the  |   |                  |
|        |              |   | del |     | Panel     |   |                  |
|        |              |   | ing |     |           |   |                  |
|        |              |   | and |     |           |   |                  |
|        |              |   | Pr  |     |           |   |                  |
|        |              |   | act |     |           |   |                  |
|        |              |   | ice |     |           |   |                  |
|        |              |   | Ba  |     |           |   |                  |
|        |              |   | sed |     |           |   |                  |
|        |              |   | Re  |     |           |   |                  |
|        |              |   | sea |     |           |   |                  |
|        |              |   | rch |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| ***15  |              |   |     |     |           |   |                  |
| minute |              |   |     |     |           |   |                  |
| break  |              |   |     |     |           |   |                  |
| (C     |              |   |     |     |           |   |                  |
| ongres |              |   |     |     |           |   |                  |
| sional |              |   |     |     |           |   |                  |
| Foy    |              |   |     |     |           |   |                  |
| er)*** |              |   |     |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **3:30 | Techniques   |   | Ana |     | Getting   |   | Practical        |
| PM --  | and          |   | lyz |     | your      |   | Considerations   |
| 4:30   | Organization |   | ing |     | Research  |   | for Applying     |
| PM**   | Strategies   |   | D   |     | in the    |   | Informatics      |
|        | Helpful in   |   | ata |     | Headlines |   | Techniques in    |
|        | Managing     |   | us  |     |           |   | *your* PBRN      |
|        | Multiple     |   | ing |     |           |   |                  |
|        | Projects     |   | M   |     |           |   |                  |
|        |              |   | ult |     |           |   |                  |
|        |              |   | ile |     |           |   |                  |
|        |              |   | vel |     |           |   |                  |
|        |              |   | Mo  |     |           |   |                  |
|        |              |   | del |     |           |   |                  |
|        |              |   | ing |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| ***15  |              |   |     |     |           |   |                  |
| minute |              |   |     |     |           |   |                  |
| Group  |              |   |     |     |           |   |                  |
| Disc   |              |   |     |     |           |   |                  |
| ussion |              |   |     |     |           |   |                  |
| to     |              |   |     |     |           |   |                  |
| D      |              |   |     |     |           |   |                  |
| evelop |              |   |     |     |           |   |                  |
| Topics |              |   |     |     |           |   |                  |
| for    |              |   |     |     |           |   |                  |
| Future |              |   |     |     |           |   |                  |
| Sessi  |              |   |     |     |           |   |                  |
| ons*** |              |   |     |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **[Co  |              |   |     |     |           | * |                  |
| cktail |              |   |     |     |           | * |                  |
| Rec    |              |   |     |     |           | 4 |                  |
| eption |              |   |     |     |           | : |                  |
| &      |              |   |     |     |           | 4 |                  |
| Post   |              |   |     |     |           | 5 |                  |
| ers]{. |              |   |     |     |           | P |                  |
| smallc |              |   |     |     |           | . |                  |
| aps}** |              |   |     |     |           | M |                  |
|        |              |   |     |     |           | . |                  |
|        |              |   |     |     |           | - |                  |
|        |              |   |     |     |           | 6 |                  |
|        |              |   |     |     |           | : |                  |
|        |              |   |     |     |           | 0 |                  |
|        |              |   |     |     |           | 0 |                  |
|        |              |   |     |     |           | P |                  |
|        |              |   |     |     |           | . |                  |
|        |              |   |     |     |           | M |                  |
|        |              |   |     |     |           | . |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           |   |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | M |                  |
|        |              |   |     |     |           | a |                  |
|        |              |   |     |     |           | r |                  |
|        |              |   |     |     |           | y |                  |
|        |              |   |     |     |           | l |                  |
|        |              |   |     |     |           | a |                  |
|        |              |   |     |     |           | n |                  |
|        |              |   |     |     |           | d |                  |
|        |              |   |     |     |           | S |                  |
|        |              |   |     |     |           | u |                  |
|        |              |   |     |     |           | i |                  |
|        |              |   |     |     |           | t |                  |
|        |              |   |     |     |           | e |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **[E   |              |   |     |     |           | * |                  |
| vening |              |   |     |     |           | * |                  |
| P      |              |   |     |     |           | 6 |                  |
| lenary |              |   |     |     |           | : |                  |
| Kick-  |              |   |     |     |           | 0 |                  |
| Off]{. |              |   |     |     |           | 0 |                  |
| smallc |              |   |     |     |           | P |                  |
| aps}** |              |   |     |     |           | . |                  |
|        |              |   |     |     |           | M |                  |
| C      |              |   |     |     |           | - |                  |
| arolyn |              |   |     |     |           | - |                  |
| C      |              |   |     |     |           | 6 |                  |
| lancy, |              |   |     |     |           | : |                  |
| MD     |              |   |     |     |           | 1 |                  |
|        |              |   |     |     |           | 5 |                  |
| Dir    |              |   |     |     |           | P |                  |
| ector, |              |   |     |     |           | . |                  |
| AHRQ   |              |   |     |     |           | M |                  |
|        |              |   |     |     |           | . |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           |   |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | C |                  |
|        |              |   |     |     |           | o |                  |
|        |              |   |     |     |           | n |                  |
|        |              |   |     |     |           | g |                  |
|        |              |   |     |     |           | r |                  |
|        |              |   |     |     |           | e |                  |
|        |              |   |     |     |           | s |                  |
|        |              |   |     |     |           | s |                  |
|        |              |   |     |     |           | i |                  |
|        |              |   |     |     |           | o |                  |
|        |              |   |     |     |           | n |                  |
|        |              |   |     |     |           | a |                  |
|        |              |   |     |     |           | l |                  |
|        |              |   |     |     |           | B |                  |
|        |              |   |     |     |           | a |                  |
|        |              |   |     |     |           | l |                  |
|        |              |   |     |     |           | l |                  |
|        |              |   |     |     |           | r |                  |
|        |              |   |     |     |           | o |                  |
|        |              |   |     |     |           | o |                  |
|        |              |   |     |     |           | m |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+
| **[Pi  |              |   |     |     |           | * |                  |
| oneers |              |   |     |     |           | * |                  |
| of     |              |   |     |     |           | 6 |                  |
| PBRN   |              |   |     |     |           | : |                  |
| E      |              |   |     |     |           | 1 |                  |
| fforts |              |   |     |     |           | 5 |                  |
| in the |              |   |     |     |           | P |                  |
| U      |              |   |     |     |           | . |                  |
| .S.]{. |              |   |     |     |           | M |                  |
| smallc |              |   |     |     |           | . |                  |
| aps}** |              |   |     |     |           | - |                  |
|        |              |   |     |     |           | 7 |                  |
| -   [  |              |   |     |     |           | : |                  |
| Facili |              |   |     |     |           | 3 |                  |
| tator] |              |   |     |     |           | 0 |                  |
| {.unde |              |   |     |     |           | P |                  |
| rline} |              |   |     |     |           | . |                  |
|     -- |              |   |     |     |           | M |                  |
|        |              |   |     |     |           | . |                  |
|    Dr. |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|  David |              |   |     |     |           |   |                  |
|        |              |   |     |     |           | * |                  |
| Lanier |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
| -      |              |   |     |     |           | C |                  |
| Eugene |              |   |     |     |           | o |                  |
|     F  |              |   |     |     |           | n |                  |
| arley, |              |   |     |     |           | g |                  |
|     MD |              |   |     |     |           | r |                  |
|        |              |   |     |     |           | e |                  |
| (ASPN) |              |   |     |     |           | s |                  |
|        |              |   |     |     |           | s |                  |
| -      |              |   |     |     |           | i |                  |
| Robert |              |   |     |     |           | o |                  |
|        |              |   |     |     |           | n |                  |
|    Hag |              |   |     |     |           | a |                  |
| gerty, |              |   |     |     |           | l |                  |
|     MD |              |   |     |     |           | B |                  |
|        |              |   |     |     |           | a |                  |
| (PROS) |              |   |     |     |           | l |                  |
|        |              |   |     |     |           | l |                  |
| -      |              |   |     |     |           | r |                  |
|   John |              |   |     |     |           | o |                  |
|     W  |              |   |     |     |           | o |                  |
| asson, |              |   |     |     |           | m |                  |
|     MD |              |   |     |     |           | * |                  |
|        |              |   |     |     |           | * |                  |
|   (Dar |              |   |     |     |           | * |                  |
| tmouth |              |   |     |     |           |   |                  |
|        |              |   |     |     |           |   |                  |
| CO-OP) |              |   |     |     |           |   |                  |
+--------+--------------+---+-----+-----+-----------+---+------------------+

# *Tuesday, May 16, 2006 [**top**](#top)* CONFERENCE AGENDA

+-------------------------------------------------+---+-------------------+
| **[Registration]{.smallcaps}**                  |   | **7:30 A.M.-11:30 |
|                                                 |   | A.M.**            |
|                                                 |   |                   |
|                                                 |   | *Grand Salon A    |
|                                                 |   | Foyer*            |
+-------------------------------------------------+---+-------------------+
| **[Overview of the Conference]{.smallcaps}**    |   | **8:00 A.M.-8:15  |
|                                                 |   | A.M.**            |
| David Lanier, MD                                |   |                   |
|                                                 |   | *Congressional    |
| Associate Director CP3, AHRQ                    |   | Ballroom*         |
+-------------------------------------------------+---+-------------------+
| **[PBRN Resource Center Update]{.smallcaps}**   |   | **8:15 A.M.-9:00  |
|                                                 |   | A.M.**            |
| William Tierney, MD & Dan Gaylin, MPA           |   |                   |
|                                                 |   | *Congressional    |
| Co-directors, National PBRN Resource Center     |   | Ballroom*         |
+-------------------------------------------------+---+-------------------+
| **[PBRNs at the Interface of Research and       |   | **9:00 A.M.-10:30 |
| Quality Improvement]{.smallcaps}**              |   | A.M.**            |
|                                                 |   |                   |
| -   [Facilitator]{.underline} -- Dan Gaylin,    |   | *Congressional    |
|     MPA                                         |   | Ballroom*         |
|                                                 |   |                   |
| -   James Mold, MD MPH (OKPRN)                  |   |                   |
|                                                 |   |                   |
| -   Dale Bratzler, DO MPH (OK Foundation for    |   |                   |
|     Medical Quality)                            |   |                   |
+-------------------------------------------------+---+-------------------+
| **[Coffee & Posters]{.smallcaps}**              |   | **10:30           |
|                                                 |   | A.M.-11:15 A.M.** |
|                                                 |   |                   |
|                                                 |   | *Maryland Suite*  |
+-------------------------------------------------+---+-------------------+
| **[Concurrent Sessions I]{.smallcaps}**         |   | **11:15           |
|                                                 |   | A.M.-12:15 P.M.** |
+-------------------------------------------------+---+-------------------+
| > **IA *-- Follow-up with QI Panel***           |   | *Congressional    |
|                                                 |   | Salon 1*          |
+-------------------------------------------------+---+-------------------+
| -   [Facilitator]{.underline} -- Kevin          |   |                   |
|     Peterson, MD MPH                            |   |                   |
|                                                 |   |                   |
| >           James Mold, MD MPH (OKPRN)         |   |                   |
|                                                 |   |                   |
| -   Dale Bratzler, DO MPH (OK Foundation for    |   |                   |
|     Medical Quality)                            |   |                   |
+-------------------------------------------------+---+-------------------+
| > **IB *-- Recruitment & Retention of           |   | *Congressional    |
| > Clinicians and Practices in PBRNs***          |   | Salon 2*          |
+-------------------------------------------------+---+-------------------+
| >      John Hickner, MD MSc (PBRN Resource     |   |                   |
| > Center)                                       |   |                   |
+-------------------------------------------------+---+-------------------+
| > **IC *-- Nutrition and Obesity***             |   | *Congressional    |
|                                                 |   | Salon 3*          |
+-------------------------------------------------+---+-------------------+
| -   [Facilitator]{.underline} -- Laura Anderko, |   |                   |
|     RN PhD                                      |   |                   |
|                                                 |   |                   |
| >           "Using Focus Groups to Identify    |   |                   |
| > Potential Culturally-Specific Interventions   |   |                   |
| > for Obesity Prevention in Young Children" -   |   |                   |
| > Barbara Sarter, PhD (LA Net)                  |   |                   |
| >                                               |   |                   |
| >           "Poor Nutritional Habits: A        |   |                   |
| > Modifiable Predecessor of Chronic Disease" -  |   |                   |
| > Philip Sloane, MD MPH (NC-FP-RN)              |   |                   |
| >                                               |   |                   |
| >           *Research in Progress:* "Don't     |   |                   |
| > Tell Me My Child is Overweight or Fat" -      |   |                   |
| > Cecelia Gaffney, MEd (CECH)                   |   |                   |
+-------------------------------------------------+---+-------------------+
| > **ID *-- Medication Safety***                 | * |                   |
|                                                 | P |                   |
|                                                 | o |                   |
|                                                 | o |                   |
|                                                 | k |                   |
|                                                 | s |                   |
|                                                 | H |                   |
|                                                 | i |                   |
|                                                 | l |                   |
|                                                 | l |                   |
|                                                 | / |                   |
|                                                 | K |                   |
|                                                 | e |                   |
|                                                 | n |                   |
|                                                 | s |                   |
|                                                 | i |                   |
|                                                 | n |                   |
|                                                 | g |                   |
|                                                 | t |                   |
|                                                 | o |                   |
|                                                 | n |                   |
|                                                 | * |                   |
+-------------------------------------------------+---+-------------------+

+------------------------------------------------+--------------------+---+
| -   [Facilitator]{.underline} -- Walter        |                    |   |
|     Calmbach, MD                               |                    |   |
|                                                |                    |   |
| >           "The Comparison of an Electronic  |                    |   |
| > Medical Record (EMR) and a Paper Medical     |                    |   |
| > Record (PMR) on Medication Counseling in     |                    |   |
| > Primary Care Clinics: A SPUR-Net Study" -    |                    |   |
| > Grace Kuo, PharmD (SPUR-Net)                 |                    |   |
| >                                              |                    |   |
| >          *Research in Progress:* "In        |                    |   |
| > Partnership with the Community: Developing   |                    |   |
| > the Role of the Community Advisory Board     |                    |   |
| > (CAB) in the Implementation of a Rural       |                    |   |
| > Health Information Technology Project" -     |                    |   |
| > James Wallace (ORPRN)                        |                    |   |
| >                                              |                    |   |
| >           *Research in Progress:*           |                    |   |
| > "Improving Geriatric Drug Safety in          |                    |   |
| > Underserved Practices" - Gurdev Singh, PhD   |                    |   |
| > (UNYNET)                                     |                    |   |
+------------------------------------------------+--------------------+---+
| **[Networking Lunch [top](#top)]{.smallcaps}** | **12:15 P.M.-1:15  |   |
|                                                | P.M.**             |   |
|                                                |                    |   |
|                                                | *Grand Ballroom    |   |
|                                                | A/B/C*             |   |
+------------------------------------------------+--------------------+---+
| **[PBRNs and Health Disparities                | **1:15 P.M.-2:45   |   |
| Research]{.smallcaps}**                        | P.M.**             |   |
|                                                |                    |   |
|                                                | *Grand Ballroom    |   |
|                                                | A/B/C*             |   |
+------------------------------------------------+--------------------+---+
| -   [Facilitator]{.underline} -- Lisa Cooper,  |                    |   |
|     MD MPH (Johns Hopkins University)          |                    |   |
|                                                |                    |   |
| -   George Rust, MD (Southeast Regional        |                    |   |
|     Clinicians' Network)                       |                    |   |
|                                                |                    |   |
| -   Margaret Handley, PhD MPH (UCSF CRN)       |                    |   |
|                                                |                    |   |
| -   Diane McKee, MD MS (NYCRing)               |                    |   |
+------------------------------------------------+--------------------+---+
| **[Break]{.smallcaps}**                        | **2:45 P.M. --     |   |
|                                                | 3:00 P.M.**        |   |
|                                                |                    |   |
|                                                | *Maryland Suite*   |   |
+------------------------------------------------+--------------------+---+
| **[Concurrent Sessions II]{.smallcaps}**       | **3:00 P.M.-4:00   |   |
|                                                | P.M.**             |   |
+------------------------------------------------+--------------------+---+
| > **IIA *-- Follow-up with Health Disparities  | *Congressional     |   |
| > Panel***                                     | Salon 1*           |   |
+------------------------------------------------+--------------------+---+
| -   [Facilitator]{.underline} -- Lisa Cooper,  |                    |   |
|     MD MPH                                     |                    |   |
|                                                |                    |   |
| -   George Rust, MD (Southeast Regional        |                    |   |
|     Clinicians' Network)                       |                    |   |
|                                                |                    |   |
| -   Margaret Handley, PhD MPH (UCSF CRN)       |                    |   |
|                                                |                    |   |
| -   Diane McKee, MD MS (NYCRing)               |                    |   |
+------------------------------------------------+--------------------+---+
| > **IIB *-- Pediatric Research***              | *Congressional     |   |
|                                                | Salon 2*           |   |
+------------------------------------------------+--------------------+---+
| -   [Facilitator]{.underline} -- Mort          |                    |   |
|     Wasserman, MD MPH                          |                    |   |
|                                                |                    |   |
|     -   "Validity of Parental Reporting of     |                    |   |
|         Recent Episodes of Acute Otitis        |                    |   |
|         Media" - Louis Vernacchio, MD MS (SCOR |                    |   |
|         Network)                               |                    |   |
|                                                |                    |   |
| >         "Parental Gun Storage Patterns and  |                    |   |
| > Attitudes about Gun Safety Counseling and    |                    |   |
| > Gun Safety Education" - Jack Pascoe, MD      |                    |   |
| > (Dayton Primary Care PBRN)                   |                    |   |
| >                                              |                    |   |
| >          *Research in Progress:* "Treating  |                    |   |
| > Sleep Terrors with Iron Fortified            |                    |   |
| > Multivitamins" - Christopher Bolling, MD     |                    |   |
| > (CPRG)                                       |                    |   |
+------------------------------------------------+--------------------+---+
| > **IIC *-- Rural PBRNs***                     | *Congressional     |   |
|                                                | Salon 3*           |   |
+------------------------------------------------+--------------------+---+
| -   [Facilitator]{.underline} -- Margaret      |                    |   |
|     Love, PhD                                  |                    |   |
|                                                |                    |   |
|     -   "Testing to Prevent Colon Cancer in    |                    |   |
|         Rural Colorado" - Linda Zittleman,     |                    |   |
|         MSPH (High Plains Research Network)    |                    |   |
|                                                |                    |   |
| >         "Bridging The Gap Between Public    |                    |   |
| > And Private Health Care: Influenza-Like      |                    |   |
| > Illness Surveillance in a Practice-Based     |                    |   |
| > Research Network" -- Zsolt Nagykaldi, PhD    |                    |   |
| > (OKPRN)                                      |                    |   |
| >                                              |                    |   |
| >         "2005 ORPRN Practice and Clinician  |                    |   |
| > Surveys" - Lyle Fagnan, MD (ORPRN)           |                    |   |
+------------------------------------------------+--------------------+---+
| > **IID *-- Workshop: Technology and Practice  | *Pooks             |   |
| > Change to Support Patient-Centered,          | Hill/Kensington*   |   |
| > Collaborative Care***                        |                    |   |
+------------------------------------------------+--------------------+---+

+-----------------------------------------------------------------------+
| -   [Moderator]{.underline} -- John H. Wasson, MD                     |
|                                                                       |
| > Workshop Learning Objectives:                                       |
| >                                                                     |
| > 1\. Understand much more than the jargon of \"patient-centered\"    |
| > and \"collaborative care.\"                                         |
| >                                                                     |
| > 2\. Learn the practical implications of patient-centered,           |
| > collaborative care for primary care practices.                      |
| >                                                                     |
| > 3\. Be able to implement technologies and practice changes to       |
| > support patient-centered, collaborative care.                       |
+-----------------------------------------------------------------------+

+----------------------------------------------+---+----------------------+
| **[Break [top](#top)]{.smallcaps}**          |   | **4:00 P.M.-4:15     |
|                                              |   | P.M.**               |
|                                              |   |                      |
|                                              |   | *Maryland Suite*     |
+----------------------------------------------+---+----------------------+
| **[Concurrent Sessions]{.smallcaps} *III***  |   | **4:15 P.M.-5:30     |
|                                              |   | P.M.**               |
+----------------------------------------------+---+----------------------+
| > **IIIA *-- Workshop: Research Integrity    |   | *Congressional Salon |
| > Indicators for PBRNs***                    |   | 1*                   |
+----------------------------------------------+---+----------------------+
| -   [Moderator]{.underline} -- Victoria      |   |                      |
|     Neale, PhD (MetroNet)                    |   |                      |
|                                              |   |                      |
| > Workshop Learning Objectives:              |   |                      |
|                                              |   |                      |
| 1.  To consider the ethical challenges that  |   |                      |
|     confront PBRNs.                          |   |                      |
|                                              |   |                      |
| 2.  To review the Institute of Medicine's    |   |                      |
|     statements about deficiencies in the     |   |                      |
|     research integrity knowledge base.       |   |                      |
|                                              |   |                      |
| 3.  To discuss policies and procedures that  |   |                      |
|     promote PBRN research integrity.         |   |                      |
|                                              |   |                      |
| 4.  To develop strategies for PBRNs to       |   |                      |
|     monitor their research integrity.        |   |                      |
+----------------------------------------------+---+----------------------+
| > **IIIB *-- Workshop: The Impact of         | * |                      |
| > Community Member Participation on PBRN     | C |                      |
| > Research***                                | o |                      |
|                                              | n |                      |
|                                              | g |                      |
|                                              | r |                      |
|                                              | e |                      |
|                                              | s |                      |
|                                              | s |                      |
|                                              | i |                      |
|                                              | o |                      |
|                                              | n |                      |
|                                              | a |                      |
|                                              | l |                      |
|                                              | S |                      |
|                                              | a |                      |
|                                              | l |                      |
|                                              | o |                      |
|                                              | n |                      |
|                                              | 2 |                      |
|                                              | * |                      |
+----------------------------------------------+---+----------------------+
| -   [Moderator]{.underline} -- John          |   |                      |
|     Westfall, MD (High Plains Research       |   |                      |
|     Network)                                 |   |                      |
|                                              |   |                      |
| > Workshop Learning Objectives:              |   |                      |
|                                              |   |                      |
| 1.  Illustrate examples of active community  |   |                      |
|     member involvement in the High Plains    |   |                      |
|     Research Network in Rural Colorado.      |   |                      |
|                                              |   |                      |
| 2.  Describe the impact of community         |   |                      |
|     involvement on PBRN research.            |   |                      |
|                                              |   |                      |
| 3.  Discuss strategies and needs for         |   |                      |
|     involving community members PBRN         |   |                      |
|     research.                                |   |                      |
+----------------------------------------------+---+----------------------+
| > **IIIC *-- PBRN Methods to Engage          | * |                      |
| > Clinicians***                              | C |                      |
|                                              | o |                      |
|                                              | n |                      |
|                                              | g |                      |
|                                              | r |                      |
|                                              | e |                      |
|                                              | s |                      |
|                                              | s |                      |
|                                              | i |                      |
|                                              | o |                      |
|                                              | n |                      |
|                                              | a |                      |
|                                              | l |                      |
|                                              | S |                      |
|                                              | a |                      |
|                                              | l |                      |
|                                              | o |                      |
|                                              | n |                      |
|                                              | 3 |                      |
|                                              | * |                      |
+----------------------------------------------+---+----------------------+
| -   [Facilitator]{.underline} -- Tom Stewart |   |                      |
|                                              |   |                      |
|     -   "CD-ROM Decision Aid for Mammography |   |                      |
|         Screening in Women 40-49" - William  |   |                      |
|         Curry, MD MS (Penn State Ambulatory  |   |                      |
|         Care Network)                        |   |                      |
|                                              |   |                      |
| >          "Screening Mammography for Older |   |                      |
| > Women: PBRN Clinicians\' Perceived         |   |                      |
| > Barriers and 'Best Practices'" - Margaret  |   |                      |
| > Love, PhD (KAN)                            |   |                      |
| >                                            |   |                      |
| >       "Optimizing the Limited Resources   |   |                      |
| > Available for Implementing Shared          |   |                      |
| > Decision-making in Primary Care" - France  |   |                      |
| > Legare, MD PhD (Laval University)          |   |                      |
|                                              |   |                      |
| -   *Research in Progress:* "Integrating     |   |                      |
|     Practice-based Learning and Improvement  |   |                      |
|     Groups into a Practice-based Research    |   |                      |
|     Network" - Lucia Sommers, DrPH (UCSF     |   |                      |
|     Collaborative Practice Network)          |   |                      |
+----------------------------------------------+---+----------------------+
| > **IIID *-- Refining Research in Progress:  | * |                      |
| > Providing Feedback to Your Colleagues***   | P |                      |
|                                              | o |                      |
|                                              | o |                      |
|                                              | k |                      |
|                                              | s |                      |
|                                              | H |                      |
|                                              | i |                      |
|                                              | l |                      |
|                                              | l |                      |
|                                              | / |                      |
|                                              | K |                      |
|                                              | e |                      |
|                                              | n |                      |
|                                              | s |                      |
|                                              | i |                      |
|                                              | n |                      |
|                                              | g |                      |
|                                              | t |                      |
|                                              | o |                      |
|                                              | n |                      |
|                                              | * |                      |
+----------------------------------------------+---+----------------------+
| -   [Facilitator]{.underline} -- Alan        |   |                      |
|     Adelman, MD MS                           |   |                      |
|                                              |   |                      |
|     -   *Research in Progress:*              |   |                      |
|         "Effectiveness of a Diabetes         |   |                      |
|         Management Program in Primary Care   |   |                      |
|         Practice" - John Lynch, MPH          |   |                      |
|         (ProHealth Physicians)               |   |                      |
|                                              |   |                      |
| >        *Research in Progress:*            |   |                      |
| > "Unanticipated Problems with Implementing  |   |                      |
| > Point-of-Care Lab Testing in Primary Care  |   |                      |
| > Settings" -  Bennett Parnes, MD (CaReNet)  |   |                      |
| >                                            |   |                      |
| >        *Research in Progress:*            |   |                      |
| > "Feasibility of Incorporating PDA Use to   |   |                      |
| > Enhance the Self-Care Activities of        |   |                      |
| > Patients with Diabetes" - Samuel Forjuoh,  |   |                      |
| > MD (CenTexNet)                             |   |                      |
+----------------------------------------------+---+----------------------+

# *Wednesday, May 17, 2006 [**top**](#top)* CONFERENCE AGENDA

+------------------------------------------------+---------------------+
| ***Breakfast and Poster Presentations***       | > **8:00 A.M.-9:00  |
|                                                | > A.M.**            |
|                                                | >                   |
|                                                | > *Maryland Suite*  |
+------------------------------------------------+---------------------+
| **[Concurrent Sessions IV]{.smallcaps}**       | **9:00 A.M.-10:00   |
|                                                | A.M.**              |
+------------------------------------------------+---------------------+
| > **IVA *-- Health Literacy***                 | *Congressional      |
|                                                | Salon 1*            |
+------------------------------------------------+---------------------+
| -   [Facilitator]{.underline} -- Carmela       |                     |
|     Lomonaco, PhD                              |                     |
|                                                |                     |
|     -   "Integrating Multiple Perspectives to  |                     |
|         Measure the Reach of Diabetes          |                     |
|         Self-Management Support Interventions  |                     |
|         in a Safety Net Primary Care           |                     |
|         Network" - Margaret Handley, PhD MPH   |                     |
|         (UCSF Collaborative Research Network)  |                     |
|                                                |                     |
| >          "Literacy in Primary Care:         |                     |
| > Comparison of Wisconsin to National          |                     |
| > Approaches and Attitudes" - Michael          |                     |
| > Grasmick, PhD (WREN)                         |                     |
| >                                              |                     |
| >          *Research in Progress:*            |                     |
| > "Evaluating the Effects of Cognitive         |                     |
| > Impairment and Low Health Literacy on        |                     |
| > Medication Adherence in Aging Minority       |                     |
| > Populations: A Significant Role for Primary  |                     |
| > Care Providers" - Charles P. Mouton, MD MS   |                     |
| > (DC PrimCaRe)                                |                     |
+------------------------------------------------+---------------------+
| > **IVB *-- Colorectal Cancer***               | *Congressional      |
|                                                | Salon 2*            |
+------------------------------------------------+---------------------+
| -   [Facilitator]{.underline} -- Kevin         |                     |
|     Peterson, MD MPH                           |                     |
|                                                |                     |
|     -   "Patient Reported Barriers to, and     |                     |
|         Facilitators of, Colorectal Cancer     |                     |
|         (CRC) Screening: Qualitative Study     |                     |
|         Results" - Kelly Devers, PhD (ACORN)   |                     |
|                                                |                     |
| >          "Improved Screening Colonoscopy    |                     |
| > Rates with Use of an Optimized Electronic    |                     |
| > Medical Record and Supportive Clinical       |                     |
| > Systems" - Jacob Prunuske, MD (Utah Health   |                     |
| > Research Network)                            |                     |
| >                                              |                     |
| >          "Colorectal Cancer Testing Among   |                     |
| > Patients Cared for by Iowa Family            |                     |
| > Physicians" - Barcey Levy, MD PhD (Iowa      |                     |
| > Research Network)                            |                     |
+------------------------------------------------+---------------------+
| > **IVC *-- Chronic Care Model***              | *Congressional      |
|                                                | Salon 3*            |
+------------------------------------------------+---------------------+
| -   [Facilitator]{.underline} -- John Pascoe,  |                     |
|     MD                                         |                     |
|                                                |                     |
|     -   "QuitLink: Partnering Clinical         |                     |
|         Practices and Telephone Quit Lines to  |                     |
|         Leverage an Improvement in the Quality |                     |
|         of Tobacco Counseling in Primary       |                     |
|         Care" - Steven Rothemich, MD MS        |                     |
|         (ACORN)                                |                     |
|                                                |                     |
| >          "A Controlled Trial of Methods for |                     |
| > Managing Pain in Primary Care Patients With  |                     |
| > or Without Co-Occurring Psychosocial         |                     |
| > Problems" - Deborah Johnson (Dartmouth       |                     |
| > CO-OP)                                       |                     |
| >                                              |                     |
| >          *Research in Progress:* "A         |                     |
| > Comprehensive Practice-Friendly Model for    |                     |
| > Promoting Healthy Behaviors. A Prescription  |                     |
| > for Health Study" - Alex Krist, MD (ACORN)   |                     |
+------------------------------------------------+---------------------+
| > **IVD *-- Workshop: Best Practices: Engaging | *Pooks              |
| > Medical Students to Overcome Recruitment     | Hill/Kensington*    |
| > Challenges in Rural Networks***              |                     |
+------------------------------------------------+---------------------+

+------------------------------------------------+---------------------+
| -   [Moderator]{.underline} -- Aimee James,    |                     |
|     PhD MPH                                    |                     |
|                                                |                     |
| > Workshop Learning Objectives:                |                     |
|                                                |                     |
| 1.  Identify methods for involving medical     |                     |
|     students in PBRN activities.               |                     |
|                                                |                     |
| 2.  Describe specific training and design      |                     |
|     concerns pertinent to engaging students in |                     |
|     research.                                  |                     |
|                                                |                     |
| 3.  Describe mutual benefits to students and   |                     |
|     practices resulting from participation in  |                     |
|     research.                                  |                     |
|                                                |                     |
| 4.  State how this strategy can enhance        |                     |
|     relationships between practices and PIs.   |                     |
|                                                |                     |
| 5.  Discuss innovative methods for relieving   |                     |
|     the research burden in practices.          |                     |
+------------------------------------------------+---------------------+
| **[Break [top](#top)]{.smallcaps}**            | **10:00 A.M.-10:15  |
|                                                | A.M.**              |
|                                                |                     |
|                                                | *Maryland Suite*    |
+------------------------------------------------+---------------------+
| **[Overview of Today's Sessions]{.smallcaps}** | **10:15 A.M.-10:30  |
|                                                | A.M.**              |
| David Meyers, MD                               |                     |
|                                                | *Congressional      |
| CP3, AHRQ                                      | Ballroom*           |
+------------------------------------------------+---------------------+
| **[PBRNs and the NIH Roadmap                   | **10:30 A.M.-12:00  |
| Initiative]{.smallcaps}**                      | P.M.**              |
|                                                |                     |
|                                                | *Congressional      |
|                                                | Ballroom*           |
+------------------------------------------------+---------------------+
|          [Facilitator]{.underline} -- David   |                     |
| Meyers, MD                                     |                     |
|                                                |                     |
| -   Barbara Alving, MD (Acting Director,       |                     |
|     NCRR-NIH)                                  |                     |
|                                                |                     |
| -   Kevin Peterson, MD MPH (MN AFP Network)    |                     |
|                                                |                     |
| -   John Hickner, MD MSc (PBRN Resource        |                     |
|     Center)                                    |                     |
|                                                |                     |
| -   Robert Williams, MD MPH (RIOS Net)         |                     |
+------------------------------------------------+---------------------+
| **[Networking Lunch]{.smallcaps}**             | **12:00 P.M.-1:15   |
|                                                | P.M.**              |
|                                                |                     |
|                                                | *Grand Ballroom     |
|                                                | A/B/C*              |
+------------------------------------------------+---------------------+
| **[Funders' Fair]{.smallcaps}**                | **1:15 P.M.-2:45    |
|                                                | P.M.**              |
|                                                |                     |
|                                                | *Grand Ballroom     |
|                                                | D/E*                |
+------------------------------------------------+---------------------+
| American Cancer Society                        |                     |
|                                                |                     |
| National Cancer Institute (NCI)                |                     |
|                                                |                     |
| National Center for Complementary and          |                     |
| Alternative Medicine (NCCAM)                   |                     |
|                                                |                     |
| National Center on Minority Health & Health    |                     |
| Disparities (NCMHD)                            |                     |
|                                                |                     |
| National Center for Research Resources (NCRR)  |                     |
|                                                |                     |
| National Committee for Quality Assurance       |                     |
| (NCQA)                                         |                     |
|                                                |                     |
| National Heart, Lung and Blood Institute       |                     |
| (NHLBI)                                        |                     |
|                                                |                     |
| National Institute on Aging (NIA)              |                     |
|                                                |                     |
| National Institute on Alcohol Abuse and        |                     |
| Alcoholism (NIAAA)                             |                     |
|                                                |                     |
| National Institute of Child Health & Human     |                     |
| Development (NICHD)                            |                     |
|                                                |                     |
| National Institute of Diabetes & Digestive &   |                     |
| Kidney Diseases (NIDDK)                        |                     |
|                                                |                     |
| National Institute on Drug Abuse (NIDA)        |                     |
|                                                |                     |
| National Institute of Mental Health (NIMH)     |                     |
|                                                |                     |
| National Institute of Nursing Research (NINR)  |                     |
+------------------------------------------------+---------------------+
| **Adjourn**                                    | **2:45 P.M.**       |
+------------------------------------------------+---------------------+

**AHRQ's 2006 Annual PBRN Research Conference [top](#top)**

**Monday May 15^th^ Workshop Descriptions**

The AHRQ 2006 Annual PBRN Research Conference will kick-off on May
15^th^ at the Pooks Hill Marriott in Bethesda, MD at 1:00 PM with a
series of workshops on PBRN Operations, PBRN Methodology and Research
Design, Quality Improvement in PBRNs, and IT and HIT in PBRNs. Full
descriptions of these sessions can be found below. Participants may
choose to attend all three sessions offered under a single topic, or to
attend sessions from multiple topics. A workshop schedule is provided
below, after the session descriptions.

The workshops continue to develop themes and topics covered earlier in
the year through the PBRN Resource Center's Peer Learning Groups. All
meeting attendees are welcome and encouraged to participate in the
Monday workshops regardless of prior involvement with a Peer Learning
Group. At the end of the workshop sessions, participants will be asked
to provide additional topics for the group to explore during the
upcoming year. Participants will also have the opportunity to sign-up
for participation in a Peer Learning Group.

**[PBRN Operations: Managing Multiple Projects: Mastering the Art of
"Juggling" in 3 Easy Hours]{.underline}**

**[Presenter: Mary Ellen McCann]{.underline}**

**Part 1: Understanding the Art of Project Management and its
Methodology**

In this session, Mary Ellen McCann will give an overview of how to
manage a project successfully. Mary Ellen will discuss key components to
project management as well as work with the group on successful
strategies to overcome challenges to implementing project management
strategies. Small groups will discuss the challenges to effectively
managing one's workload.

**Part 2: Assessing the Situation**

In this session, Mary Ellen will discuss how do you evaluate and assess
your current management system. We will examine the processes for this
assessment including assessing each projects complexities, priorities,
and objectives. The group will discuss causes for work overload, as well
as the ramifications of delaying tasks.

**Part 3: Techniques and Organization Strategies Helpful in Managing
Multiple Projects**

In this session, the group will discuss resources one can to use
organize self (and network) for management of multiple projects. Learn
new or improve upon skills to assist managers in planning, prioritizing,
setting boundaries, and determining the appropriate level of detail to
assist you in managing projects effectively.

**[PBRN Research Design and Methodology: Expanding your Methods Skill
Set]{.underline} [top](#top)**

**[Presenters: Cecelia Gaffney, MEd and Miriam Dickinson,
PhD]{.underline}**

**Part 1: Exploring the Fundamentals of Motivational Interviewing in
Primary Care -- Cecelia Gaffney, MEd**

This session will provide a brief overview on adapting Motivational
Interviewing (MI) techniques for use by primary care providers. Topics
covered will include review of some key techniques, revising the patient
visit to incorporate brief MI and basic instruction on conducting MI.

**Part 2: Understanding Multilevel Modeling and Practice-Based
Research - Miriam Dickinson, PhD**

The objective of this session is to provide a context and understanding
of multilevel modeling and its appropriate applications in PBRN
research. Topics covered will include terminology, and recognizing and
accommodating a multilevel structure during the research design and
sampling phase.

**Part 3: Analyzing Data using Multilevel Modeling - Miriam Dickinson,
PhD**

The second half of our series on multilevel modeling will provide an
overview of the techniques used to analyze clustered data. Topics
covered will include capabilities of statistical analysis packages, and
the consequences of using traditional linear regression techniques to
analyze clustered data.

\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--

**[QI in PBRNs: Moving Beyond Peer Review Publications - Disseminating
your QI Research]{.underline}**

**[Presenters: Michael O'Grady, PhD, Jeff Lemieux, Janet Firshein, Linda
Loranger]{.underline}**

**Part 1: Communicating with Policy Makers and Payers - Michael O'Grady,
PhD and Jeff Lemieux**

Session one, led by Michael O'Grady former Assistant Secretary for
Planning and Evaluation at the U.S. Department of Health and Human
Services, and Jeff Lemieux, Director of AHIP's new Center for Policy and
Research, will provide a rare opportunity to hear from policy makers and
payers about the information they need to make policy and coverage
decisions related to quality improvement interventions and activities.
The policy and payer panelists will each deliver a short presentation
during this session.

**Part 2: Communicating with Policy Makers and Payers - Open Forum with
the Panel**

The first session will no doubt leave you with additional questions.
"Does my research need to be complete before I can talk about it?" "If
my intervention worked in Maine, will a payer in Missouri care about the
results?" In this session, Dan Gaylin, Co-Director of the PBRN Resource
Center, will moderate an open Q&A forum where you can get all your
questions on translating research into policy answered.

**Part 3: Getting your Research in the Headlines -- Janet Firshein and
Linda Loranger**

Janet and Linda, from Burness Communications, will lead an interactive
workshop during this session. In the workshop, Janet and Linda will work
with attendees to take a selection of PBRN QI research and transform it
into a document ready for release to the media.

**[IT and HIT in PBRNS: Health Informatics in the Research
Setting]{.underline} [top](#top)**

**[Presenters: Atif Zafar, MD and Abel Kho, MD,]{.underline}**

**Part 1: What PBRNs Should Know about Health Informatics**

Atif and Abel will discuss how networks can use electronic means of data
collection to help alleviate some of the problems associated with PBRN
research (ex. duplicate data entry, syntactic errors, data validation
and just-in-time data access). This tutorial will help you understand
how informatics can be used within PBRNs to help solve some common
problems.

**Part 2: Strategies for Identifying Eligible Patients**

In this session, Atif and Abel will discuss in more detail the methods
for implementing electronic systems for identifying patients. Many
possible implementation strategies could be used, from a fully
electronic system to hybrid paper-electronic processes. Some methods
that will be discussed are "Backend" identification prior to patient
arrival and "Just in Time" notification using computerized
notifications.

**Part 3: Practical Considerations for Applying Informatics Techniques
in *your* PBRN**

In this session, Atif and Abel will addresses several problems in
implementing IT in networks including topics such as how to pay for it,
data modeling, data quality, and personnel and technical requirements.
In this session, they will use case examples to illustrate how networks
can successfully host an informatics endeavor in their PBRN.

**[May 15, 2006 PBRN Annual Meeting Workshop Schedule:]{.underline}**

+--------------+------------+--------------+------------+------------+
|              | **PBRN**   | **PBRN**     | **Quality  | **IT/HIT   |
|              |            |              | Imp        | in PBRNs** |
|              | **Op       | **Methods**  | rovement** |            |
|              | erations** |              |            |            |
+--------------+------------+--------------+------------+------------+
| **1:00 PM -- | Und        | Exploring    | Com        | What PBRNs |
| 2:00 PM**    | erstanding | the          | municating | Should     |
|              | the Art of | Fundamentals | with       | Know about |
|              | Project    | of           | Policy     | Health     |
|              | Management | Motivational | Makers and | I          |
|              | and its    | Interviewing | Payers     | nformatics |
|              | M          | in Primary   |            |            |
|              | ethodology | Care         |            |            |
+--------------+------------+--------------+------------+------------+
| ***15 minute |            |              |            |            |
| break***     |            |              |            |            |
+--------------+------------+--------------+------------+------------+
| **2:15 PM -- | Project    | U            | Com        | Strategies |
| 3:15 PM**    | M          | nderstanding | municating | for        |
|              | anagement: | Multilevel   | with       | I          |
|              | Assessing  | Modeling and | Policy     | dentifying |
|              | the        | Pr           | Makers and | Eligible   |
|              | Situation  | actice-Based | Payers -   | Patients   |
|              |            | Research     | Open Forum |            |
|              |            |              | with the   |            |
|              |            |              | Panel      |            |
+--------------+------------+--------------+------------+------------+
| ***15 minute |            |              |            |            |
| break***     |            |              |            |            |
+--------------+------------+--------------+------------+------------+
| **3:30 PM -- | Techniques | Analyzing    | Getting    | Practical  |
| 4:30 PM**    | and        | Data using   | your       | Cons       |
|              | Or         | Multilevel   | Research   | iderations |
|              | ganization | Modeling     | in the     | for        |
|              | Strategies |              | Headlines  | Applying   |
|              | Helpful in |              |            | I          |
|              | Managing   |              |            | nformatics |
|              | Multiple   |              |            | Techniques |
|              | Projects   |              |            | in *your*  |
|              |            |              |            | PBRN       |
+--------------+------------+--------------+------------+------------+
| ***15 minute |            |              |            |            |
| Group        |            |              |            |            |
| Discussion   |            |              |            |            |
| to Develop   |            |              |            |            |
| Topics for   |            |              |            |            |
| Future       |            |              |            |            |
| Sessions***  |            |              |            |            |
+--------------+------------+--------------+------------+------------+

***Please join us at 4:45 PM for the cocktail reception and poster
session, followed by the "Pioneers of PBRN Efforts in the U.S." plenary
session at 6:15 PM.***

[]{#Speaker_Bios .anchor}**Barbara Alving, MD** [top](#top)

Dr. Barbara M. Alving is the Acting Director of the National Center for
Research Resources (NCRR) at the National Institutes of Health. Dr.
Alving earned her medical degree---cum laude---from Georgetown
University School of Medicine, where she also completed an internship in
internal medicine. She received her residency training in internal
medicine at the Johns Hopkins University Hospital, followed by a
fellowship in hematology. Dr. Alving then became a research investigator
in the Division of Blood and Blood Products at the Food and Drug
Administration. In 1980, she joined the Department of Hematology at the
Walter Reed Army Institute of Research and became Chief of the
Department in 1992. She left the Army at the rank of Colonel in 1996 to
become the Director of the Medical Oncology/Hematology section at
Washington Hospital Center in Washington, D.C. In 1999, she joined the
National Heart, Lung, and Blood Institute (NHLBI), serving as the
Director of the extramural Division of Blood Diseases and Resources
until becoming the Deputy Director of the Institute in September 2001.
From September 2003 until February 1, 2005, she served as the Acting
Director of NHLBI. In March 2005 she became the Acting Director of NCRR.

**Dale W. Bratzler, DO MPH**

Dale Bratzler serves as the Principal Clinical Coordinator Oklahoma
Foundation for Medical Quality, Inc. Bratzler has served as OFMQ\'s
principal clinical coordinator since 1994 and both as a consultant and
full-time employee. He also served as an associate professor of medicine
and director of medical education for post-graduate training with the
Oklahoma State University College of Osteopathic Medicine in Tulsa.
Bratzler is also the principal clinical coordinator for the Pneumonia
QIO Support Center. He is originally from Clinton, Mo. He earned a
bachelor\'s degree from Central Missouri State University, his D.O. from
the University of Health Science, College of Osteopathic Medicine and an
M.P.H. from the University of Oklahoma Health Sciences Center College of
Public Health. He also served on the OFMQ board for six years.

**Miriam Dickinson, PhD\
**Miriam Dickinson is an Associate Professor in the Department of Family
Medicine and an Adjunct Associate Professor in the Department of
Preventive Medicine and Biometrics, University of Colorado Health
Sciences Center. She also serves as a Senior Scientist for the AAFP
National Research Network. Miriam's areas of research and teaching
interest include practice-based research, health services research,
research methods, and multilevel modeling.

**Eugene Farley, MD**

Eugene Farley serves as an emeritus faculty member in the UW-Madison
Department of Family Medicine. He chaired the Family Medicine
Departments at the University of Colorado and University of Wisconsin.
Dr. Farley received a degree in Zoology and Political Science from
Swarthmore College and a Medical Degree at the University of Rochester.
He completed his internship at the Philadelphia General Hospital and his
residency at the University of Colorado and Denver General Hospitals. He
received his Medical Doctorate from Johns Hopkins University and
developed and directed the Family Medicine Program at the University of
Rochester. He was the field medical officer in charge at a clinic on the
Navajo reservation where he studied TB and was a visiting professor in
Social and Preventive Medicine at the University of West Indies.

**Janet Firshein [top](#top)**

Janet Firshein is Vice President for Health Policy at Burness
Communications. Janet has 20 years of experience writing about and
analyzing health care policy issues. Janet joined Burness Communications
in 1998 with extensive credentials as a highly respected health care
journalist. During her tenure at Burness, Janet has directed and worked
on projects related to health care policy, including access to care for
the uninsured, public health and bioterrorism, quality improvement,
breast cancer detection and diagnosis, and Medicare and Medicaid. Janet
joined Burness after spending several years as an independent health
care writer and reporter, working for National Public Radio, WNET
television\'s special series on death and dying and drug and alcohol
addiction, the British medical journal *The Lancet*, and *Reuters Health
Daily*. In 1994, she was selected as a Kaiser Family Foundation Media
Fellow in Health, where she spent a year studying the effects of managed
care on medical education in the United States. She also is a recipient
of the National Press Club Award for Outstanding Newsletter Journalism.
Janet worked for five years as editor of the Washington-based newsletter
*Medicine and Health*, and several more as its congressional
correspondent. She also was editor for the newsletter *Health
Legislation and Regulation*. Janet was the first Washington bureau chief
of Hospitals magazine and spent nearly three years as a writer at the
American Hospital Association. She earned her B.A. from the University
of Maryland.

**Cecelia Gaffney, M.Ed**

Cecelia Gaffney is an Instructor in the Department of Community and
Family Medicine at Dartmouth Medical School and a Senior Research
Associate at the Norris Cotton Cancer Center. She is a recognized expert
in translating smoking cessation research into clinical practice. In
1986, as Director of Health Promotion at a HMO in Texas, she pioneered
providing smoking cessation as a covered member service. In 1992, while
working with community health centers in New Hampshire, she designed and
implemented the first program for Medicaid-reimbursed smoking cessation
counseling for pregnant women. This reimbursement for evidence-based
counseling remains in effect. While working in managed care, she
developed one of the first outpatient diabetes education programs which,
in its first year, of implementation reduced hospital claims costs 35%.
Ms. Gaffney also assisted with developing cost-effective care
alternatives for HMO members with AIDS. These alternatives reduced the
average cost of providing care by 65%.

She has worked in practice-based research for over 15 years striving to
translate behavioral science into relevant, doable prevention and
treatment programs for primary care. She works with practices in the
Dartmouth Coop and the Clinicians Enhancing Child Health (CECH) Network
as well as primary care providers around the country. These programs
range from breast and cervical cancer screening, depression screening,
smoking cessation to multiple risk factor screening and health education
for adolescents. She has extensive experience in health communications
and has written patient education materials and public health reports
read by thousands. She has authored papers in smoking cessation,
practice-based prevention services and community health promotion. She
also works with Dartmouth Medical School and other medical schools to
develop and test training programs on behavioral counseling for
undergraduate students and residents.

Ms. Gaffney is co-investigator on two current CECH projects focusing on
improving behavioral counseling during well care visits. Funded by The
Robert Wood Johnson Foundation, one uses PDAs to improve screening and
to shift time normally spent gathering information to behavioral
counseling. The second, funded by NICHD, again uses technology to screen
for obesity risk factors for 4-10 years olds and prompt clinician
counseling based on percent BMI and behaviors.

Ms. Gaffney serves as co-chair for the research workgroup of the
National Partnership to Help Pregnant Smokers Quit and Chair of the
Executive Board for the New Hampshire Smokefree Alliance. She worked as
a medical technologist before returning to school and becoming a health
educator. She received her Masters in Health Education (Phi Beta Kappa)
from the University of Texas in 1985.

**Robert Haggerty, MD [top](#top)**

Robert Haggerty, MD is a Professor and Chair Emeritus of General
Pediatrics at University of Rochester Medical Center. Dr. Haggerty
received his M.D. degree from Harvard Medical School. In 2004 he
received the Alfred I. Dupont Award for Excellence in Children's Health
Care. The author of more than 120 original papers, Dr. Haggerty is also
editor or author of three books, one of which -- "Ambulatory Pediatrics"
-- is in its fifth printing. In addition, he has authored nearly 200
book chapters, editorials, and abstracts. He has been visiting professor
and/or lecturer at more than 50 institutions. Haggerty was a founding
member of the Ambulatory Pediatric Association and one of its
presidents.

**Margaret A. Handley, PhD MPH**

Margaret A. Handley, Ph.D., M.P.H., is an adjunct professor at the
University of California (UCSF), San Francisco and co-director of the
UCSF collaborative research network. Her areas of interest are:
translational stduies that link primary care epidemiology and public
health; binational community health; and practice-based research on
health disparities. Dr. Handley received her Ph.D. and M.P.H. in
Epidemiology from the University of California, Berkeley.

**John Hickner, MD MSc**

John Hickner is a Professor of Family Medicine at The University of
Chicago. He received his M.D. degree from Indiana University, completed
his family practice training at the Medical University of South Carolina
in Charleston in 1978, and earned a Masters degree in clinical research
design and biostatistics at the University of Michigan School of Public
Health in 1995. Dr. Hickner moved to The University of Chicago in
September 2003 to be the Associate Chair for Research in the newly
established Department of Family Medicine. From 1978 to 2000 Dr. Hickner
practiced the full spectrum of rural family medicine, taught medical
students and led a clinical research program called the Upper Peninsula
Research Network at the Upper Peninsula Campus of Michigan State
University. From 2000 to 2004 he was the founding director of the
American Academy of Family Physicians (AAFP) National Research Network,
and in 2001 he established the American Academy of Family Physicians
Patient Safety Research Center. Patient safety, systems improvement, and
quality in primary care practice are his research areas, supported by
grant funding from the Agency for Healthcare Research and Policy. He is
a founding member of the editorial board of The Journal of Patient
Safety and on the steering committee of the Chicago Patient Safety
Forum.

**Abel Kho, MD**

Abel Kho completed a B.S. degree in Theoretical and Applied Mechanics at
the University of Illinois in Urbana-Champaign. He went on to attend
medical school at the Medical College of Wisconsin. He completed a
Residency in Internal Medicine at the University of Wisconsin, Madison,
where he stayed on to serve a year as Chief Medical Resident. Dr. Kho
joined the Regenstrief Institute in July 2003 after completing a chief
residency in internal medicine. His work involves mining the Regenstrief
Medical Record System (RMRS) to determine the utility of commonly
ordered laboratory tests as predictors of mortality. Dr. Kho is also
exploring novel methods to detect hospital disease outbreaks in realtime
using existing laboratory and geographic data.

**Jeff Lemieux [top](#top)**

Jeff Lemieux is the Senior Vice President directing AHIP\'s new Center
for Policy and Research. Prior to joining AHIP, Lemieux was Executive
Director of Centrists.Org, a small think tank dedicated to pursuing
bipartisan policy solutions. Before founding Centrists.Org in 2003,
Lemieux worked as a senior economist for the Progressive Policy
Institute (PPI). At PPI, he was responsible for studies of overall
economy including federal budget, tax, and entitlement issues, as well
as health care. In 1998 and 1999, Lemieux served as the staff economist
for the National Bipartisan Commission on the Future of Medicare, which
was co-chaired by Senator John Breaux and Congressman Bill Thomas.
Before joining the Commission, from 1992 to 1998, Lemieux was with the
Congressional Budget Office, where he estimated the cost of national
health reform plans and, later, the impact of Medicare reforms enacted
in the Balanced Budget Act of 1997 and other laws. An economist
specializing in health care and public finance, Jeff is the author of
centrist proposals for health coverage, Medicare reform, and balanced
budgets, and creator of long-term projections of entitlement spending
and federal budgets used by Congress and the policymaking community. He
has testified before the House Ways and Means Committee, the Senate
Finance Committee, and other committees in Congress on Medicare reform,
tax-based proposals to expand access to health coverage, chronic care
management, and other topics.

**Linda Loranger**

Linda Lorange is Senior Vice President, and Director, Health Policy
Team, Burness Communications. Linda has 20 years of experience in public
relations and journalism, and is now a key strategist for health
policy-related initiatives at Burness Communications.  As the manager of
the Health Policy team, Linda provides insight, strategic counsel, and
effective media relations in a number of health policy areas, ranging
from health care quality to health care financing, from access issues to
health care for children.  Linda is a highly effective media trainer and
has trained numerous health policy researchers and leaders.  Since
joining Burness Communications in 1995, she has worked extensively with
the Robert Wood Johnson Foundation, the Commonwealth Fund, the Harvard
School of Public Health, the journal *Health Affairs*, and several
health-related commissions.  Linda began her career as a daily newspaper
reporter in Connecticut, reporting for several years at the Hartford
Courant.  Prior to joining Burness, Linda headed communications for the
Alpha Center, a Washington, D.C.-based health think tank, and at an
RWJF-funded  national program office focused on long-term care
financing.  She holds a B.A. in English and communications from the
University of New Hampshire.

##### Mary Ellen McCann

Mary Ellen McCann is a consultant, facilitator and trainer, specializing
in leadership development, strategic planning, communications, team
building, customer service and priority management. Mary Ellen has a
broad-based background with over 20 years of professional training and
consulting experience in higher education, telecommunications and
restaurant institutions. She is one of two full-time Organizational
Development consultants for Indiana University and has served as a
faculty advisor for a second-year graduate course in the Kelley School
of Business, Indiana University. Mary Ellen's clients include: Ball
State University; Vincennes University; Monroe County Public Library;
and National Association of Auctioneers. Mary Ellen has presented at an
international conference for the Association of Quality and
Participation as well as provided training on leadership and strategic
planning skills for the Council of Alumni Association Executives.

**Melissa Diane McKee, MD MS [top](#top)\
**Diane McKee is an Assistant Professor in the Department of Family and
Social Medicine at the Albert Einstein College of Medicine. McKee joined
the Department in 1992 after completing her residency at Brown
University. McKee is the recipient of a Robert Wood Johnson General
Physicians' Faculty Scholar Award. Currently, she is studying barriers
that adolescent girls face in starting gynecologic care. McKee is also
involved in a study assessing the clinical and economic impact of an
intervention to increase breastfeeding in an urban primary care setting.
Most recently she has taken on the role of directing the Department's
Primary Based Research Network (NYCRING).

**James Mold, MD, MPH**

James Mold is a Professor and Director, Research Division, Department of
Family and Preventive Medicine at Oklahoma University Health Sciences
Center and the Director, Oklahoma Center for Family Medicine Research.
Dr. Mold was the former Director of Oklahoma Physicians
Research/Resource Center (OKPRN). OKPRN has expanded its research scope
by focusing on translational research, successfully bridging the gap
between research and quality improvement. Dr. Mold and his group have
also pioneered a new research method called "best practices research"
(PEAs) which involves identification of exemplars who provide
characterization and dissemination of their methods.  This method has
been used to study some processes of care such as management of
laboratory test results and management of prescription refills.

**Michael O'Grady, PhD**

Michael O'Grady is a Senior Fellow with NORC at the University of
Chicago. Prior to joining NORC, Dr. O'Grady served as the Assistant
Secretary for Planning and Evaluation at the U.S. Department of Health
and Human Services. The Assistant Secretary for Planning and Evaluation
(ASPE) is the principal advisor to the Secretary of Health and Human
Services on policy development in health, disability, aging, human
services, and science and data; and provides advice and analysis on
economic policy. Prior to his appointment, Dr. O'Grady served as the
Senior Health Economist on the majority staff of the Joint Economic
Committee of the U.S. Congress. At the Committee, his work focused
primarily on Medicare reform, the uninsured and other national health
issues. Prior to joining the Joint Economic Committee, Dr. O'Grady was a
Senior Research Director at Project Hope\'s Center for Health Affairs,
where his work focused on Medicare reform issues. He holds a doctorate
in Political Science from the University of Rochester.

**Kevin Peterson, MD MPH**

Kevin Peterson is an Assistant Professor in the Department of Family
Practice and Community Health at the University of Minnesota Medical
School, Minneapolis. Dr. Peterson chairs the National Diabetes Education
Program's Health Care Provider Work Group, and is former Chair of the
Federation of Practice-Based Research Networks. He serves on the
Clinical Policies and Research Commission for the American Academy of
Family Physicians, and directs EMDI, a quality improvement program for
diabetes in St. Paul, MN. Dr. Peterson is principle investigator for the
IMPACT trial (NIDDK, NIH) examining methods to improve diabetes care in
primary care settings, and principle investigator for the University of
Minnesota ACCORD project (NHLBI, NIDDK, NIH).

**George Rust, MD MPH [top](#top)**

George Rust is a professor of family medicine and interim director of
the National Center for Primary Care at Morehouse School of Medicine,
previously serving as deputy director of the Center under former US
Surgeon General, David Satcher, MD. He completed residency training at
Cook County Hospital and is board certified in both family medicine and
preventive medicine. In 1994, he was named Family Practice Educator of
the Year by the Georgia Academy of Family Physicians. At the Morehouse
School of Medicine he has also served as acting chair of the Department
of Family Medicine and founding director of the Morehouse Faculty
Development program. He is the author of numerous articles, book
chapters, monographs, and peer-reviewed research publications related to
primary care and underserved populations.

**John Wasson, MD**

John Wasson, MD, is The Herman O. West Professor of Geriatrics in
Community and Family Medicine and Medicine at Dartmouth Medical School;
Director of the Center for the Aging; and Research Director of the
Dartmouth, Northern New England Primary Care (COOP) Research Network. He
is also an advisor and faculty member for the Institute for Healthcare
Improvement\'s Idealized Design of Clinical Office Practices, Pursuing
Perfection, and IMPACT initiatives.

**Robert Williams, MD, MPH**

Robert Williams is Professor of Family and Community Medicine with the
University of New Mexico. He graduated from Baylor College of Medicine,
completed his Family Medicine Residency training at the University of
Rochester, and received his MPH at Harvard. He is also the Director of
Research Involving Outpatient Settings Network (RIOS Net), an innovative
PBRN designed specifically to conduct research that has direct relevance
to the Southwest's diverse and medically underserved populations. From
an initial handful of members, RIOS Net has steadily grown to over 250
members who practice primary care in over 60 locations throughout New
Mexico.

**Atif** **Zafar, MD**

Atif Zafar is a General Internist who trained in medical informatics at
the Regenstrief Institute and Indiana University. His interests include
the human-computer interface, data capture at the point-of-care,
clinical decision support and order entry systems, systems engineering
for healthcare and portable computing technologies. He developed a
speech-recognition interface to the Regenstrief Medical Record System,
has worked on designing a mobile computer EMR system, and is working on
a distributed health information exchange system and on clinical
education tools developed using web-technology. He serves on the staff
of both the AHRQ PBRN Resource Center and the AHRQ National Resource
Center for Health IT. Dr. Zafar received his medical degree from the
University of Buffalo.

[[]{#ConcurrentSessions .anchor}top](#top)

+-------------------------------------------------+--------------------+
| **[Concurrent Sessions I]{.smallcaps}**         | **11:15 A.M.-12:15 |
|                                                 | P.M.**             |
+-------------------------------------------------+--------------------+
| > **IC *-- Nutrition and Obesity***             |                    |
+-------------------------------------------------+--------------------+
| -   [Facilitator]{.underline} -- Laura Anderko, |                    |
|     RN PhD                                      |                    |
|                                                 |                    |
| >           "Using Focus Groups to Identify    |                    |
| > Potential Culturally-Specific Interventions   |                    |
| > for Obesity Prevention in Young Children" -   |                    |
| > Barbara Sarter, PhD (LA Net)                  |                    |
| >                                               |                    |
| >           "Poor Nutritional Habits: A        |                    |
| > Modifiable Predecessor of Chronic Disease" -  |                    |
| > Philip Sloane, MD MPH (NC-FP-RN)              |                    |
| >                                               |                    |
| >           *Research in Progress:* "Don't     |                    |
| > Tell Me My Child is Overweight or Fat" -      |                    |
| > Cecelia Gaffney, MEd (CECH)                   |                    |
+-------------------------------------------------+--------------------+

Title: [top](#top)\
Using Focus Groups to Identify Potential Culturally-Specific
Interventions for Obesity Prevention in Young Children

Authors:\
Sarter, Barbara, Ph.D.\
Jacques Barth, M.D.\
Theresa Woehrle, M.D.\
Lorena Luke, M.A.\
Carmela Lamonaco, Ph.D.\
Ronald Labugen, M.D.\
Lyndee Knox, Ph.D.

Context:\
Childhood obesity is an increasing epidemic in the Hispanic population.
Few studies exist on Hispanic parents\' beliefs and actions about
feeding their children and few culturally-specific interventions are
described.\
\
Objective:\
To identify knowledge, attitudes, beliefs and behaviors held by
immigrant Hispanic parents/caregivers concerning their children\'s
health, weight, exercise pattern and nutrition. To identify possible
interventions for lowering the rate of pediatric obesity that will meet
the perceived needs of this group. \
\
Design:\
This was an exploratory/descriptive study using focus groups. The
research team reviewed transcripts of the focus groups, identified
recurrent themes until data saturation was obtained, and identified
interventions for reducing child obesity that would be consistent with
the needs and attitudes articulated by the study participants.\
\
Setting:\
Two family practice clinics located in inner-city Los Angeles served as
the research setting. They are part of LANet, a Practice-Based Research
Network (PBRN) in Los Angeles.\
\
Participants:\
A non-random sample of female and male parents/caregivers of Hispanic
children ages 3-5 that are at-risk (65th or greater percentile)or
currently overweight (85th or greater percentile) was recruited from two
participating inner-city clinics in Los Angeles.  A total of 38 women
and 8 men participated in the study (38.9% had immigrated to the U.S.
within the past 10 years).\
\
Intervention or Essential Feature of Study:\
A focus group guide was used that included questions on changes in
eating habits and patterns since immigration, definitions of healthy
eating for child, perceived barriers to implementing healthy eating
practices, perceived influences on child feeding practices, and
satisfaction with interactions with healthcare providers around the
topic of child nutrition and feeding.  Half way through the project, the
guide was modified to include questions on themes that emerged during
previous focus groups. A trained bilingual focus group facilitator
conducted sessions. Sessions were audio taped and then transcribed and
translated to English.\
\
Outcome Measures:\
Data were analyzed for content and themes using grounded theory
methodology. Summary statements were developed based on this preliminary
analysis on the attitudes, experiences and beliefs of caregivers about
child health, eating and obesity. Finally, the research team identified
potential areas of intervention that can be implemented by
community-based primary care clinics to reduce the rate of obesity in
young Latino children.\
\
Results:\
Participants reported significant changes in their eating practices and
nutrition after arriving in the U.S.: consumption of greater quantities
of meat and other proteins, increased consumption of processed foods,
reduced consumption of fresh foods.  Participants also reported
significant disruption of family mealtimes after immigration. There were
ambivalent beliefs and emotions concerning the significance of weight in
children with larger body size. The influence of the father\'s eating
practices on children\'s eating behaviors was felt to be particularly
significant. Finally, participants indicated a desire for their
providers to discuss more extensively with them issues of child
nutrition and weight management. They also indicated inconsistencies in
the nutrition information provided them by WIC, the schools, and their
primary care providers.\
\
Conclusions:\
Potential interventions to prevent child obesity in Hispanic populations
that emerged from this study include: suggesting a return to traditional
foods with modifications to increase their nutritional value; helping
the family develop and/or maintain a family mealtime routine even when
there is a multi-family household in small quarters; identifying quick
recipes utilizing fresh foods (vegetables, whole grains, beans, fruit)
that can substitute processed foods; setting limits on portion sizes
with children; increasing and coordinating information provided by
primary care providers, schools and WIC on child nutrition with specific
suggestions. More data is needed on the many barriers to maintaining a
healthy food routine, such as the challenges of multi-family households.

Title: [top](#top)\
Poor Nutritional Habits:  A Modifiable Predecessor of Chronic Disease

Authors:

Philip D. Sloane, MD, MPH

Nicole Gaskins

Alice Ammerman, PhD

C. Madeline Mitchell, MURP

Context:\
Many chronic illnesses, such as diabetes mellitus, osteoarthritis, and
coronary artery disease, are related to poor diet and other modifiable
lifestyle factors.\
 \
Objective:\
In a diverse, representative sample of adult patients from primary care
settings, to examine associations between personal nutritional  patterns
and indicators of health, disease risk, and chronic illness.\
 \
Design:\
As part of a survey of adult patients conducted in the waiting rooms  of
four primary care practices, a health status was administered to 1785
study participants (recruitment rate:  75%).\
 \
Setting:\
Three private practices and one community health center serving a 
diverse population of rural and urban adults in North Carolina.\
 \
Participants:\
292 African Americans (17.3%), 1004 non-Hispanic whites (59.4%), 255 
Hispanics/Latinos (15.1%), 126 American Indians (7.4%), with a mean age
of 47.5 years.\
 \
Intervention or Essential Feature of Study:\
Cross-sectional, descriptive and correlative study.\
 \
Outcome Measures:\
A previously-validated, reliable 7-item nutrition questionnaire.\
 \
Results:\
Among study participants, 30% ate 3 or more fast food meals weekly, 29%
drank 3 or more high-sugar beverages weekly, 22% ate 3 or more high-fat
snacks weekly, 36% ate 3 or more desserts weekly,  11% reported eating
\"a lot\" of margarine, butter, or meat fat; 62% ate  2 or fewer fruits
or vegetables daily; and 42% consumed  protein less than 3 times a
week.  Scores on a nutritional index were worse for prediabetics
compared with diabetics, for young adults compared with older persons,
and for persons reporting good or excellent health compared with those
reporting fair or poor health.   Other factors associated with poor
nutritional habits included male gender, lack of physical activity,
smoking status, alcohol consumption, and obesity.\
 \
Conclusions:\
Individuals at high risk for developing chronic illnesses later in life
have poorer diets in comparison with people who are already ill.  
Promotion of better nutrition among younger adults without chronic
illness has the potential for reducing risk and incidence of chronic
disease and disability.   Because of the high prevalence of
chronic disease risk factors in that setting, the primary care office
setting may constitute a particularly appropriate location for nutrition
education.

Title: [top](#top)\
Don't Tell Me My Child is Overweight or Fat

Authors:\
Cecelia A. Gaffney, MEd\
Pamela W. Lee PhD\
Ardis L. Olson, MD\
\
Context:\
BMI has become a common tool to identify children at risk for overweight
or obese. Talking with parents of children with BMI greater than 85%
presents a challenge for primary care providers. Parents are often
overweight themselves and can be defensive about discussing these
issues. \
\
Objective:\
What are the messages about exercise and nutrition to which parents of
overweight children are receptive? \
\
Design:\
Parents of children with BMI \>85%\<95% and with BMI \>95% were
identified by pediatricians and invited to participate in a telephone
interveiw. Twenty mothers completed a 30 minute interview using
open-ended questions about current exercise and nutrition, advice they
had received from their physician and their interest in discussing their
child\'s exercise and nutrition with their clinician.  Mothers were
encouraged to talk about their challenges and barriers to helping their
child maintain a healthy weight.\
\
Current Challenges:\
The topics of weight management, nutrition and exercise are so value
laden that parents often feel guilty or defensive about discussing these
issues if their child has an elevated BMI or they perceive that their
child is being labeled as obese.  Finding neutral or acceptable language
to train providers to counsel parents of children during well visits is
a first step to improving counseling and potentially changing child and
parent behaviors.\
\
Goals for Session/Questions for Audience Consideration:\
We will present newly crafted messages based on our parent interviews
and ask for feedback on how appropriate and useful practicing clinicians
find them. We will be conducting training in the summer for clinicians
in our current study and it would be extremely useful to \"test\" them
with a diverse group of providers prior to taking them into the field.

+-------------------------------------------------+--------------------+
| **[Concurrent Sessions I                        | **11:15 A.M.-12:15 |
| [top](#top)]{.smallcaps}**                      | P.M.**             |
+-------------------------------------------------+--------------------+
| > **ID *-- Medication Safety***                 |                    |
+-------------------------------------------------+--------------------+
| -   [Facilitator]{.underline} -- Walter         |                    |
|     Calmbach, MD                                |                    |
|                                                 |                    |
| >           "The Comparison of an Electronic   |                    |
| > Medical Record (EMR) and a Paper Medical      |                    |
| > Record (PMR) on Medication Counseling in      |                    |
| > Primary Care Clinics: A SPUR-Net Study" -     |                    |
| > Grace Kuo, PharmD (SPUR-Net)                  |                    |
| >                                               |                    |
| >          *Research in Progress:* "In         |                    |
| > Partnership with the Community: Developing    |                    |
| > the Role of the Community Advisory Board      |                    |
| > (CAB) in the Implementation of a Rural Health |                    |
| > Information Technology Project" - James       |                    |
| > Wallace (ORPRN)                               |                    |
| >                                               |                    |
| >           *Research in Progress:* "Improving |                    |
| > Geriatric Drug Safety in Underserved          |                    |
| > Practices" - Gurdev Singh, PhD (UNYNET)       |                    |
+-------------------------------------------------+--------------------+

Title: [top](#top)

The Comparison of an Electronic Medical Record (EMR) and a Paper Medical
Record (PMR) on Medication Counseling in Primary Care Clinics: A
SPUR-Net Study

Authors:

Grace Kuo, PharmD MPH

Patricia D. Mullen, DrPH

Henry Hung-Wen Yeh

John Rogers, MD MPH MEd

Context:\
Electronic medical records (EMR), when used by clinicians to prepare
medication prescriptions, can prevent prescribing errors; however,
little is known about whether EMR can increase medication counseling at
the point of care.\
\
Objective:\
To compare the frequency of oral and written medication counseling by
primary care physicians at paper medical record (PMR) clinics and EMR
clinics.\
\
Design:\
A cross-sectional design; the study was conducted between January 2004
and March 2005.  Record reviews and personal interviews were conducted
after the index visit.\
\
Setting:\
The study was conducted in four representing SPUR-Net clinics in
Houston, two using EMR and two using PMR.\
\
Participants:\
A convenience sample of 182 English-speaking adult patients from 22
physicians in two PMR primary care clinics and 250 patients from 25
physicians in two EMR clinics.\
\
Intervention or Essential Feature of Study:\
Outcome comparisons between EMR and PMR clinics were conducted.\
\
Outcome Measures:\
Frequency of patients reporting oral (indications and/or side-effects)
or written counseling by their physicians. \
\
Results:\
A total of 432 patients (182 from PMR clinics and 250 from EMR clinics)
completed the study; over two-thirds were female, in their early
fifties, and taking an average of 7-8 medications.  Patient
race/ethnicity was similar at PMR and EMR clinics (59% non-Hispanic
White, 13% Hispanic, 25% Black, and 2% Asian).  Of the 1,095 medication
entries, 665 (61%) medications had reported oral counseling for
indications only, 228 (21%) had oral counseling for indications and
side-effects, and 129 (12%) had written counseling plus oral counseling
of indications, side-effects, and both indications and side-effects.
 The GLMM model showed that the frequency of oral counseling in the PMR
(n=516) and EMR (n=579) clinics were 69% and 53% (*t-value=2.49,
p=0.0130*) for indications, and 22% and 20% (*t-value=0.30, p=0.76*) for
indications and side-effects; the frequency of written counseling in the
two groups of clinics were 2% and 20% (*t-value=-5.09, p=\<0.0001*).

Conclusions:\
EMR was positively correlated with an increased frequency of written
counseling and negatively correlated with oral counseling of medication
indications.

Title: [top](#top)\
In Partnership with the Community: Developing the Role of the Community
Advisory Board (CAB) in the Implementation of a Rural Health Information
Technology Project\
\
Authors:\
James Wallace BA\
Lyle J Fagnan MD\
Paul Gorman MD\
Anne King MBA\
\
Context:\
This research propject (RxSafe) goal is to develop a web-enabled
consolidated medication list (CML) to improve the quality and safety of
healthcare for elders in rural assisted living (ALFs) and skilled
nursing facilities (SNFs).  Research on patient safety related to
medications in rural communities is in its infancy, and little is known
about rural ALF settings.\
\
Objective:\
Substantial input is obtained from members of the Community Advisory
Board (CAB), which is established for the project. The CAB consists of
community leaders with significant working knowledge of rural
information technology implementation, and active expertise and
participation in the county and community healthcare planning
activities. A member of the CAB advises on the RxSafe Steering
Committee. The Lincoln County Chronic Care Committee included a
presentation of RxSafe as a part of an October 2005 conference on the
Chronic Care Model.\
\
Design\
Approach:\
1.      Develop participatory research where patients, pharmacists, and
clinicians participate in project design.  Methods include: town hall
meetings, key-informant interviews, and culture of safety surveys.\
2.      Flexible solutions - may achieve same goals by differing means.
Sophisticated implementation and dissemination model, informed by
research on practice change and guided by an understanding of diffusion
of innovations.\
3.      Local reinvention - State of the art innovation from outside:
local application, modification, implementation from within.\
\
Current Challenges:\
Challenges:\
To align our research driven and funding agency-driven agendas with the
needs and interests of the community; 2) Deliver real benefits to the
community in a timely manner, to maintain and build the community
relationship. 3) Characteristics of this CAB that may be hard to
generalize in other locales.\
\
Please describe the next steps you are planning for your study.\
1-Stimulate inter-PBRN conversation on the role of community advisory
boards within PBRN project specific research,  and more generalizably
within the context of national PBRNs.\
2- Compare and contrast organizational objectives for Community Advisory
Boards.\
3- Review current literature for community advisory board roles.

Title: [top](#top)\
Improving Geriatric Drug Safety in Underserved Practices\
\
Authors:\
Gurdev Singh PhD\
Ranjit Singh MD MBA\
\
Context:\
Adverse Drug Events (ADEs) are common and often preventable among older
patients in ambulatory settings. Patients with cardiovascular disease
appear to have the highest rates of ADEs. It is widely accepted that
systemic problems, including the prevailing culture of blame are largely
to blame. Crew Resource Management (CRM) approaches have been successful
in aviation and other fields at helping organizations to move towards a
culture of safety. This type of approach, suitably adapted, has the
potential to offer benefits to primary care offices. The Institute of
Medicine advocates the use of Failure Modes and Effects Analysis(FMEA)
for identifying and solving systemic safety problems.\
\
Objective:\
To determine whether a novel approach, incorporating CRM principles,
based on FMEA is effective for reducing ADEs among older adults and for
creating a sustainable culture of safety in primary care settings.\
\
Design:\
15 practices in medically underserved communities within the Upstate New
York Practice Based Research Network are randomized to one of the
following groups: (1) Intervention facilitated by Practice Enhancement
Associate (PEA), (2) Intervention without PEA, or (3) Control. The
intervention involves a series of staff surveys including a safety
attitudes questionnaire (SAQ), an FMEA survey, and team meetings to
prioritize problems based on survey results, and to develop and
implement solutions to prioritized problems. Outcomes measure: (a)
changes in number and severity of ADEs based on chart review of a random
sample of older adults with cardiovascular disease and (b) changes in
safety climate, teamwork climate, and working conditions, before and
after the intervention and in comparison with the control group.\
\
Current Challenges:\
Difficulty incorporating a complex intervention into busy practices.
Limited time to discover sufficient numbers of ADEs. HIPAA issues.\
\
Goals for Session/Questions for Audience Consideration:\
To share our experience and invite guidance from participants.

+------------------------------------------------+---------------------+
| **[Concurrent Sessions II                      | **3:00 P.M.-4:00    |
| [top](#top)]{.smallcaps}**                     | P.M.**              |
+------------------------------------------------+---------------------+
| > **IIB *-- Pediatric Research***              |                     |
+------------------------------------------------+---------------------+
| -   [Facilitator]{.underline} -- Mort          |                     |
|     Wasserman, MD MPH                          |                     |
|                                                |                     |
|     -   "Validity of Parental Reporting of     |                     |
|         Recent Episodes of Acute Otitis        |                     |
|         Media" - Louis Vernacchio, MD MS (SCOR |                     |
|         Network)                               |                     |
|                                                |                     |
| >          "Parental Gun Storage Patterns and |                     |
| > Attitudes about Gun Safety Counseling and    |                     |
| > Gun Safety Education" - Jack Pascoe, MD      |                     |
| > (Dayton Primary Care PBRN)                   |                     |
| >                                              |                     |
| >           *Research in Progress:* "Treating |                     |
| > Sleep Terrors with Iron Fortified            |                     |
| > Multivitamins" - Christopher Bolling, MD     |                     |
| > (CPRG)                                       |                     |
+------------------------------------------------+---------------------+

Title: [top](#top)\
Validity of Parental Reporting of Recent Episodes of Acute Otitis Media

Author:\
Louis Vernacchio, MD, MSc\
Richard M. Vezina, MPH\
Allen A. Mitchell, MD\
\
Context:\
Validity of parental reporting of children\'s health outcomes is an
important methodological issue in community-based pediatric research.\
\
Objective:\
To determine the validity of parental reporting of children\'s recent
history of acute otitis media (AOM).\
\
Design:\
Parents of children participating in a pilot study of xylitol for the
prevention of AOM were interviewed monthly for three months and asked
whether their child had been diagnosed with AOM in the previous month. 
Medical records covering the time of study participation were reviewed
for episodes of AOM.\
\
Setting:\
The Slone Center Office-based Research (SCOR) Network, a practice-based
pediatric research network consisting of 498 pediatricians and family
physicians from 42 states.\
\
Participants:\
Parents of children aged six months to three years participating in the
xylitol pilot study.\
\
Intervention or Essential Feature of Study:\
Validation of parental reporting of recent AOM episodes by medical
record review.\
\
Outcome Measures:\
Accuracy and predictive values of parental reports.\
\
Results:\
Medical records were obtained for 102 out of the 120 children in the
study (85.0%).  On a subject level, the reports of 95 parents (93.1%)
agreed completely with the medical record.  There were discrepancies for
seven subjects (6.9%); six parents reported an episode of AOM that was
not found in the medical record and one reported no AOM when two
episodes were documented in the medical record.  On an interview level,
264 of 272 interviews (97.1%) were in agreement with the medical record
and eight (2.9%) were discrepant.  The positive predictive value of a
parental report of an AOM episode in the previous month was 85.0%
(34/40); the negative predictive value of a parental report of no AOM
episodes in the previous month was 99.1% (230/232).\
\
Conclusions:\
Parental reports of children\'s recent AOM episodes are generally
accurate, especially negative reports.  Parental errors are few and
mainly involve overreporting of episodes.

Title: [top](#top)\
Parental Gun Storage Patterns and Attitudes about Gun Safety Counseling
and Gun Safety Education

Authors:

John M. Pascoe, MD, MPH

Shalini G. Forbis, MD, MPH

Adrienne Stolfi, MSPH

Christopher A. Schlorman, BS

Terence R. McAllister, MD

Context:\
There may be important differences in parental attitudes between
civilian and military parents\' attitudes and behaviors regarding
firearms.\
\
Objective:\
To compare gun storage and safety attitudes and behaviors between
military and civilian parents\
\
Design:\
Cross-sectional, two-page survey about parental firearms attitudes and
behaviors\
\
Setting:\
Dayton Primary Care Practice-Based Research Network (PBRN) includes the
primary care pediatric practice at Wright Patterson Air Force Base
(N=574) and civilian pediatric practices in the Greater Dayton area
(N=451)\
\
Participants:\
Convenience sample of parents whose children receive their primary
health care from practices within the Dayton Primary Care PBRN\
\
Intervention or Essential Feature of Study:\
N/A\
\
Outcome Measures:\
N/A\
\
Results:\
Military parents (MP) were more educated, 85%\>high school education
(civilian parents \[CP\] 52%\>HS education, p=0.00).  18% of CPs and 27%
of MP reported at least one gun in the home (p=0.00).  CPs were more
likely to report that the child\'s doctor had talked about guns than MPs
(11% v 6%, p=0.00).  CPs were also more likely to believe that
physicians should ask about guns in the home (78% v 61%, p=0.00), advise
about gun storage (88% v 64%, p=0.00) and advise about removal of guns
from the home (48% v 24%, p=0.00).  MPs were more likely to report that
the child had been taught gun safety by a parent (93% v 77%, p=0.00). 
However, children of CPs were more likely to be taught gun safety
through a formal course (17% v 7%, p=0.00).  All of the above
differences remained significant and in the same direction when solely
analyzing parents who had guns at home.\
\
Conclusions:\
Civilian parents are more likely to believe that physicians should ask
about gun presence and advise about gun storage than military parents. 
Military parents are more likely to report that children have been
taught gun safety by a parent.

Title: [top](#top)\
Treating Sleep Terrors with Iron Fortified Multivitamins

Authors:\
Christopher Bolling, MD\
Mark Deis, MD\
Jeralyn Bernier, MD, MPH\
Robert Siegel, MD\
Jane Khoury, MS\
\
Context:\
A frequently encountered sleep disorder in children from age two to ten
is sleep terrors.  This disorder presents a challenge to obtaining
adequate rest for both parent and child, and has the potential to
exacerbate behavioral conflicts, to harm self-esteem and to magnify
other medical conditions due to sleep deprivation.  Sleep terrors may be
a manifestation of restless leg syndrome or other parasomnias.  Some
parasomnias are associated with subclinical iron deficiency.  From the
authors\' clinical experience, it is hypothesized that therapy with
standard multivitamins with iron will reduce sleep terrors.\
\
Objective:\
1) To demonstrate that children with sleep terrors have depletion of
iron stores before clinical anemia is present.\
\
2) To demonstrate that sleep terrors can be reduced by addition of a
regimen of iron-fortified multivitamins.\
\
Design:\
The study population is CPRG practice patients aged two to ten years,
not on iron therapy, who exhibit sleep terrors characterized by sudden
waking due to terror combined with screaming, confusion, sweating and
increased heart rate.  Eligible children with at least three episodes in
the last month will have a CBC and ferritin level obtained.  Patients
with anemia by CBC indices will be excluded.  Those consenting will be
randomized to receive standard multivitamins without added iron or the
same preparation of multivitamin with iron.  CBC, ferritin level and
response to treatment, as determined by frequency of sleep terrors, will
be measured after three months of therapy.\
\
Current Challenges:\
1) Clarifying the role played by undiagnosed restless leg syndrome in
children with sleep terrors\
2) Funding\
3) IRB approval\
4) Informed consent issues\
\
Goals for Session/Questions for Audience Consideration:\
This presentation will provide needed feedback on clinical relevance,
logistic challenges, and study design.  The audience will be asked to
contribute expertise and advice regarding study methodology and
application to practice.

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions II                     | **3:00 P.M.-4:00     |
| [top](#top)]{.smallcaps}**                    | P.M.**               |
+-----------------------------------------------+----------------------+
| > **IIC *-- Rural PBRNs***                    |                      |
+-----------------------------------------------+----------------------+
| -   [Facilitator]{.underline} -- Margaret     |                      |
|     Love, PhD                                 |                      |
|                                               |                      |
|     -   "Testing to Prevent Colon Cancer in   |                      |
|         Rural Colorado" - Linda Zittleman,    |                      |
|         MSPH (High Plains Research Network)   |                      |
|                                               |                      |
| >          "Bridging The Gap Between Public  |                      |
| > And Private Health Care: Influenza-Like     |                      |
| > Illness Surveillance In A Practice-Based    |                      |
| > Research Network" -- Zsolt Nagykaldi, PhD   |                      |
| > (OKPRN)                                     |                      |
| >                                             |                      |
| >          "2005 ORPRN Practice and          |                      |
| > Clinician Surveys" - Lyle Fagnan, MD        |                      |
| > (ORPRN)                                     |                      |
+-----------------------------------------------+----------------------+

Title: [top](#top)\
Testing to Prevent Colon Cancer in Rural Colorado\
\
Authors:\
Linda Zittleman, MSPH\
Rodrigo Araya-Guerra, BA\
John M. Westfall, MD, MPH\
\
Context:\
Despite effective early detection and prevention screening methods,
colorectal cancer is the second leading cause of cancer death in the
United States.\
\
Objective:\
As part of a CDC-funded study aiming to increase colorectal cancer
screening (CRCS) rates in rural northeastern Colorado, this research
activity assessed the reach and effect of an intervention in two
communities in NE Colorado.\
\
Design:\
The intervention was piloted in two communities to assess residents\'
exposure to intervention materials. The research team conducted
semi-structured interviews with a convenience sample of local community
residents.\
\
Setting:\
Rural NE Colorado communities\
\
Participants:\
Local community residents over age 50 and clinic staff. \
\
Intervention or Essential Feature of Study:\
Using community-based participatory methods, the Joint Planning
Committee (JPC), led the development of a multi-component,
population-based CRCS intervention. Comprised of local rural community
members, the JPC provided insight on rural cultures, access to local
figures and organizations, and the ideas for intervention messages,
materials, and dissemination strategies. The educational intervention
heavily incorporates local residents and includes small and mass print
media, community talks, and incentives.\
\
Outcome Measures:\
A quantitative outcome measure was the number of people who recalled or
recognized each intervention component. Qualitative data included
residents\' reactions to each intervention component and feedback from
clinic staff on the implementation of the intervention in the clinic
setting.\
\
Results:\
Forty-six community members were interviewed. Over 85% recognized at
least one intervention component, with reach varying by component.
Exposure to intervention messages appeared to increase awareness of
colon cancer and CRCS. The inclusion of local people was the most
prominent and influential aspect of the intervention materials. Main
messages remembered were \"get tested\" and \"prevention\". Several
clinic staff and community members used the intervention as a vehicle to
discuss colon cancer with others.\
\
Conclusions:\
Using a community participatory approach produced a message and
dissemination model that was effective in reaching the target audience.

Title: [top](#top)\
Bridging The Gap Between Public And Private Health Care: Influenza-Like
Illness Surveillance In A Practice-Based Research Network\
\
Authors:\
Zsolt, Nagykaldi, PhD\
James Mold, MD, MPH\
Dan Hollacher, BS\
Wendy Zhou, BS\
Mike Crutcher, MD, MPH\
\
Context:\
Practice-Based Research Networks (PBRNs) offer unique opportunities for
bridging the gap between the public and private health care sectors.
Traditional public health surveillance relies primarily on passive
reports from hospitals, private health care providers and laboratories. 
By tapping into an electronic sentinel physician reporting system, the
public health sector has the potential to increase the timeliness,
sensitivity, and granularity of conventional disease surveillance while
participating health care providers benefit from timely aggregated
information about infectious diseases affecting their communities\
\
Objective:\
This presentation describes the development, testing and implementation
of the OKAlert® - ILI System, a bidirectional, dual-use influenza-like
illness (ILI) surveillance and messaging system during the influenza
seasons of 2003-06 in the Oklahoma Physicians Resource/Research Network
(OKPRN), a primary care PBRN.\
\
Design:\
We have analyzed the OKAlert® - ILI electronic database to determine the
timeliness, completeness, validity, flexibility, and cost of the system
based on sentinel ILI reports from 2003 to 2006. We interviewed OKPRN
providers to receive personal feedback on the usefulness, acceptability,
and simplicity of the system. We also compared ILI reports to influenza
isolate laboratory data published by the OSDH to determine the
specificity and sensitivity of electronic sentinel ILI reporting.\
\
Setting:\
OKPRN Network.\
\
Participants:\
OKPRN primary care clinicians.\
\
Intervention or Essential Feature of Study:\
Health IT implementation study.\
\
Outcome Measures:\
Evaluation parameters of the surveillance system according to CDC
criteria.\
\
Results:\
Electronic sentinel ILI surveillance in a PBRN is feasible, effective,
timely, and contributes significantly to existing disease surveillance
systems. The OKAlert® - ILI system is easy to use, flexible, and it is
well received by OKPRN providers. Regular feedback from the system
provides very useful information for practicing clinicians to tailor
patient care during the flu season.\
\
Conclusions:\
The success of the OKAlert® - ILI System demonstrates that PBRNs have a
significant potential for bridging the communication gap between the
public and private health care sectors. Their unique position empowers
them to develop and implement disease surveillance solutions that are
accepted and utilized.

Title: [top](#top)\
2005 ORPRN Practice and Clinician Surveys\
\
Authors:\
Lyle J. Fagnan, MD\
Cynthia Morris, PhD, MPH\
Paul McGinnis, MPA\
Heather Angier, CCRP\
Anne King, MBA\
Nora Mattek, MPH\
\
Context:\
A \"snapshot\" of the Oregon Rural Practice-based Research Network
(ORPRN) including the influences of degrees of rurality\
\
Objective:\
1) Describe the denominator for ORPRN studies and grant proposals\
2) Compare ORPRN survey data with other primary care databases\
\
Design:\
Cross-sectional. \
\
Setting:\
129 ORPRN clinicians in 32 practices located in 26 rural Oregon
communities\
\
Participants:\
Practices and clinicians involved in ORPRN studies as of November 2005.\
\
Intervention or Essential Feature of Study:\
Three-part survey-practice, clinician, and anonymous satisfaction\
\
Outcome Measures:\
31/32 practices and 96/129 clinicians completed the practice and member
surveys; 64 clinicians completed the anonymous satisfaction survey\
\
Results:\
Practice survey\
·       60% of the practices are private businesses\
·       90 % of practices are accepting new patients, including Medicare
and Medicaid patients\
·       47% of practice payments come from Medicare and Medicaid\
·       19/31 practices will have an Electronic Health Record (EHR) in
place by December 2006\
\
Clinician Survey\
·       Over 50% of clinicians make home visits and almost 2 out of 3
clinicians see patients in the nursing home\
·       30% of ORPRN clinicians provide labor and delivery services\
·       Significant gaps exist regarding access to dental, mental health
and substance services\
\
Anonymous Survey\
·       Over 90% of clinicians report being very or somewhat satisfied\
·       The majority (80 to 90%) of clinicians feel in control of their
income, hours, and clinical decisions\
·       30% of clinicians report feeling isolated in their practice\
·       1 out of 4 clinicians plan on leaving practice or retiring in
the next 5 years\
\
Conclusions:\
Implications for PBRNs: \
The influence of the five working definitions of rurality on member
practices and clinicians will be discussed.  Each definition has
strengths and weaknesses.  The five definitions include:  1) The US
Bureau of Census,  2) The Office of Management and Budget,  3) Goldsmith
Modification, 4) Rural Urban Commuting Areas and 5) The Oregon Office of
Rural Health

+------------------------------------------------+---------------------+
| **[Concurrent Sessions II                      | **3:00 P.M.-4:00    |
| [top](#top)]{.smallcaps}**                     | P.M.**              |
+------------------------------------------------+---------------------+
| > **IID *-- Workshop: Technology and Practice  |                     |
| > Change to Support Patient-Centered,          |                     |
| > Collaborative Care***                        |                     |
+------------------------------------------------+---------------------+
| -   [Moderator]{.underline} -- John H. Wasson, |                     |
|     MD (Dartmouth CO-OP)                       |                     |
|                                                |                     |
| > Workshop Learning Objectives:                |                     |
| >                                              |                     |
| > 1\. Understand much more than the jargon of  |                     |
| > \"patient-centered\" and \"collaborative     |                     |
| > care.\"                                      |                     |
| >                                              |                     |
| > 2\. Learn the practical implications of      |                     |
| > patient-centered, collaborative care for     |                     |
| > primary care practices.                      |                     |
| >                                              |                     |
| > 3\. Be able to implement technologies and    |                     |
| > practice changes to support                  |                     |
| > patient-centered, collaborative care.        |                     |
+------------------------------------------------+---------------------+

Workshop Title [top](#top)\
Technology and Practice Change to Support Patient-Centered,
Collaborative Care\
\
Workshop Leader\
John H. Wasson, MD\
\
Please list additional workshop presenters and their network
affiliation:\
Deborah J. Johnson, BS\
Dartmouth-Northern New England COOP Project\
L. Gordon Moore, MD\
IdealMicrosystem Practice Network\
\
Please describe the intended audience for your workshop.\
PBRN leadership and research investigators, network clinicians,
coordinators, and staff\
\
Please provide a synopsis of your workshop.\
\"Patient-centered, collaborative care\" is health care jargon. But
underlying the jargon is the principle that a patient who receives such
care will strongly agree that \"I receive exactly the health care I want
and need exactly when and how I want and need it.\" Currently only about
1 in 4 Americans who have adequate financial resources can make that
claim.\
\
Think of a pyramid. At the apex is the highest level of
\"patient-centered, collaborative care.\" At the base are measures about
\"what\'s the matter\" (from the clinical perspective) and \"what
matters\" (from the patient perspective). As patients and clinicians act
collaboratively on these measures, they climb closer to the apex of the
pyramid.\
\
Given the realities of health care in the Unites States, how can busy
clinicians climb this pyramid?\
\
In this interactive workshop attendees will learn about available
technology and feasible practice changes that bridge the gap between
desirable goals and limited time. Our past research and that of many
others reinforce the observation that only technology (such as hardware
and software) and the way humans use the technology (called techne) can
not overcome the many obstacles for patient-centered, collaborative
care.  Despite these limitations, the examples will demonstrate ways
that significant progress toward patient-centered, collaborative care
can be made.\
\
\
What are the learning objectives for your workshop.\
1. Understand much more than the jargon of \"patient-centered\" and
\"collaborative care.\"\
2. Learn the practical implications of patient-centered, collaborative
care for primary care practices.\
3. Be able to implement technologies and practice changes to support
patient-centered, collaborative care.\
\
\
Please provide an agenda for the 75 minute workshop.\
Agenda:\
\
1. Definitions and data supporting patient-centered, collaborative care.
(10 minutes)\
2. An illustration of resource planning for patient-centered,
collaborative care.\
(10 minutes)\
3. Discussion of barriers and opportunities for resource planning.
(Group-15 minutes)\
4. Description of technologies and techne (10 minutes)\
5. Implementing technologies and techne in practice (10 minutes)\
6. Discussion of implementation (Group -15 minutes)

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions]{.smallcaps} *III      | **4:15 P.M.-5:30     |
| [top](#top)***                                | P.M.**               |
+-----------------------------------------------+----------------------+
| > **IIIA *-- Workshop: Research Integrity     |                      |
| > Indicators for PBRNs***                     |                      |
+-----------------------------------------------+----------------------+
| -   [Moderator]{.underline} -- Victoria       |                      |
|     Neale, PhD (MetroNet)                     |                      |
|                                               |                      |
| > Workshop Learning Objectives:               |                      |
|                                               |                      |
| 5.  To consider the ethical challenges that   |                      |
|     confront PBRNs.                           |                      |
|                                               |                      |
| 6.  To review the Institute of Medicine's     |                      |
|     statements about deficiencies in the      |                      |
|     research integrity knowledge base.        |                      |
|                                               |                      |
| 7.  To discuss policies and procedures that   |                      |
|     promote PBRN research integrity.          |                      |
|                                               |                      |
| 8.  To develop strategies for PBRNs to        |                      |
|     monitor their research integrity.         |                      |
+-----------------------------------------------+----------------------+

Workshop Title [top](#top)\
Research Integrity Indicators for PBRNs\
\
Workshop Leader\
Victoria Neale, PhD\
\
Please list additional workshop presenters and their network
affiliation:\
Kendra Schwartz, MD, MetroNet\
\
Please describe the intended audience for your workshop.\
PBRN Directors, Research Directors and Coordinators\
\
If relevant, please describe any prerequisite knowledge required of your
audience.\
None\
\
Please provide a synopsis of your workshop.\
The practice-based research network (PBRN) movement has resulted in
decentralized community-based research, which raises particular
challenges to research integrity.  While PBR offers the advantage of
greater external validity, it also presents challenges that include:
implementing standardized research protocols in decentralized settings;
training and monitoring of responsible conduct of research practices
among the community-based clinic staff; and data management and quality
control issues.  The purpose of this interactive workshop is to:  1)
Identify PBRN research integrity challenges; 2) Discuss PBRN adherence
to standards of research professionalism that relate to research
integrity; and 3) Develop key indicators for PBRN research integrity.\
\
What are the learning objectives for your workshop.\
1) To consider the ethical challenges that confront PBRNs\
2) To review the Institute of Medicine\'s statements about deficiencies
in the research integrity knowledge base\
3) To discuss policies and procedures that promote PBRN research
integrity\
4) To develop strategies for PBRNs to monitor their research integrity\
\
Please provide an agenda for the 75 minute workshop.\
The session will have three segments:\
1) What is Research Integrity?  An overview of the current concepts
related to research integrity will be described, including factors that
promote responsible conduct at the levels of the individual, the
research group and the PBRN.\
2) What Research Integrity Challenges Confront PBRNs?  Following
Institute of Medicine statements, challenges will be organized and
discussed under 3 topic categories:  a) Research Community (self
regulation and quality assurance); b) Professional Development (training
in responsible conduct of research, and research development for PBRN
staff) and c) Research Process (study supervision, data management and
publication policies). \
3) What Are Indicators of PBRN Research Integrity?  PBRNs will describe
their policies and procedures that promote research integrity.  Group
discussion will identify key indicators of PBRN research integrity.

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions]{.smallcaps} *III      | **4:15 P.M.-5:30     |
| [top](#top)***                                | P.M.**               |
+-----------------------------------------------+----------------------+
| > **IIIB *-- Workshop: The Impact of          |                      |
| > Community Member Participation on PBRN      |                      |
| > Research***                                 |                      |
+-----------------------------------------------+----------------------+
| -   [Moderator]{.underline} -- John Westfall, |                      |
|     MD (High Plains Research Network)         |                      |
|                                               |                      |
| > Workshop Learning Objectives:               |                      |
|                                               |                      |
| 4.  Illustrate examples of active community   |                      |
|     member involvement in the High Plains     |                      |
|     Research Network in Rural Colorado.       |                      |
|                                               |                      |
| 5.  Describe the impact of community          |                      |
|     involvement on PBRN research.             |                      |
|                                               |                      |
| 6.  Discuss strategies and needs for          |                      |
|     involving community members PBRN          |                      |
|     research.                                 |                      |
+-----------------------------------------------+----------------------+

Workshop Title [top](#top)\
The Impact of Community Member Participation on PBRN Research\
\
Workshop Leader\
John Westfall, MD\
\
Please list additional workshop presenters and their network
affiliation:\
Linda Zittleman, MPH - HPRN Research Coordinator\
Rodrigo Araya-Guerra - HPRN PRA\
\
Please describe the intended audience for your workshop.\
PBRN leaders, staff, and medical providers.  Community members
interested in becoming involved in their local PBRN.\
\
If relevant, please describe any prerequisite knowledge required of your
audience.\
 None, just a desire to consider participatory research in your PBRN.\
\
Please provide a synopsis of your workshop.\
   Community-Based Participatory Research (CBPR) has become an important
and valuable method for conducting primary care clinical research.
Funding agencies have recently started emphasizing the use of CBPR for
research done within Practice-based Research Networks. The High Plains
Research Network (HPRN) has been involving community members in research
for 3 years.\
   This interactive session will provide a brief background on CBPR
methodology and the history of the High Plains Research Network\'s
Community Advisory Council (C.A.C.).  Research staff and C.A.C.members
will describe how community members are engaged in research and the
impact of their participation on individual research projects. We will
discuss the necessary components for developing and maintaining a
Community Advisory Council and the challenges we have faced.  We will
conclude with an open discussion among workshop participants on how to
support active participation by physicians and community members in a
PBRN.\
\
What are the learning objectives for your workshop.\
The purpose of this workshop is to:\
1)      Illustrate examples of active community member involvement in
the High Plains Research Network in Rural Colorado\
2)      Describe the impact of community involvement on PBRN research\
3)      Discuss strategies and needs for involving community members
PBRN research\
\
Please provide an agenda for the 75 minute workshop.\
This interactive session will provide a brief background on CBPR
methodology and the history of the High Plains Research Network\'s
Community Advisory Council (C.A.C.).  Research staff and C.A.C.members
will describe how community members are engaged in research and the
impact of their participation on individual research projects. We will
discuss the necessary components for developing and maintaining a
Community Advisory Council and the challenges we have faced.  We will
conclude with an open discussion among workshop participants on how to
support active participation by physicians and community members in a
PBRN.\
\
This workshop will be led by a panel of HPRN research staff and C.A.C.
members. The workshop will begin with a brief lecture format followed by
ample interaction between attendees and the workshop panel. We will
attempt to set up the environment for maximal audience participation.

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions]{.smallcaps} *III      | **4:15 P.M.-5:30     |
| [top](#top)***                                | P.M.**               |
+-----------------------------------------------+----------------------+
| > **IIIC *-- PBRN Methods to Engage           |                      |
| > Clinicians***                               |                      |
+-----------------------------------------------+----------------------+
| -   [Facilitator]{.underline} -- Tom Stewart  |                      |
|                                               |                      |
|     -   "CD-ROM Decision Aid for Mammography  |                      |
|         Screening in Women 40-49" - William   |                      |
|         Curry, MD MS (Penn State Ambulatory   |                      |
|         Care Network)                         |                      |
|                                               |                      |
| >          "Screening Mammography for Older  |                      |
| > Women: PBRN Clinicians\' Perceived Barriers |                      |
| > and 'Best Practices'" - Margaret Love, PhD  |                      |
| > (KAN)                                       |                      |
| >                                             |                      |
| >       "Optimizing the Limited Resources    |                      |
| > Available for Implementing Shared           |                      |
| > Decision-making in Primary Care" - France   |                      |
| > Legare, MD PhD (Laval University)           |                      |
|                                               |                      |
| -   *Research in Progress:* "Integrating      |                      |
|     Practice-based Learning and Improvement   |                      |
|     Groups into a Practice-based Research     |                      |
|     Network" - Lucia Sommers, DrPH (UCSF      |                      |
|     Collaborative Practice Network)           |                      |
+-----------------------------------------------+----------------------+

Title: [**top**](#top)

CD-ROM Decision Aid for Mammography Screening in Women 40-49

[]{.mark}

Authors:\
William Curry, MD, MS\
Alan Adelman, MD, MS\
Marie Graybill, RN

Context:\
When discussing screening mammography, both the patient and the provider
need information about the benefits of the procedure and potential harms
of screening such as false positive tests.

Objective:\
To evaluate an interactive CD-ROM and a written decision aid to help
women in their 40s make an informed decision regarding screening
mammography.\
\
Design:\
Nonrandomized pilot test and comparison of a CD-ROM decision aid and
paper decision aid.\
\
Setting:\
A university medical center campus and affiliated primary care clinics.\
\
Participants:\
Convenience sample of women age 40 - 49 years with no personal history
of breast cancer, no history of mastectomy or breast biopsy and no
family history (first degree relatives, i.e. mother or sibling) of
breast cancer.\
\
Intervention or Essential Feature of Study:\
Comparison of the CD-ROM and paper decision aid.\
\
Outcome Measures:\
The primary outcome is change in the patients\' knowledge and perception
of risk.\
\
Results:\
Twenty one women read the paper decision aid, and 19 viewed the CD-ROM. 
The two groups differed only in higher self-assessment of health status
in the paper DA group (p=0.034) and younger age of first menstruation in
the CD-ROM DA group (p=0.025).  In the CD-ROM DA group, the use of
decision aids significantly improved knowledge that most abnormal
mammograms in this age range are not cancer (p=0.044). Both groups
overestimated their personal breast cancer risk as well as the risk of a
cohort of women similar to them.  This was significantly reduced in the
group who viewed the CD-ROM DA (p=0.023).  Confidence in making a
mammography decision was improved in both groups (paper DA p=0.042,
CD-ROM CA p=\<0.001).  Decisional conflict, although low in both groups,
was reduced significantly in the CD-ROM DA (p=0.009).\
\
Conclusions:\
Both the paper decision aid and interactive CD-ROM decision aid tested
in this pilot study improved knowledge about breast cancer screening,
reduced perception of breast cancer risk, and improved confidence in
decision making.  Only the CD-ROM decision aid showed significant
improvements in risk perception as well as reduced decisional conflict
about having a mammogram.  Further testing of the CD-ROM DA is needed to
define how this tool can best be implemented into daily practice in
primary care.

> Title: [top](#top)\
> Screening Mammography for Older Women: PBRN Clinicians\' Perceived
> Barriers and \"Best Practices\" (A Kentucky Ambulatory Network Study)
>
> Authors:\
> Margaret Love, PhD\
> Steven Fleming, PhD\
> Suzanne Tyas, PhD\
> January Breeden, MPH\
> Kevin Pearce, MD, MPH\
> \
> Context:\
> PBRN \"best practices\" research (J. Mold) creates a mechanism for
> identifying and disseminating successful strategies for improving
> practice among participating clinicians.  Barriers to screening
> mammography among older women (\>age 65) may be overcome by
> identification and sharing of these best practices.  \
> \
> Objective:\
> (1)Identify strategies to overcome perceived barriers to screening
> mammography in primary care practice\
> (2)Identify barriers for which practitioners do not seem to have
> successful strategies\
> \
> \
> Design:\
> Mail and Internet survey administered in February 2005, and telephone
> interviews in June and July.\
> \
> Setting:\
> Kentucky Ambulatory Network (KAN) community-based primary care
> physicians, nurse practitioners, physician assistants, and certified
> nurse midwives. \
> \
> Participants:\
> Seventy survey respondents (45% response rate of 156 deliverable
> surveys); 11 interviews. \
> \
> Intervention or Essential Feature of Study:\
> Solicitation of effective processes to recommend or refer screening
> mammography.\
> \
> Outcome Measures:\
> Percent of clinicians that identify a successful strategy and
> description of these best practices. \
> \
> Results:\
> Clinicians identified systems-level, clinician-level, and
> patient-level challenges that they would want to collaborate with KAN
> to facilitate delivery of screening mammography to older women (e.g.,
> identifying patients due for mammography, patients\' anticipating
> discomfort from the mammogram). Twenty respondents (29%) indicated
> that they had a successful process to recommend or refer screening
> mammography. Most of these responses included specific system
> strategies to identify patients due for mammography. The opportunity
> to talk to patients about screening mammography was a key element in
> nearly all the strategies.\
> \
> Conclusions:\
> Most of the successful strategies focused on creating the opportunity
> to bring up screening mammography with the patient. Such systems-level
> strategies may lend themselves to adoption by other clinicians.
> However, the content of clinician-patient discussions about screening
> mammography was not elucidated by this study, yet may be critical in
> addressing patient barriers to screening mammography. 
>
> Title: [top](#top)\
> Optimizing the limited resources available for implementing shared
> decision making in primary care\
> \
> Authors:
>
> France Legare, MD, PhD\
> Michele Aubin, MD, MSc\
> Lucie Baillargeon, MD, MSc\
> Yvan Leduc, MD, PhD\
> Jean Maziade, MD, MSc\
> \
> Context:\
> Shared decision making (SDM) aims at helping patients play an active
> role in decisions concerning their health. However, empirical data
> show that SDM has not been adopted yet by physicians.\
> \
> Objective:\
> To report on the constraints encountered during an implementation
> trial of SDM in primary care and suggest strategies to improve future
> trials.\
> \
> Design:\
> A before/after trial.\
> \
> Setting:\
> Five family practice teaching units.\
> \
> Participants:\
> 120 family physicians (RR=75%) and their 923 patients.\
> \
> Intervention or Essential Feature of Study:\
> The intervention comprised an interactive workshop, feedback and a
> reminder at the point of care.\
> \
> Outcome Measures:\
> Constraints observed and recommendations for future implementation
> trials.\
> \
> Results:\
> The first constraint that was addressed was the lack of a theory to
> implement change in clinical practice. We successfully used the theory
> of planned behaviour to identify which mechanisms were underpinning
> the intention of clinicians to implement SDM in their practice. A
> second constraint related to recruiting busy clinicians to commit to a
> longitudinal study. Therefore, the interactive workshop was also used
> to conduct a group discussion on barriers to implementing SDM in
> clinical practice. A third constraint concerned collecting data from
> both practitioners and patients after clinical encounters. To carry
> this out, 6 research assistants were hired to provide maximum coverage
> at the five clinical sites over a nine-month period. However, we
> estimated that only 2% of the clinical encounters that occurred during
> the study were entered in the data set.\
> \
> Conclusions:\
> Throughout this trial, the use of theory provided insight into the
> underlying mechanisms by which change occurred in the intention of
> physicians to implement SDM in their practice. We also demonstrated
> that it was possible to use an interactive workshop for data
> collection as well as for implementing change. However, this study
> reminded us that new methods will need to be developed to maximise
> data collection from both practitioners and patients at the point of
> care.
>
> Title: [top](#top)\
> Integrating Practice-based Learning and Improvement Groups into a
> Practice-based Research Network
>
> Authors:
>
> Lucia S. Sommers, DrPH
>
> Michael Potter, MD\
> \
> Context:\
> The Collaborative Research Network (CRN) was established in 1984 by
> the Department of Family and Community Medicine, University of
> California, San Francisco (UCSF) to conduct practice-based research in
> primary care settings. The over 250 clinician members come from
> practice settings throughout Northern California and the Central
> Valley. The CRN has contributed to transforming primary care through a
> research agenda emphasizing innovations in health promotion,
> preventive health, and chronic illness care. Currently funded projects
> focus on cancer screening and diabetes self-management.\
> \
> \"Practice Inquiry\" (PI) groups, affiliated with the continuing
> medical education programs of UCSF and Kaiser Permanente Medical
> Center in Oakland, California, have been meeting in San Francisco and
> the East Bay since 2002.  Currently, eight clinician small groups meet
> regularly to explore the clinical uncertainty in individual, primary
> care patients through sharing clinical experience, expertise, and
> evidence and devising new approaches to cases while drawing
> implications for improving care clinic-wide.\
> \
> To thrive, the CRN must build close relationships with practices
> interested in practice improvement and its transformative research
> agenda.  To maximize the benefits of case-based learning from
> uncertainty, the PI groups need mentorship and technical/logistic
> support.\
> \
> Objectives:\
> To determine:
>
> \- What would be the value of integrating PI groups into the CRN?
> Specifically, what could PI groups bring to CRN regarding new energy
> and ideas for learning from practice?\
> - How could CRN help PI groups develop better methods for case-based
> inquiry, searching for evidence-based sources, and surfacing
> knowledge/skills gaps?\
> \
> Design:\
> A feasibility study will be conducted that will include:\
> - Focused discussions at PI group meetings and CRN quarterly meeting.\
> - An e-mail survey of PI and CRN members\' viewpoints about the value
> of integration\
> - PI/ CRN - member sessions to review data from discussions/survey and
> draft plan for trial PI/CRN integration\
> \
> Key Challenge:\
> To involve PI/CRN clinicians in Feasibility Study without expending
> more uncompensated time\
> \
> Goals for Session:\
> -      Feedback on integration concept\
> -      Feedback on strategies to involve membership

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions]{.smallcaps} *III      | **4:15 P.M.-5:30     |
| [top](#top)***                                | P.M.**               |
+-----------------------------------------------+----------------------+
| > **IIID *-- Refining Research in Progress:   |                      |
| > Providing Feedback to Your Colleagues***    |                      |
+-----------------------------------------------+----------------------+
| -   [Facilitator]{.underline} -- Alan         |                      |
|     Adelman, MD MS                            |                      |
|                                               |                      |
|     -   *Research in Progress:*               |                      |
|         "Effectiveness of a Diabetes          |                      |
|         Management Program in Primary Care    |                      |
|         Practice" - John Lynch, MPH           |                      |
|         (ProHealth Physicians)                |                      |
|                                               |                      |
| >        *Research in Progress:*             |                      |
| > "Unanticipated Problems with Implementing   |                      |
| > Point-of-Care Lab Testing in Primary Care   |                      |
| > Settings" -  Bennett Parnes, MD (CaReNet)   |                      |
| >                                             |                      |
| >        *Research in Progress:*             |                      |
| > "Feasibility of Incorporating PDA Use to    |                      |
| > Enhance the Self-Care Activities of         |                      |
| > Patients with Diabetes" - Samuel Forjuoh,   |                      |
| > MD (CenTexNet)                              |                      |
+-----------------------------------------------+----------------------+

Title: [top](#top)

Effectiveness of a Diabetes Management Program in primary care practice

Authors:

John T Lynch MPH, Leah Alger MPH, Jonathan Rosen MD

Context:

In 2001, an evidence-based diabetes management program was introduced to
200+ primary care practitioners in 75 Connecticut practice sites. From
2001-2005, over 15,000 diabetic patients were identified and tracked.
The program integrated scheduling, claims, and laboratory data into a
diabetes patient registry, periodic feedback (patient listings and
practitioner comparison reports), patient education via monthly mailings
highlighting specific topics of diabetes care, diabetic practice
templates, office recall of patients, and office visits for diabetes
evaluation and management.

Objective:

The project objective is to evaluate the effectiveness of a Diabetes
Disease Management Program via a *retrospective* analysis of the
outcomes.

Design:

The primary HEDIS outcome goals reported on patient listings were: ≥ 2
diabetic encounters in 12 months; A1C level ≤ 8; and last lipid level ≤
100. For practitioner comparisons, these measures were converted to
percentages of patients achieving the goals. Patients were stratified by
level of risk.

Current Challenges:

On the surface, ALL pre/post outcome measures improved substantially.
However, we are challenged by the definition of the study cohort, and
the lack of a control population.

The length of 'intervention' varies. Practitioners joined and left the
group practices throughout the 'study'. Patients were diagnosed and
added to the intervention mix throughout the 'study'. Some patients
died, others changed their insurance and no longer returned to the same
practitioner, others were admitted to a SNF. The date of the last
available lab result may be months prior to study closeout. Patients
entered the study with varying degrees of illness severity. Some
patients received additional 'interventions' in other settings
(specialist, emergency department, hospital). Completeness of
information about such outside interventions is lacking. 'Success' will
be distorted by patient starting point, initial severity, length of time
in the study, and uncontrollable outside interventions.

Goal for Session:

Understand methodological issues posed by retrospective population
outcomes studies.

Questions for Audience Consideration:

How should we design a retrospective study of real world uncontrolled
populations?

How should we define the population cohorts?

How should we define starting and endpoints?

How should we control for outside interventions?

How should we handle 'missing' data?

Title: [top](#top)\
Unanticipated Problems with Implementing Point-of-Care Lab Testing in
Primary Care Settings

Authors:\
Bennett Parnes, MD\
Javan Quintela\
Linda Zittleman, MSPH\
Wilson Pace, MD\
\
Context:\
Point-of-care lab testing in primary care is well-established, such as
for urinalyses, pregnancy tests, etc.  It has potential to improve
efficiency by managing lab results with the patient present, increase
patient safety by eliminating lost results, increase patient
satisfaction, and improve outcomes.\
\
Objective:\
In a randomized-controlled trial in which point-of-care lipid testing is
a component of the intervention, describe unanticipated barriers to the
implementation of point-of-care technology.\
\
Design:\
The study is designed to improve cardiovascular risk in subjects with
type 2 diabetes. The intervention consists of (1) Home blood pressure
self-monitoring with a telephony or web-based reporting and feedback
system, and (2) point-of-care lipid testing on all subjects who present
to clinic visits fasting; results are obtained and available for
clinician review during the clinical encounter. Ten clinics in SNOCAP
are being randomized at the clinic level (about 30 consented subjects
per clinic).\
\
Current Challenges:\
Multiple barriers to point-of-care lipid testing have been identified,
with partial success thus far in overcoming them.  These include:\
1. The need for retraining of clinic staff in the technique due to staff
turnover.\
2. Concern by a hospital-owned clinic over loss of hospital lab
business.\
3. Extensive 3-month verification of the instrument, in spite of
CLIA-waived status.\
4. Requiring the study to pay for Medical Assistant time to perform
test.\
5. Requiring the on-site lab to perform the test instead of Medical
Assistants, resulting in substantial delays.\
6. Up to 12-month delay in approval of the instrument in a large health
care system.\
\
Goals for Session/Questions for Audience Consideration:\
By getting audience feedback, new solutions to barriers may emerge. This
may also be helpful for others planning point-of-care interventions.
Finally, a modified version of this intervention on a larger scale has
been funded, but not yet implemented. Audience feedback may help
anticipate or resolve problems with this new project.

Title: [top](#top)\
Feasibility of Incorporating PDA Use to Enhance the Self-Care Activities
of Patients with Diabetes

Authors:

Samuel Forjuoh, M.D., Dr.P.H.

Marcia Ory, Ph.D., M.P.H.

Michael Reis, M.D.

Glen Couchman, M.D.

Saundra Mason, BSN, RN

Sonia Holleman, BS

Context:\
The feasibility of incorporating PDA use in the self-care activities of
patients with diabetes is understudied.\
\
Objective:\
To document initial experiences in testing PDA use for diabetes
self-care activity monitoring, highlighting research challenges.\
\
Design\
Adult patients with type 2 diabetes whose last measured HbA1c \>= 9.0%
(via medical records) and/or \>= 8.0% (at research orientation visit)
were recruited from 4 family practice clinics.  A trained research
assistant (RA) provided one-on-one training on the use of a loaned PDA
with pre-installed diabetes management software.  Participants were
provided with a phone number to call for help and scheduled for return
visits in 3 months.  A monitoring phone call was made to each
participant within 1 week of the orientation visit.\
\
Current Challenges:\
All participants accepted a PDA on loan and completed the initial
training session lasting a mean of 54.7 minutes (SD=14.7; range 30-90). 
Four have dropped out.  Our major challenge has been subject recruitment
partly due to changes in HbA1c values over time.  Of 626 patients
invited for participation, only 67 (11%) have called an RA to schedule
an orientation visit; 38 (57%) met all study inclusion criteria. 
Participants\' mean age is 54.4 years (SD=9.9; range 35-77).  The
majority is female (66%) and white (61%); 63% have at least some college
education and most reported an annual household income of
\$30,000-\$49,999.   A related challenge has been providing pledged
incentives to potential subjects who fail to meet all study inclusion
criteria at the orientation visit.  Our third challenge relates to
regulatory requirements regarding HbA1c testing.  Participants\' mean
HbA1c is 10.1% (SD=1.6; range 8-14).  The majority (95%) is computer
literate; only 18% reported using a PDA before.  Other challenges have
included participants\' loss of instructional folders, difficulty with
data entry, and data loss due to incorrect saving of data after entry.\
\
(FOR PRESENTATIONS) Goals for Session/Questions for Audience
Consideration:\
1) Highlight current challenges about incorporating health information
technology into chronic disease management.\
2) Obtain audience feedback about resolving current challenges.

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions IV                     | **9:00 A.M.-10:00    |
| [top](#top)]{.smallcaps}**                    | A.M.**               |
+-----------------------------------------------+----------------------+
| > **IVA *-- Health Literacy***                |                      |
+-----------------------------------------------+----------------------+
| -   [Facilitator]{.underline} -- Carmela      |                      |
|     Lomonaco, PhD                             |                      |
|                                               |                      |
|     -   "Integrating Multiple Perspectives to |                      |
|         Measure the Reach of Diabetes         |                      |
|         Self-Management Support Interventions |                      |
|         in a Safety Net Primary Care          |                      |
|         Network" - Margaret Handley, PhD MPH  |                      |
|         (UCSF Collaborative Research Network) |                      |
|                                               |                      |
| >          "Literacy in Primary Care:        |                      |
| > Comparison of Wisconsin to National         |                      |
| > Approaches and Attitudes" - Michael         |                      |
| > Grasmick, PhD (WREN)                        |                      |
| >                                             |                      |
| >          *Research in Progress:*           |                      |
| > "Evaluating the Effects of Cognitive        |                      |
| > Impairment and Low Health Literacy on       |                      |
| > Medication Adherence in Aging Minority      |                      |
| > Populations: A Significant Role for Primary |                      |
| > Care Providers" - Charles P. Mouton, MD MS  |                      |
| > (DC PrimCaRe)                               |                      |
+-----------------------------------------------+----------------------+

Title: [top](#top)\
Integrating Multiple Perspectives to Measure the Reach of Diabetes
Self-Management Support Interventions in a Safety Net Primary Care
Network

Authors:\
Margaret, Handley, PhD MPH\
Dean, Schillinger,MD;\
Hali, Hammer, MD;\
Jorge, Palacios, MA;\
Ivonne, McLean, BA;\
Audrey, Tang, NP;\
Franes, Wang, MA.\
\
Context:\
There is a growing recognition that assessing the reach of interventions
is necessary, for implementation efforts in diverse populations and for
determining if more vulnerable population are benefiting.\
\
Objective:\
To measure the reach of 2 diabetes self-management support interventions
using perspectives from epidemiology, public health, and health
promotion (participation, representativeness, and engagement).\
\
Design:\
Population-based registry criteria and provider authorization identified
eligible patients who were recruited during clinic visits and
randomized, with 9 months of intervention exposure or usual care
follow-up.\
\
Setting:\
4 primary care clinics in the Community Health Network of San Francisco
(CHN), part of the UCSF Collaborative Research Network.\
\
Participants:\
Diabetes patients with a recent HbA1c \>8.0%, speak English, Spanish, or
Cantonese, and have a primary care provider. \
\
Intervention or Essential Feature of Study:\
Automated telephone diabetes management (ATDM) uses language-specific 
interactive technology for weekly surveillance of self-care/symptoms;
out-of-range responses trigger phone follow-up. Group medical visits
(GMV) include monthly visits of 7-10 patients facilitated by a diabetes
health educator and a clinician. \
\
Outcome Measures:\
Participation rates, patient representativeness, engagement.\
\
Results:\
4/9 clinics participated (44%), representing 1307 of 2262 eligible
patients (58%). 197/1307 (15%) had provider exclusions, 109 (8%)
reported ineligibilities, 78 (6%) refused, 584 (45%) were not
approached, and 339 enrolled (26%). 115/117 (98%) providers determined
patient eligiblility; 103 (88%) had \>1 patient enroll. Compared to
eligible non-enrolled patients, enrolled patients were significantly
more likely to speak Spanish (than English or Cantonese), and to be
Hispanic or African American, but were similar regarding age, sex and
recent HA1c. 112/133 (94%) ATDM patients completed 1+ calls; 49% of
calls triggered call backs. 55/78 (71%) GMV patients attended 1+ times;
47 (60%) made 1+ behavior change action plan (preliminary analyses).\
\
Conclusions:\
Among safety net patients with diabetes, participation rates were fairly
high among patients and providers, enrolled and eligible patients
differed by language and ethnicity, and intervention engagement was
considerable.

Title: [top](#top)\
Literacy in Primary Care: Comparison of Wisconsin to National Approaches
and Attitudes

Authors:\
Michael Grasmick, Ph.D.\
Jonathan Temte, M.D./Ph.D.\
Amber Jaeger, MS                                       \
Van Yasek, Ph.D.\
\
Context:\
Low literacy is prevalent (40%) and affects patients\' health status. \
\
Objective:\
To assess the attitudes and methods to improve communication with low
literacy patients used by clinicians from WREN (n=90), a university
department (UW-DFM: n=309) a state academy (WAFP: n=1358) and a random
sample of the AAFP members not practicing in Wisconsin (AAFP: n=500).\
\
Design:\
A 12-question survey was sent by e-mail with a hyperlink for online data
collection to all Wisconsin providers.  This same survey was mailed to
250 AAFP physicians.  250 additional AAFP physicians received a postcard
containing a URL for an online survey. \
\
Setting:\
U.S. Primary care offices. \
\
Participants:\
462 clinicians. \
\
Intervention or Essential Feature of Study:\
The survey URL was emailed to Wisconsin participants.  Non-respondents
received two reminder emails.  Paper surveys or a postcards with a
survey URL were mailed to AAFP participants.  Non-respondents received
two additional reminder letters or postcards spaced at three week
intervals. \
\
Outcome Measures:\
Response rates across 5 groups and 3 methods of survey distribution. 
Prevalence of low literacy, impact on the quality of care and patient
outcomes, frequency of screening, steps taken to improve communication,
and impact of low literacy on patient\'s health status, quality of life
and satisfaction.  \
\
Results:\
Response rates were 60% (WREN), 19% (UW-DFM), 18% (WAFP), 38%
(AAFP-mail) and 2.8% for (AAFP-postcard-URL).  All groups significantly
underestimated the prevalence of low literacy to a similar degree
(17.4%), and had similar estimates of the impact of low literacy on
health outcomes.  Significant differences were found between Wisconsin
Clinicians and non-Wisconsin Clinicians in the rates of screening for
low literacy (7.1% vs. 17.5%).\
\
Conclusions:\
Clinicians recognize the importance of low literacy in the health of
their patients, but underestimate its prevalence, and few employ
screening.  WREN accurately represents Wisconsin but has difference from
a national sample.

Title: [top](#top)

Evaluating the Effects of Cognitive Impairment and Low Health Literacy
on Medication Adherence in Aging Minority Populations: A Significant
Role for Primary Care Providers

Authors:

Charles P. Mouton, MD, MS

Finie Hunter, MPH

Context: 

The medical literature contains several well-documented studies that
estimate up to sixty percent of the minority population does not comply
with the prescribed drug regimen.  Although the reasons for lack of
compliance may vary, the role of cognitive impairment has not been
explored. Community-based primary care clinicians are the frontline and
cornerstone for addressing the health care needs of poor and underserved
populations.

 

Objective:

1\) What is the prevalence of cognitive impairment as measured by the
Clock Drawing Test (CLOX) among  the target population consisting of
urban, underserved patients seen in primary care practices, and to what
extent do these two factors overlap in that population?   2) What are
the effects of cognitive impairment on the ability of a patient to
adhere to a prescribed drug regimen?

 

Design:

A multi-level study implemented at 25 member practices consisting of a
cross-sectional demographic survey and two health assessments
administered to a convenient sample for a two week period.  Pilot study
utilizes CLOX, an executive clock drawing test to screen for cognitive
impairment and the Rapid Estimate of Adult Literacy in Medicine (REALM)
test to measure health literacy.  In addition, we will conduct
stimulated patient chart reviews to record medication adherence
behavior.

 

Current Challenges:

Current challenges include clinician and patient willingness to
participate, recruiting practices outside of the Howard University
Hospital Provider Network, insufficient manpower for providing
assistance to short-staffed practices, and quality assurance of
personnel administering study.

Goals for Session/Questions for Audience Consideration

1\) How do cognition and executive decision making affect medication
adherence?

2\) What are the most reliable and practical methods of measuring
medication adherence in this setting?

3\) Does physician expectation play a role in reliability of data
collected from patients?

+------------------------------------------------+---------------------+
| **[Concurrent Sessions IV                      | **9:00 A.M.-10:00   |
| [top](#top)]{.smallcaps}**                     | A.M.**              |
+------------------------------------------------+---------------------+
| > **IVB *-- Colorectal Cancer***               |                     |
+------------------------------------------------+---------------------+
| -   [Facilitator]{.underline} -- Kevin         |                     |
|     Peterson, MD MPH                           |                     |
|                                                |                     |
|     -   "Patient Reported Barriers to, and     |                     |
|         Facilitators of, Colorectal Cancer     |                     |
|         (CRC) Screening: Qualitative Study     |                     |
|         Results" - Kelly Devers, PhD (ACORN)   |                     |
|                                                |                     |
| >          "Improved Screening Colonoscopy    |                     |
| > Rates with Use of an Optimized Electronic    |                     |
| > Medical Record and Supportive Clinical       |                     |
| > Systems" - Jacob Prunuske, MD (Utah Health   |                     |
| > Research Network)                            |                     |
| >                                              |                     |
| >          "Colorectal Cancer Testing Among   |                     |
| > Patients Cared for by Iowa Family            |                     |
| > Physicians" - Barcey Levy, MD PhD (Iowa      |                     |
| > Research Network)                            |                     |
+------------------------------------------------+---------------------+

Title: [top](#top)

Patient Reported Barriers to, and Facilitators of, Colorectal Cancer
(CRC) Screening: Qualitative Study Results

Authors:

Kelly J. Devers, Ph.D.

Resa M. Jones, M.P.H., Ph.D.

Anton J. Kuzel, M.D.

Steven H. Woolf, M.D., M.P.H.

Context:

CRC is the second leading cause of cancer deaths in the United States.
Understanding the factors that account for the low proportion of
age-eligible adults that undergo CRC screening and possible ways to
address them is essential for improving CRC screening rates and reducing
mortality.

Objective:

To describe the factors that patients identify as their reason(s) for
not undergoing CRC screening and patients' perspectives on potential
solutions.

Design:

Literature review and analysis of open-ended survey item responses and
focus groups.

Setting:

Diverse practices participating in the Virginia Ambulatory Care Outcomes
Research Network (ACORN).

Participants:

Three-hundred seventeen (317) randomly selected patients ages 50 and
older who answered an open-ended survey question about "the most
important reason" why people might not undergo CRC screening, and 36
patients ages 45 and older who participated in six gender-specific focus
groups about barriers to, and facilitators of, CRC screening.

Intervention or Essential Feature of the Study:

Identifying patient-reported barriers to CRC screening in general and to
each of the four nationally recommended screening tests (i.e., fecal
occult blood testing, flexible sigmoidoscopy, colonoscopy, and barium
enema), and potential ways of overcoming these barriers.

Outcome Measures:

Patients' characterizations of: 1) barriers to CRC screening generally
and to each of the four tests; and, 2) potential remedies.

Results: Although we identified many of the generic barriers (e.g.,
knowledge, attitudes and beliefs, time, costs) previously documented in
the literature, we also identified specific barriers that have not been
highlighted to date, and we gained additional perspectives from patients
about potential solutions.

Conclusions:

While patients reported many barriers to CRC screening, they also
identified numerous ways screening could be facilitated. These
qualitative results will be used to develop a postal survey, which will
allow us to gauge the relative importance of specific barriers, and help
develop effective strategies to increase CRC screening rates.

Title: [top](#top)\
Improved screening colonoscopy rates with use of an optimized electronic
medical record and supportive clinical systems

Authors:\
Jacob, Prunuske, MD MSPH\
Anna, Baker, MPH\
Annie, Mervis, MSW\
Linda, Johnson, RN\
Steve, Donnelly, PhD\
Julie, Day, MD\
Mary, Parsons, MD\
Michael, Magill, MD\
Randall, Burt, MD\
\
Context:\
Colorectal cancer (CRC) is the third-leading cause of cancer death for
men and women in the United States.  Many eligible adults have not had
CRC screening despite availability and reliability.  Primary care
physicians provide the majority of preventive health care services in
the United States, and have an essential role in improving CRC screening
rates. \
\
Objective:\
Can use of an optimized electronic medical record (EMR) reminder and
supportive clinical systems increase the rate of CRC screening in a
large primary care network? \
\
Design:\
Quasi-experimental prospective controlled trial\
\
Setting:\
University of Utah Community Clinics (UUCC), a 100,000 patient,
seven-practice, multi-specialty, primary care network, linked by EMR,
located in and around Salt Lake City, Utah. \
\
Participants:\
All patients age \> 50 at UUCC, 50 physicians, 20 mid-level
practitioners, and clinic support staff.  Utah has a predominantly
Caucasian population; however the study population includes a
significant proportion of Hispanics, American Indians, and Pacific
Islanders. \
\
Intervention or Essential Feature of Study:\
Optimized electronic reminder in EMR and associated supportive clinical
systems, including practice redesign with expanded medical assistant
role, and provider education. \
\
Outcome Measures:\
Monthly referral rates for colonoscopy in eligible patients and monthly
proportion of visits at which patient is current for CRC screening. \
\
Results:\
The monthly colonoscopy referral rate for eligible patients at UUCC
increased from 5.7% pre-intervention to 10.8% post-intervention with no
overlap in control limits.  This increase remains sustained after one
year.  The monthly proportion of visits where the patient is current for
CRC screening increased from 36-40% pre-intervention to 42-45%
post-intervention. \
\
Conclusions:\
Optimal use of an electronic reminder combined with associated
supportive clinical systems and practice redesign provides sustained
improvement in CRC screening rates in a large multi-specialty primary
care network.

Title: [top](#top)\
Colorectal Cancer Testing Among Patients Cared for by Iowa Family
Physicians

Authors:\
Levy, Barcey, PhD, MD\
Dawson, Jeffrey\
Hartz, Arthur\
James, Paul\
\
Context:\
With appropriate screening, colorectal cancer (CRC) can be largely
prevented or effectively treated, yet about half of eligible Americans
have not been screened.\
\
Objective:\
The purpose of this study was to examine patient and physician factors
associated with documented CRC testing according to national
guidelines.\
\
Design:\
Cross-sectional study of 511 randomly selected rural patients aged 55 to
80 years of 16 board-certified Iowa family physicians were enrolled in
2004. Patient survey and medical record information was linked with
physician surveys. Predictors of CRC testing were examined using a
regression procedure that accommodated random physician effects
(2005-6).\
\
Setting:\
The Iowa Research Network has 270 clinicians representing 150 practices.
Our mission is to create new knowledge with relevance to rural primary
care clinicians and their patients with the outcome of improving care
for patients.\
\
Participants:\
Physicians. In mid-November 2002, letters were mailed to 240 IRENE (Iowa
Research Network) physicians briefly describing the proposed research
and asking them to indicate whether they might be interested. A total of
57 physicians indicated their potential interest in the project and
whether they or their partners performed FS or colonoscopy. Once funding
for the project was received in 2003, 18 physicians were randomly
selected from this group such that 6 each performed FS, colonoscopy, or
neither procedure. 16 physicians eventually completed the study.\
Patients. Participating physicians provided lists of their patients aged
55 to 80 years. Thirty male and 30 female patients were randomly chosen
from this list and were mailed study materials. Medical records of
consenting patients were reviewed. \
\
Intervention or Essential Feature of Study:\
Information from patient self-report about attitudes and recollections
concerning CRC screening was linked with information obtained from
detailed, structured medical record review, and with information
obtained from physicians by questionnaire. Reason for any CRC screening
was recorded, so that diagnostic tests could be separated from screening
tests.\
\
Outcome Measures:\
The main outcome variable was whether a patient was \"up to date\" with
colorectal cancer screening determined by medical record review. \"Up to
date\" was defined as any of the following within the time interval
noted from the initial mailing date: five take home hemoccult tests
within the previous 5.5 years, flexible sigmoidoscopy within the
previous 5.5 years, barium enema within the previous 5.5 years, or
colonoscopy within the previous 10.5 years.\
\
Results:\
Forty-six percent of patients were up to date with CRC testing in
accordance with national guidelines. This percentage varied from 5% to
75% by physician (p \< .0001). Of the patients who were up to date, 89%
had colonoscopy and 62% had symptoms prior to testing that could
indicate CRC. The strongest univariate predictors other than symptoms
were: patient recollection of physician recommendation (OR 6.4; 95% CI
4.2, 9.6) and physician documentation of recommendation (OR 14.1; CI
8.5, 23.3). A multivariable regression model showed testing in
accordance with guidelines significantly increased with government
insurance (OR 1.6; CI 1.2, 2.3), having a health maintenance visit in
the preceding 26 months (OR 2.4; CI 1.4, 4.1), family history of CRC (OR
3.1; CI 1.6, 5.8), number of medical conditions (OR 1.2 for each
additional condition; CI 1.1, 1.3), high importance of screening to
patient (OR 2.6; CI 1.5, 4.5), patient satisfaction with doctor\'s
discussions (OR 3.3; CI 2.2, 4.8), physician trained in flexible
sigmoidoscopy (OR 2.3; CI 1.6, 3.4), and physician report of trying to
follow American Cancer Society guidelines (OR 1.7; CI 1.2,2.5).  After
excluding patients who had symptoms prior to screening, most of the odds
ratios in the logistic regression analysis increased except that the
number of medical conditions and physician trying to follow ACS
guidelines became non-significant.\
\
Conclusions:\
Less than half of rural patients received CRC testing, and most of those
tested had symptoms. Physician recommendations and manner of presenting
the recommendations greatly influenced whether patients were tested. 

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions IV]{.smallcaps}**      | **9:00 A.M.-10:00    |
| [top](#top)                                   | A.M.**               |
+-----------------------------------------------+----------------------+
| > **IVC *-- Chronic Care Model***             |                      |
+-----------------------------------------------+----------------------+
| -   [Facilitator]{.underline} -- John Pascoe, |                      |
|     MD                                        |                      |
|                                               |                      |
|     -   "QuitLink: Partnering Clinical        |                      |
|         Practices and Telephone Quit Lines to |                      |
|         Leverage an Improvement in the        |                      |
|         Quality of Tobacco Counseling in      |                      |
|         Primary Care" - Steven Rothemich, MD  |                      |
|         MS (ACORN)                            |                      |
|                                               |                      |
| >          "A Controlled Trial of Methods    |                      |
| > for Managing Pain in Primary Care Patients  |                      |
| > With or Without Co-Occurring Psychosocial   |                      |
| > Problems" - Deborah Johnson (Dartmouth      |                      |
| > CO-OP)                                      |                      |
| >                                             |                      |
| >          *Research in Progress:* "A        |                      |
| > Comprehensive Practice-Friendly Model for   |                      |
| > Promoting Healthy Behaviors. A Prescription |                      |
| > for Health Study" - Alex Krist, MD (ACORN)  |                      |
+-----------------------------------------------+----------------------+

Title: [top](#top)\
QuitLink: Partnering Clinical Practices and Telephone Quit Lines to
Leverage an Improvement in the Quality of Tobacco Counseling in Primary
Care\
\
Authors:\
Stephen Rothemich, MD, MS\
Steven Woolf, MD, MPH\
Robert Johnson, PhD\
Sharon Flores, MS\
Amy Burgett, RN\
Pamela Villars, M.Ed., LPC\
Vance Rabius, PhD\
\
Context:\
Counseling by clinicians promotes smoking cessation, but routinely
providing more than brief advice is difficult in most U.S. primary care
practices.  Barriers include competing demands and inadequate office
support systems.\
\
Objective:\
Telephone quit lines, whose staff deliver more effective intensive
counseling, are proliferating in the U.S., but few work closely with
clinicians to provide feedback or forward requests for cessation
medications.  Whether such a partnership improves outcomes has not been
studied.  We present an ongoing trial (ClinicalTrials.gov #NCT00112268)
of such an intervention.\
\
Design:\
Cluster-randomized controlled trial. All practices implemented smoking
status as a routine vital sign before a 3 month baseline, followed by
allocation and analysis by practice.  Outcomes are measured over 9
months.\
\
Setting:\
16 primary care practices in metropolitan Richmond, Virginia
participating in the Virginia Ambulatory Care Outcomes Research Network
(ACORN).\
\
Participants:\
789 adult smokers had participated in an exit survey by 4.5 months
(study midpoint).\
\
Intervention or Essential Feature of Study:\
The intervention combines: (1) an expanded \"vital sign\" screening; (2)
fax referral of smokers to the American Cancer Society quit line; and
(3) quit line feedback to providers, including progress reports and
prescription requests.\
\
Outcome Measures:\
The primary outcome is the frequency of intensive counseling (more than
brief advice to quit), reported by patients in exit surveys.  The study
includes a qualitative component with interviews of patients and
practice staff about the intervention.\
\
Results:\
Preliminary data at 4.5 months reveal intensive counseling in
intervention practices increased from 30% to 43% (+13%) while in control
practices it minimally changed from 34% to 33% (-1%).\
\
Conclusions:\
Exit surveys from this period suggest that the intervention is producing
an increase in intensive counseling, although data collection must be
completed to achieve adequate statistical power and assess
sustainability.  Details of the QuitLink system and the first 6 months
of trial results will be presented.

Title: [top](#top)\
A Controlled Trial of Methods for Managing Pain in Primary Care Patients
With or Without Co-Occurring Psychosocial Problems

Authors:\
Deborah J. Johnson, BS\
Tim Ahles, PhD\
John H. Wasson, MD\
Janette Seville, PhD\
Bernard Cole, PhD\
Brett Hanscom, MS\
Therese Stukel, PhD\
Elizabeth McKinstry, MSN

Context:\
Pain is a common reason for visits to primary care physicians (PCPs)
that is often not well managed.\
\
Objective:\
To determine the effectiveness of pain management interventions suitable
for PCPs.\
\
Design:\
Patients from rural practices reporting diverse pain problems with
(N=644) or without (N=693) psychosocial problems randomized.
Intervention received information tailored to problems and concerns
(INFO).  PCPs received feedback about patients\' problems and concerns
(FEED). Nurse Educator (NE) telephoned patients with pain and
psychosocial problems to teach Problem-Solving strategies and basic pain
management skills. \
\
Setting:\
Oldest research network in the country, reaching across northern New
England (New Hampshire, Vermont and Maine).\
\
Participants:\
Patients reporting pain for at least a month\'s duration of 3 or above
on 5-point scale stratified into two groups, patients without (Cohort 1)
and with (Cohort 2) self-reported psychosocial problems.\
\
Intervention or Essential Feature of Study:\
Usual Care-received care as usual.\
Patient Information and Physician Feedback (INFOFEED). \"Prescription\"
letter generated tailored to patient\'s responses. Patient referred to
self-care educational information.  Physician sent computer-generated
feedback form describing items endorsed by patient, particularly the
presence and level of pain.\
NE Intervention. Nurse-educators contacted patients by telephone.
Conducted pain assessment and psychosocial problems; established patient
preferences for types of pain management strategies; reviewed pain
self-management strategies and provided supplemental materials; provided
problem solving approach for psychosocial issues and; provided rapid
feedback to physician regarding interventions initiated and
identification of concerning symptoms or psychosocial problems.\
\
Outcome Measures:\
SF36, Functional Interference Estimate, and health care utilization.\
\
Results:\
Patients with pain and psychosocial problems, NE+INFOFEED significantly
improved Bodily Pain (p = 0.02), Physical Function (p = 0.02), Emotional
Function (p = 0.03), and Vitality (p \< 0.001) at six months.
Improvements maintained at 12 months.  Compared to Usual Care, patients
receiving INFOFEED experienced significant improvements at six months in
social functioning and less interference in daily activities from pain.\
\
Conclusions:\
For patients with pain and psychosocial problems, telephone-based
assistance with techniques such as problem solving, relaxation, sleep
hygiene and activity pacing resulted in significant, sustained benefit.

Title: [top](#top)\
A Comprehensive Practice-Friendly Model for Promoting Healthy Behaviors.
A Prescription for Health Study\
\
Authors:\
Alex Krist MD\
Steven Woolf MD\
Stephen Rothemich MD\
Robert Johnson PhD\
Diane B Wilson Ed.D\
Kelly Devers PhD\
\
Context:\
Linking clinical and community resources can provide patients with
necessary support to facilitate behavior change. Clinicians are well
equipped to identify patients with unhealthy behaviors (A1), advise them
to improve behaviors (A2), help reach agreement on whether to improve
behaviors (A3), and follow-up on progress (A5). While clinicians
frequently lack resources to provide intensive assistance (A4) in their
office, community programs exist that can more effectively support
patients\' needs.  \
\
Objective:\
To test a package of interventions designed to assist patients with
healthy diet, increased exercise, smoking cessation, and alcohol
moderation. An electronic health record (EHR) prompt system will
facilitate the delivery of A1-3 and A5 in the office as well as refer
patients to existing intensive community programs (A4). Interested
patients will be able to select nine months of telephone counseling,
group classes, online assistance, or usual care. \
\
Design:\
Nine practices using a common EHR within the Virginia Ambulatory Care
Outcomes Research Network (ACORN) are participating. In a pre-post
design, postal surveys will assess changes in health behavior among a
random sample of patients from study practices. The EHR will track how
clinicians use EHR prompts, allowing an assessment of how providers vary
in their use of prompts and of the patients for whom prompts are used. A
second survey, mailed to patients participating in intensive
interventions, will measure patients\' experience with the program and
changes in health behaviors.\
\
Current Challenges:\
Creating an effective, user-friendly EHR prompt system is challenging.
Prompts must be unobtrusive and appear at a time when clinicians can
respond, integrating smoothly into the natural flow of clinical
encounters. We will also discuss challenges in developing e-counseling
and telephone counseling programs to which primary care patients can be
referred.\
\
Goals for Session/Questions for Audience Consideration:\
It is anticipated that information from the presentation will assist the
authors with:\
1. Ensuring effective use of intensive counseling interventions;\
2. Refining research questions about the intervention\'s Reach and
Implementation; and\
3. Analyzing preliminary experience about barriers to creating EHR
prompts.

+-----------------------------------------------+----------------------+
| **[Concurrent Sessions IV]{.smallcaps}**      | **9:00 A.M.-10:00    |
| [top](#top)                                   | A.M.**               |
+-----------------------------------------------+----------------------+
| > **IVD *-- Workshop: Best Practices:         |                      |
| > Engaging medical students to overcome       |                      |
| > recruitment challenges in rural networks*** |                      |
+-----------------------------------------------+----------------------+
| -   [Moderator]{.underline} -- Aimee James,   |                      |
|     PhD MPH                                   |                      |
|                                               |                      |
| > Workshop Learning Objectives:               |                      |
|                                               |                      |
| 6.  Identify methods for involving medical    |                      |
|     students in PBRN activities.              |                      |
|                                               |                      |
| 7.  Describe specific training and design     |                      |
|     concerns pertinent to engaging students   |                      |
|     in research.                              |                      |
|                                               |                      |
| 8.  Describe mutual benefits to students and  |                      |
|     practices resulting from participation in |                      |
|     research.                                 |                      |
|                                               |                      |
| 9.  State how this strategy can enhance       |                      |
|     relationships between practices and PIs.  |                      |
|                                               |                      |
| 10. Discuss innovative methods for relieving  |                      |
|     the research burden in practices.         |                      |
+-----------------------------------------------+----------------------+

Workshop Title [top](#top)\
Best Practices: Engaging medical students to overcome recruitment
challenges in rural networks

Workshop Leader\
Aimee, James, PhD, MPH\
\
Please list additional workshop presenters and their network
affiliation:\
KA Greiner, MD, MPH, Network Director;\
KK Engelman, PhD, Affiliated Researcher;\
L Mussulman, MA, Project Director;\
E Ellerbeck, MD, MPH, Affiliated Researcher\
\
Please describe the intended audience for your workshop.\
PBRN directors, investigators, and practitioners\
\
Please provide a synopsis of your workshop.\
The distance between practices is one challenge for rural PBRNs. The
KPEPR network spans over 400 miles across rural Kansas.  Budget
limitations have constrained our ability to hire research coordinators
at every practice.\
\
To address this challenge, we developed sustainable research training
and placement programs for medical students completing elective and
required rural preceptorship rotations.  Students blend research
activities and clinical activities under the supervision of their
precepting network physicians. Students perform project activities
including recruitment, eligibility screening, and data collection.\
\
Several studies in the KPEPR network either have been completed or are
underway that successfully use this strategy.  For example, in the
NIH-funded Kan-Quit smoking cessation study, students in 52 practices
screened over 1800 patients, recruiting 750 smokers into a 24-month
randomized trial. The same approach will be used for a colorectal cancer
screening intervention starting in June 2006. \
\
Engaging medical students in PBRN functions not only facilitates project
recruitment and implementation, but also exposes students to primary
care research.  Students can relieve practice research burdens and
maintain program visibility within a network.  Student involvement and
enthusiasm for research within practices strengthens academic and
practitioner ties.\
\
\
What are the learning objectives for your workshop.\
Upon completion, participants will be able to:\
(1) Identify methods for involving medical students in PBRN activities;\
(2) Describe specific training and design concerns pertinent to engaging
students in research;\
(3)  Describe mutual benefits to students and practices resulting from
participation in research. State how this strategy can enhance
relationships between practices and PIs;\
(4) Discuss innovative methods for relieving the research burden in
practices\
\
\
Please provide an agenda for the 75 minute workshop.\
(1) KPEPR and rural preceptorship programs;\
(2) Use and limitations of medical students: research education,
engaging students in rural network research, and integrating medical
education and PBRN activities to strengthen relationships and improve
research outcomes;\
(3) Student training and involvement in PBRN research:  Examples from
KPEPR research activities.

[]{#Posters .anchor}**POSTERS** [top](#top)

+-----------------------------------------------------------------------+
|   --------                                                            |
| -- ------------ ----------- ----------------------------------------- |
|   **Poster   **Last       **First     **Poster Title**                |
|   \#**       Name**       Name**                                      |
|                                                                       |
|   1                                                                   |
|        Manning      Brian       Relationship between Patient Question |
|                                                                       |
|                                   Asking and Health Outcomes in a RCT |
|                                                                       |
|   2                                                                   |
|        Hickner      John        Evaluation of an Emergency Department |
|                                       Primary Care Referral Program   |
|                                                                       |
|   3                                                                   |
|     Lin          Ge          Using geographic information to evaluate |
|                                       primary care physician demand   |
|                                                                       |
|   4                                                                   |
|         Dulin        Michael     Analysis of Healthcare Delivery to a |
|                                       Transitioning Community         |
|                                                                       |
|   5          McKee        M. Diane    Latinas with Diabetes Mellitus: |
|                                                                       |
|                              Predictors of Poor Glycemic Control in a |
|                                                                       |
|                                    Low Income Primary Care Population |
|                                                                       |
|   6                                                                   |
|         Day          Julie       Improving Care for our Patients with |
|                                                                       |
|                                      Diabetes: A System-Wide Approach |
|                                                                       |
|   7                                                                   |
|        Fernald      Douglas     Designing a Patient-Centered Diabetes |
|                                                                       |
|                                    Registry: Successes and Challenges |
|                                                                       |
|   8                                                                   |
|          Gaffney      Cecelia     Web-based Training Improved Smoking |
|                                                                       |
|                                  Cessation Counseling in Primary Care |
|                                       Practices                       |
|                                                                       |
|                                                                       |
|  9          Kho          Abel        Informatics Solutions to Achieve |
|                                                                       |
|                              Just-in-Time Subject Enrollment Across a |
|                                       Practice Based Research Network |
|                                                                       |
|                                                                       |
| 10         Labuda       Susan       Profiles of Medically Underserved |
|                                                                       |
|    Schrop                   Patients Who Use Computer Kiosks to Learn |
|                                       about Preventive Health         |
|                                                                       |
|   11                                                                  |
|       Ariza        Adolfo      Testing a Computer System to Interpret |
|                                       Child Nutritional Health        |
|                                                                       |
|   12         Angier       Heather     Screening Kids in Lakeview for  |
|                                       Developmental Delays (SKILDD)   |
|                                                                       |
|   13                                                                  |
|    Garbutt      Jane        What Constitutes Maintenance Asthma Care? |
|                                                                       |
|   14                                                                  |
|       Eberl        Margaret    Primary Care Pathway to Improve Breast |
|                                       Diagnostic Care                 |
|                                                                       |
|   15                                                                  |
|        Line         Laura       Pilot Studies That Have Helped Design |
|                                                                       |
|                               Better Data Collection: Data Collection |
|                                                                       |
|                                     Tools for Practice-based Research |
|                                                                       |
|   16                                                                  |
|        Crichlow     Renee       Established PBRN Patterns of Funding, |
|                                       Governance and Publication      |
|                                                                       |
|   1                                                                   |
| 7         Peterson     Kevin       Universal Modeling of Primary Care |
|                                       Clinical Trials                 |
|                                                                       |
|   18                                                                  |
|     Miles        Toni        Studies of Research Readiness in Primary |
|                                       Care                            |
|                                                                       |
|   19         Ryan         Alexandra   Evaluation of Bias in Consented |
|                                       Practice-Based Research         |
|                                                                       |
|   20                                                                  |
|     Pascoe       John        Attitudes Regarding Physician Counseling |
|                                                                       |
|                                 on Gun Safety Practices: A Comparison |
|                                                                       |
|                                 between Military and Civilian Parents |
|                                                                       |
|   21                                                                  |
|          Sokolnicki   Annette     Primary Care Patients Self Reported |
|                                                                       |
|                                 Health Behavior Risks and Interest in |
|                                       Change                          |
|                                                                       |
|   2                                                                   |
| 2         Robinson     Stacy       HHS Quick Guide to Health Literacy |
|                                                                       |
|                                                                       |
| 23         Cardarelli   Roberto     Cardiovascular Disease, Perceived |
|                                                                       |
|                             Discrimination, Social Support, and Sense |
|                                       of Personal Control             |
|                                                                       |
|   24                                                                  |
|     Anderko      Laura       Methylmercury Exposure Assessment within |
|                                       a PBRN                          |
|                                                                       |
|   25         PBRN RC                  About the PBRN Resource Center  |
|   --------                                                            |
| -- ------------ ----------- ----------------------------------------- |
+-----------------------------------------------------------------------+

Title: [top](#top)\
Relationship between Patient Question Asking and Health Outcomes in a
RCT

Authors:\
Brian Manning, MPH, CHES\
Aaron J. Bonham, MS\
James M. Galliher, PhD\
Thomas V. Stewart\
IC-DOV Research Team\
\
Context:\
Some research suggests patients who ask questions and actively
participate in medical encounters have better health outcomes than less
involved patients.\
\
Objective:\
1) Assess effectiveness of a brief intervention that encourages patient
participation and question asking, and 2) evaluate whether question
asking affects patient and physician communication and selected patient
outcomes\
\
Design:\
RCT with 20 practices and two arms: 1)   Practices implementing the
Ask-Me-3 patient advocacy and health communication program, and 2)
practices without the program.\
\
Setting:\
Twenty AAFP National Research Network practices from 18 states.\
\
Participants:\
Forty-one physicians and 829 patients.\
\
Intervention or Essential Feature of Study:\
Ask-Me-3 is a brief intervention to improve patients\' contribution to
communication during patient-physician visits.  Practice staff
distributed Ask-Me-3 brochures to patients at office visit check-in,
encouraged them to read the brochure, and ask their physician
questions.  Physicians and patients completed post-visit questionnaires
for each visit. Research staff attempted to re-contact patients who were
prescribed medications for follow-up telephone interviews.  Visits were
audio recorded.\
\
Outcome Measures:\
Primary outcomes included: number of questions asked by patients,
physicians\' and patients\' evaluation of visits and communication,
patients\' recall of physicians\' prescriptions and lifestyle
recommendations, patients\' filling of prescriptions and attempts at
modifying recommended lifestyles.\
\
Results:\
1108 patients invited and 829 (75%) enrolled (443 intervention & 386
standard care); 524 (87% of eligible) patients completed follow-up
telephone calls. While some hypotheses were supported at the bivariate
level, they did not remain statistically significant at the multivariate
level (p\'s \>.05).\
\
Conclusions:\
Use of the brief patient advocacy and health communication intervention
for patients was hypothesized to have positive effects on question
asking, patient and physician communication, and selected patient
outcomes.  However, results at the multivariate level provide little
support for these hypotheses.  Moreover, the hypothesis that enhanced
patient question asking would be associated with health outcomes also
was not supported.

Title: [top](#top)

Evaluation of an Emergency Department Primary Care Referral Program

[]{.mark}

Authors:

John Hickner, MD, MSc

James Walter, MD

Maria Camargo, MSPH

Laura Derks, MSPH

Mary Pat Olson, RN, MSPH

Context. Having a primary care physician improves health outcomes and
can decrease emergency department visits. The South Side Health
Collaborative (SSHC), a consortium consisting of the University of
Chicago Hospitals and 17 primary health care centers on the south side
of Chicago, was formed in 2005 to connect UCH-ED patients with SSHC
primary care providers\
\
Objective.To evaluate the effectiveness of the SSHC in linking low
income uninsured and underinsured UCH ED patients to a primary care
provider.\
\
Design.\
Methods. Trained lay patient advocates approach patients who were
identified by the triage nurse as lacking a medical home. They schedule
primary care visits at community health centers while the patient is in
the UCH-ED or by phone following discharge.\
\
Setting. The South Side of Chicago, which has a large medically indigent
population.\
\
Participants. Adults presenting to the UCH-ED who lacked a primary care
medical home.\
\
Outcome Measures. Percent of patients 1) approached by patient advocates
who accepted referral services, 2) who accepted referral services for
whom an appointment was scheduled, and 3) with appointments scheduled
who showed up for the appointment.\
\
Results. Of 44,422 patients seen in the UCH ED during the first 9 months
of the program, 19,944 (45%) did not have a primary care physician. Of
the 5,541 patients approached by the patient advocates 4,164 (75%)
accepted a primary care referral to a SSHC health center of their choice
and 1,816 (33%) had an appointment scheduled. 40% of patients who had
appointments scheduled showed up for the appointment, 13% of the
eligible patients seen by the patient advocates.\
\
Conclusions. Referring ED patients who do not have a medical home for
ongoing, community-based primary care is a challenging task. A
substantial minority (25%) of ED patients who do not have a regular
doctor do not want assistance in finding one. A small percent of
eligible patients (13%) were linked with a primary care medical home. It
remains to be proven if this program will lessen the load of primary
care visits to the UCH ED. Further efforts will focus on improving the
reach and efficiency of the program.

[top](#top)

Title:\
Using geographic information to evaluate primary care physician demand

Author:\
Ge Lin, Ph.D\
Dr. Spann Stephen\
Dr. Andrew Bazemore\
Dr. Robert Graham\
\
Context:\
The U.S. population has put pressure on physician demands  that have
largely unmeasured.    This study uses  a demographic accounting method
to assess Texas primary care physician supply by county \
\
Objective:\
The paper intends to reexamine the current use of the gross
population-to-physician ratio to measure shortages of primary
health-care professionals and relate the measure to health outcomes
(hospitalization). An adjustment of the current population-to-physician
ratio according to age and sex is made and the result is compared
with the existing designations based on the current criteria with the
adjusted criteria. The proposed measure is easy to calculate and
potentially can be incorporated into the designation criteria for
shortage areas of primary health-care professionals. \
\
Design:\
Based on a GIS operation that matching avoidable hospitalizations with
physician supply,  head to head comparison of age-adjusted and the
traditional methods have been carried out. It was found that that the
standardized population-to-physician ratio tend to correspond to better
with avoidable hospital admissions\
\
Current Challenges:\
If we adjust physician supply based on the new demographic accounting
method, we may reduce the rate of avoidable hospitalization \
\
Please describe the next steps you are planning for your study.\
Write two papers on this issue.

Title: [top](#top)\
Analysis of Healthcare Delivery to a Transitioning Community

Authors:\
Michael, Dulin, MD, PhD\
Heather, Smith, PhD\
Furuseth, Owen, PhD\
\
Context:\
Unprecedented growth of the Hispanic population in Charlotte, NC has
created a novel set of forces converging upon the city\'s healthcare
system and has subsequently challenged the capacity of local clinics
despite predicted underutilization of primary-care services by this
population. \
\
Objective:\
To utilize tenets of Community Participatory Research within a new
Practice-Based Research Network in order to study healthcare delivery
and potential disparities in healthcare access for the Hispanic
population in the greater metropolitan area of Charlotte, NC.  Results
will be used to design interventions aimed at ameliorating disparities
in healthcare access.\
\
Design:\
A group of ambulatory clinics designed to care for the disadvantaged
population of Charlotte and the county health department are providing
the clinical services expertise for the network.  Three academic
institutions with experience in Geographic Information Systems (GIS) and
the Community-Oriented Primary Care model have created the research
infrastructure. Community involvement has been incorporated extensively
throughout the network.  A Hispanic community advocacy organization has
been instrumental in the network\'s design and implementation.  A
community advisory board has been established, and community member\'s
feedback has been incorporated into the research design and data
analysis.  Qualitative data including feedback on the research process
itself is being collected through community surveys and focus groups.  
Quantitative data on current healthcare access patterns is being mapped
using GIS techniques to determine clinic service areas that can then be
compared with known neighborhood demographics.\
\
Current Challenges:\
(1) Securing funding for the network. (2) Overcoming language and
cultural barriers in recruiting community participants into the
network.\
\
Please describe the next steps you are planning for your study.\
(1) Completion of qualitative data collection showing community
perceived barriers to healthcare access.  (2)  Finish GIS mapping
demonstrating current patterns of healthcare access.  (3) Present
qualitative and quantitative data back to the community and PBRN members
to help design interventions aimed at improving healthcare access.

Title: [top](#top)\
Latinas with Diabetes Mellitus: Predictors of Poor Glycemic Control in a
Low Income Primary Care Population

Authors:\
M. Diane McKee, MD, MS\
Jeffrey Levine, MD

Arthur Blank, PhD

Jason Fletcher, MS

Nellie Fernando, MS

Eliana Korin Dipl.Psych.

Charles E. Schwartz, MD

Context:\
Type 2 diabetes mellitus (DM) is more common among Latinos than among
non-Hispanic whites and control of blood sugar is less successful. A
clear understanding of how psychosocial issues affect diabetes control
is lacking for low-income Latinas.\
\
Objective:\
We explored the influence of family environment and mental health on
glycemic control for Latina women to inform development of primary
care.\
\
Design:\
Interviewer-directed survey.\
\
Setting:\
Family medicine practices in the Bronx serving low income patients.\
\
Participants:\
Latina women with at least two office visits in the previous year,
defined as out of control (HbA1C \> 9.5 on two occasions) or in-control
(HbA1C less than 7.5).\
\
Intervention or Essential Feature of Study:\
Analyses compared women with out-of control DM (OC; n=40) and in-control
DM (IC; n=62) to identify predictors of glycemic control.\
\
Outcome Measures:\
Depression (PHQ), Bipolar Illness (MDQ), Regimen Specific Social
Support, Problem Areas in Diabetes (PAID), Family Cohesion and Conflict,
Familism, Stanford Physician Trust, and Health Literacy.\
\
Results:\
Women with out-of control DM  and in-control DM were similar
demographically. Health literacy was lower than the general population
(mean 26.8). PHQ scores ?10, compatible with clinically significant
depression, were present in 29% of subjects but did not differ between
groups.  The proportion with MDQ?7, compatible with bipolar spectrum
disorders, was higher in the OC group (35.9% vs 14.5%, p=.02). The PAID
scale indicated greater diabetes distress in the OC group (38 vs 25,
p-.046). PHQ and PAID scores were highly correlated (R=.74). Family
cohesion scores were high and family conflict moderate but not
discriminating of glycemic control. Analysis of PAID by question
suggested that IC subjects had greater optimism and self-efficacy, but
multivariate analyses did not result in stable models discriminating IC
and OC groups in these domains.\
\
Conclusions:\
Significant levels of depression were found in nearly one-third of
subjects whether IC or OC. Bipolar disorders may be more common among OC
subjects. Further studies to understand and improve diabetes outcomes in
Latino women should focus on psychological factors in addition to
depression, particularly bipolar disorders and the presence of potential
protective factors such as optimism and self-efficacy.

Title: [top](#top)\
Improving Care for our Patients with Diabetes:  A System-Wide Approach

Authors:\
Julie Day, MD\
Earl Hodgkins, BS\
Annie Sheets Mervis, MSW\
\
Context:\
Reducing complications of diabetes is a high priority to improve quality
of care.\
\
Objective:\
Improve the care of patients with diabetes, by designing, implementing,
and evaluating EMR-based tools and a diabetic registry to assist
providers in identifying and managing their population of patients with
diabetes.\
\
Design:\
Longitudinal study before and after implementation of a diabetes quality
improvement program. \
\
Setting:\
University of Utah Health Care:  Community Clinics (UHCC), a 100,000
patient, seven-practice, multi-specialty, primary care network, linked
by electronic medical record (EMR), located in and around Salt Lake
City, Utah\
\
Participants:\
Patients with diabetes, age ? 16 years.\
\
Intervention or Essential Feature of Study:\
.       EMR-based template for diabetes visit with built-in electronic
orders.\
.       EMR-based Flow Sheet Report summarizing history of lab results
and referrals\
.       Disease registry .\
.       Outreach letters to patients\
\
Outcome Measures:\
Percent of patients with HgbA1c ordered twice annually, LDL and
microalbumin ordered at least annually, HgbA1C \< 7%, LDL \< 100, and BP
controlled at \< 130/80.\
\
Results:\
Results for 2570 patients seen Feb 2003 - Jan 2004 were compared to
results for 2719 patients seen June 2004 - May 2005.  Statistically
significant (p\<.002) improvements included: HgbA1c ordered twice
annually increased from 71% to 75%, LDL ordered annually increased from
74% to 81%, microalbumin ordered annually increased from 54% to 63%, LDL
values \< 100 increased from 28% to 41%, and BP \< 130/80 increased from
28% to 34%..  Patients with HgbA1c values \< 7 increased from 47% to
49.5%, but change was not significant.\
\
Conclusions:\
The interventions were associated with improvement in process and
outcome measures.  However, identifying the provider primarily
responsible for managing diabetes is an ongoing challenge in producing
registries.  Providers need additional resources to consistently use the
registries and conduct outreach activities.

Title: [top](#top)\
Designing a Patient-Centered Diabetes Registry: Successes and
Challenges\
\
Authors:\
Douglas H. Fernald, MA\
Anne Kinney

Leah Haverhals MA

Greg Higgins

Steve Ross MD

Bennett Parnes MD

Wilson Pace MD

Elizabeth Staton MSTC

Deborah S. Main PhD.\
\
Context:\
Chronic disease registries are viewed as essential to improve chronic
care yet they are difficult to implement and sustain in primary care
offices.\
\
Objective:\
To determine the feasibility and impact of an automated,
patient-centered diabetes registry for improving guideline-concordant
diabetes care and patient self-management.\
\
Design:\
We adopted an innovative quality improvement model for engaging
practices and all patients with diabetes in this project. We designed an
automated system for ongoing population of a registry using existing
clinical information (from billing, diagnostic and scheduling systems)
and regular data collection from patients with diabetes (via web,
automated telephony system or paper) about diabetes self-management
activities.  To help clinicians and patients plan their visits, patients
receive reports about their own status with respect to
guideline-concordant diabetes care along with information about their
diabetes. Primary care offices receive a condensed version of this
patient-level diabetes summary.\
\
Current Challenges:\
Successes: The patient-centered diabetes registry has been well received
by primary care practices and by patients with diabetes.  Their
involvement in developing the registry interfaces, measures and reports
improved the system for communicating with patients, clinicians and
practices about diabetes care, and enhanced methods and tools to expand
the registry for other chronic conditions and to sustain it beyond
current funding.\
Current Challenges: Despite the receptivity of critical end-users of
this system (i.e., practices, clinicians and patients), we have had
challenges resulting in significant delays in \"rolling out\" the system
in pilot practices.  Key challenges include: turnover in programmers,
limited capacity for data transfer in one system, use of outside vendor
for telephony portion of the system, and initial reluctance of a
hospital system to define this as a quality improvement rather than
research project. Despite these challenges, we expect the registry to go
\"live\" within the next two months.\
\
Please describe the next steps you are planning for your study.\
We will \"go live\" within the next two months and will refine our
communication processes and reports for patients and practices.

Title: [top](#top)\
Web-Based Training Improved Smoking Cessation Counseling in Primary Care
Practices

Authors:\
Cecelia A. Gaffney, MEd\
Cathy L. Melvin, PhD\
C. Tracy Orleans, PhD\
\
Context:\
Moderate increases in likelihood of successful implementation of
evidence-based interventions (EBI) have resulted from on-site training
such academic detailing. These approaches are expensive and difficult to
implement in busy practices.\
\
Objective:\
Can a web-based interactive, self-directed program result in office
system changes and increased counseling? \
\
Design:\
Patient exit interviews, chart audits and clinician surveys were
collected prior to the practice viewing the program and three months
after they reported implementing changes based on their viewing of the
program.\
\
Setting:\
Six rural primary care practices in New England participated in a study
of the impact of completing the program on clinician skills and office
system changes.\
\
Participants:\
All women ages 18-45 years who presented for care were asked to complete
an exit survey during two data collection periods. All clinicians and
staff at participating practices completed program evaluations and
self-reported behaviors. \
\
Intervention or Essential Feature of Study:\
A multi-media training program, \"Smoking Cessation for Pregnancy and
Beyond: Learn Proven Strategies to Help Your Patients Quit,\" offered
case simulations and discussions, mini-lectures, patient interviews,
tools for changing office systems and web resources. The tools
accommodate different learning styles. Topics presented assured that
information needed by all staff to perform different roles was
provided.  Individual learning occurred at each person\'s convenience
and pace rather than requiring the entire staff to meet as a group.
Participants could earn continuing education credits. \
\
Outcome Measures:\
Patient reported receipt of the 5 A\'s, documentation of 5 A\'s in
random charts at most recent visit and clinician self-report of
providing counseling based on the 5 A\'s.\
\
Results:\
Patients reported significant increases in assessment of smoking status
(p=.02) and of exposure to second hand smoke. Patient reported
assistance with quitting and arranging follow-up increased by not
significantly.  Self-report by clinicians found a significant increase
in assisting with quitting (p=.008) and arranging follow-up (p=.03). \
\
Conclusions:\
Three quarters of staff and clinicians found that the program contained
enough information to implement the EBI. A well-designed interactive
training program can increase provision of EBI. 

Title: [top](#top)\
Informatics Solutions to Achieve Just-in-Time Subject Enrollment Across
a Practice Based Research Network

Authors:\
Abel Kho, MD MS\
Brenda, Hudson, MA\
Jane French\
Mike Litherland\
William Tierney, MD\
\
Context:\
Practice Based Research Networks (PBRNs) typically involve
geographically dispersed practices which complicates screening,
enrolling, and following of research subjects.  Electronic health
records (EHRs) can provide solutions.\
\
Objective:\
1)      Use informatics expertise and an EHR to efficiently enroll
subjects in a PBRN.\
2)      Identify eligible subjects from patients\' EHRs despite Open
Access (i.e. same day) patient scheduling.\
\
Design:\
Before and after interventional study.\
\
Setting:\
Indiana University Medical Group\'s PBRN (ResNet) covering 17 primary
care sites.\
\
Participants:\
ResNet involves an even mix of commercial and indigent populations and
employs three full time research assistants.  \
\
Intervention or Essential Feature of Study:\
In 2005, IUMG instituted Open Access scheduling of appointments.  Open
Access necessitated a system for real-time communication between the
scheduling system and research assistants enrolling patients for
multiple studies. We implemented an open-source software application to
receive electronic appointment notices from ResNet clinics and
automatically match registered patients to a list of eligible patients. 
Research assistants verify patient eligibility from this dynamically
updated list and tailor recruitment at the various clinics based on
numbers of eligible patients visiting. \
\
Outcome Measures:\
Number of eligible research patients screened\
\
Results:\
Since 1999, ResNet has screened over 18,000 patients and recruited over
6,000 subjects for over 30 studies with more than \$15 million in
extramural direct cost funding.  Fewer than 2% of potentially eligible
patients were missed prior to the institution of Open Access.  Our
software solution enabled research assistants to resume electronic
screening of eligible patients and maintain pre-Open Access levels of
recruitment efficiency. \
\
Conclusions:\
1)      Informatics tools can greatly increase the efficiency of subject
recruitment and expand the reach of a limited pool of research
assistants.\
2)      Electronic registration messages present an opportunity for the
automatic capture of appointment data.  This open source solution can be
a useful adjunct, or stand alone application for subject enrollment in
PBRNs. 

Title: [top](#top)

Profile of Medically Underserved Patients who Use Computer Kiosks to
Learn about Preventive Health 

Authors:\
Susan Labuda Schrop, M.S.\
Brian F. Pendleton, Ph.D.\
Gary McCord, M.A.\
\
Context:

Delivering patient education concerning preventive health in clinics for
the medically underserved and ensuring patient adherence to
recommendations can be difficult due to provider and patient barriers.
Increasing patient-provider discussions is an important first step to
increasing healthy behaviors.\
\
Objective:

The purpose of this study is to determine the effect of a computer-based
intervention on physician-patient discussions regarding smoking,
exercise, weight control and alcohol use.\
\
Design:

Touch-screen computer kiosks for patients' use were placed in the
waiting rooms of clinics for the medically underserved. The program
consists of demographic questions, comorbidities, patient's status
regarding cigarette smoking, alcohol intake, exercise and maintaining a
healthy weight, and willingness to modify their behavior. Targeted
preventive health messages are provided with an option to print two
copies -- one for the patient and one to share with the health care
provider to stimulate discussion about healthy behaviors.

Setting:

Six community-based clinics for the medically underserved in Northeast
Ohio.

Participants:

Adults who visited the participating clinics and used the computers.\
\
Outcome Measures:

Profiles of kiosk users including demographics, comorbidities and stage
of change for target behaviors, and frequency of provider/patient
discussions regarding the target behaviors as reported by patients in
exit interviews.\
\
Results:

This poster presents the profile of kiosk users. The program has been
accessed by 5,276 users with an average age of 38. Almost 63% were
female, 61% were Caucasian, and 60% had a high school education or less.
Users had an average BMI of 29.6, and the top four comorbidities
reported were weight problems (41%), sleep problems (40%), depression
(39%) and tobacco use (38%). The topic of most interest was weight
control (44%), followed by cigarette smoking (24%), exercise (18%) and
alcohol intake (14%).\
\
Conclusions:

Data from the computers indicate that patients use the computer and are
interested in preventive health. Data from exit interviews and chart
reviews will be used to determine the effect of the computer and
preventive health messages on discussions between patients and
providers.

Title: [top](#top)\
Testing a Computer System to Interpret Child Nutritional Health\
\
Authors:

Adolfo  Ariza, MD\
Sherry Lyons, MA

J. Scott Thompson

Jeremy Samkowiak

Helen Binns, MD,MPH\
\
Context:\
Child growth interpretation is a recommended aspect of pediatric health
supervision visits (HSV).\
\
Objective:\
To implement and evaluate a new computer system to aid child growth
interpretation and health counseling in pediatric practice.\
\
Design:\
Pre- and post-intervention evaluation.   \
\
Setting:\
Two diverse PPRG practices. One practice serves mostly privately-insured
patients and the other is a community health center serving low-income
families.\
\
Participants:\
HSV of children aged 2-10 years were observed. Practice members were
interviewed.\
\
Intervention or Essential Feature of Study:\
Health Indicators Analyzer (HIA) software to assist with nutritional
health interpretation, growth tracking, and printing of educational
handouts was implemented; its adoption of use was determined by the
practice.\
\
Outcome Measures:\
Visit time and content (assessment and counseling), identification of
overweight (³95th BMI percentile, OW), parental satisfaction with visit,
and clinician response. Analyses adjust for practice clustering, where
possible.\
\
Results:\
62 visits were observed pre and 40 visits post (23 no HIA, 17 with
HIA).  65% were visits of children 2-5 years; 16% with an OW child. Time
for single child visits did not vary by intervention group (overall:
Practice A, 41 minutes; Practice B, 33 minutes). Physicians identified
abnormal weight pattern among OW children in 7/9 pre, 0/1 post no HIA,
and 4/6 post with HIA visits; (unadjusted Fisher\'s Exact, P=.374). 
Time to address growth significantly increased when the HIA was used
(median seconds: 38 pre, 30 post no HIA, 136 post with HIA; P\<.01);
however, the percent of parents very satisfied with growth information
significantly decreased (84% pre, 71% post no HIA, 41% post with HIA;
P=.03). Physicians\' reported that the HIA improved parental and child
recognition of OW.\
\
Conclusions:\
Implementing the HIA changed care delivery.  Further evaluations are
needed to clarify HIA impact on care delivery, child health outcomes,
and responses of clinicians and parents.

Title: [top](#top)\
Screening Kids in Lakeview for Developmental Delays (SKILDD)

Authors:

Heather Angier, BA, CCRP\
Lyle J. Fagnan, MD\
Cynthia Morris, MD, PhD

Context:\
Studies show that up to 20 percent of all children will have a
behavioral development issue, yet few children are identified as needing
care and even less receive necessary treatment.  A recent study found
that although most physicians are committed to the early diagnosis of
developmental delay there is considerable variability in surveillance
and screening practices.  There are no published studies regarding
screening, assessment, and referral of children for behavioral risks in
rural primary care practices.\
\
SKILDD is a quality improvement(QI)project undertaken by two Lakeview,
Oregon primary care practices. These practices have enhanced the well
child visit by instituting a standardized screening process and an
explicit referral process. \
\
Objective:\
There are three main study hypotheses:\
1.Implementation of evidence-based screening tools as part of a
well-child visit will increase the rate of identification and referral
of children at risk to appropriate community resources. \
2.Integration of a case manager model, an Early Intervention Family
Coordinator(EIFC), into the primary care office setting will increase
the rate of referral follow through.\
3.The screening and referral process will be accepted and valued by
clinicians, staff, and patients.\
\
Design:\
To assess the feasibility of the QI project, a comprehensive chart
review will be conducted 6 and 12 months after the standardized
screening process begins.   We will track and measure the percentage of
children who are screened, the percentage of children and families
referred for intervention, and what happens after referral.\
\
To assess satisfaction, a researcher from the Child and Adolescent
Health Measurement Initiative (CAHMI) has conducted in-person key
informant interviews with the EIFC, and the physicians and office staff
from the clinics involved in SKILDD. Also, several parents who have
participated in the screening process have been interviewed.\
\
Current Challenges:\
The current challenges of the QI project include: information
dissemination, screening differences between the two primary care
clinics, and a lack of communication regarding referral follow up.\
\
Questions for Audience Consideration:\
To share our experience with evaluating a QI project that includes
numerous collaborators.

Title [top](#top)\
What Constitutes Maintenance Asthma Care?

Authors:\
Jane Garbutt, MB,ChB\
Randy Sterkell, MD\
Jay Epstein, MD\
Suzanne Wells, RN\
Lisa Swerczek, BSN, RN\
Christina Banister, BA\
Gordon Bloomberg, MD\
\
Context:\
Scheduled maintenance care for asthma is considered an effective
intervention in prevention of exacerbations and need for emergent care.\
\
Objective:\
To understand what activities pediatricians include in maintenance
asthma care.\
\
Design:\
Cross-sectional survey of community pediatricians\
\
Setting:\
PBRN of community pediatricians in St. Louis, MO\
\
Participants:\
Most respondents were experienced community pediatricians (mean years in
practice 14.7), worked in group practices (61%) and were located in the
suburbs (63%). \
\
Intervention or Essential Feature of Study:\
Between June and October 2005, 135 community pediatricians completed a
34-item questionnaire about routine care for children with persistent
asthma between 5 and 12 years old. The survey response rate was 60%
(135/225).\
\
Outcome Measures:\
Median percent of patients prescribed treatment, or percent of
pediatricians who included the activity in maintenance asthma care.\
\
Results:\
Pediatricians prescribed inhaled corticosteroids for most patients with
persistent asthma (median 80%). Of the 135 respondents, most asked
questions about recent use of rescue medications (96%), emergent care
(91%), and controller medications (96%) to assess and monitor asthma
severity. While only 6% of pediatricians believed that the majority of
their patients (\> 80%) used their controller medicines as prescribed,
few asked probing questions to assess medication adherence, such as how
often doses were missed (49%), and if doses were missed on the weekend
(20%). Pediatricians were less likely to include activities to support
self management such as annual review of an asthma action plan (63%),
setting asthma care goals (60%), or asking about the impact of the
child\'s asthma on the parent and family (24%).\
\
Conclusions:\
Although pediatricians prescribed effective controller medications for
children with persistent asthma, most believed that their patients did
not use these medications as prescribed.  Helping pediatricians to
redesign how they provide maintenance asthma care may increase patient
use of effective asthma treatments and improve patient outcomes. 

Title: [top](#top)\
Primary Care Pathway to Improve Breast Diagnostic Care

Authors:\
Margaret M. Eberl, MD, MPH\
Chester H. Fox, MD\
Martin C. Mahoney, MD, PhD, FAAFP\
Nancy Watroba\
Stephen B. Edge, MD\
\
Context:\
Initial diagnostic testing is a critical component of breast cancer
treatment, but up to 30% of women with abnormal findings on mammography
do not get appropriate follow-up evaluation.  Women with BIRADS code 3
require 6 month follow up and women with BIRADS 4 and 5 need prompt
biopsy. Competing demands in a busy practice environment suggest that
primary care physicians need improved systems for dealing with low
frequency events such as abnormal mammograms. A multi-faceted practice
intervention, consisting of automated monitoring using administrative
claims data, primary care physician notification, and provision of a
care pathway, can improve the rate of optimal follow-up of abnormal
mammograms.\
\
Objective:\
To determine the impact of a multi-faceted practice-based intervention
(utilizing electronic medical record monitoring, standardized physician
care recommendation pathway, physician notification and care management)
to enhance optimal follow-up testing for abnormal mammograms.  This
electronic record case management system should be exportable to any
medical practice with electronic records and to any claims-based
administrative system.\
\
Design:\
A practice intervention using automated electronic record monitoring,
coupled with primary care physician notification of mammogram findings,
care pathways, patient education for abnormal mammograms.  The study is
being conducted in a large medical practice with 6 locations.  The
electronic record is being monitored for BI-RADS code for each mammogram
and being matched with claims data from the payer.  Care is then being
monitored by claims data to assure appropriate follow-up.  The results
of this intervention will be measured against specific outcomes measures
for BI-RADS 0, 3, 4 and 5 mammograms compared to women in the 4
preceding years.\
\
Current Challenges:\
The biggest challenge is physician education and buy-in. This is being
addressed at routine provider meetings. Distinguishing between tests not
being ordered and tests not being completed due to patient refusal is
important and will be tracked.\
\
Please describe the next steps you are planning for your study.\
If the current study, once completed, is shown to be successful in
improving breast diagnostic care, we will make plans to disseminate the
system to the Western New York region.

Title: [top](#top)\
Pilot Studies That Have Helped Design Better Data Collection: Data
Collection Tools for Practice-based Research

Authors:

Nancy Rothman, Ed.D, RN\
Laura Line, MS\
\
Context:\
In our practice-based research network we are working to build an
evidence base for the services our nurse-managed health centers provide
and the programs that address significant problems in the communities we
serve.  In the several years of collecting and analyzing data on these
services and programs, we have learned a great deal about useful tools
for data collection and their implementation in practice settings.  We
believe sharing these tools and recommendations will improve
evidence-based practice.\
\
Objective:\
To share primary care practices and project outcomes, along with issues
and recommendations specific to data collection in order to improve
evidence-based practice in PBRNs.\
\
Design:\
Present evaluation studies and results for primary care services and in
three programs implemented in our PBRN.  Discuss data collection tools
and data collection issues that arose and how we were able to address
these issues.\
\
Setting:\
Our PBRN, the Data Mart Network, consists of eight community-based
primary care centers managed by nurse practitioners in collaboration
with physicians.  These centers are based in the Philadelphia area and
serve an un- or under-insured population across all ages, consisting
primarily of african-americans and latinos.  The centers provide a range
of primary care services including prenatal and behavioral health
services.  Seven are urban-based and one is rural.  The Data MArt
Network is currently transitioning to an Electronic Medical Record
system and has engaged in a number of research studies to date.\
\
Participants:\
Clients of nurse-managed health centers. The participants vary according
to each program or service. \
\
Intervention or Essential Feature of Study:\
This is not a study.  It is analyzing data collection instruments and
data collection processes used in program evaluation towards future
evidence-based practice.\
\
Outcome Measures:\
The presentation shares program evaluations outcomes: e.g. Lower blood
lead levels, Reduced cases of asthma, Reduced anxiety and depression,
Utilization of services as we discuss the tools and processes used to
collect and understand these outcomes.\
\
Results:\
Pilot studies and improved data collection has allowed us to move to
research studies demonstrating impact and effectiveness of
interventions.\
\
Conclusions:\
Program evaluation can provide preliminary data to be used for
practice-based research, especially in the area of developing better
data collection tools and better data collection processes.

Title: [top](#top)

Established PBRN Patterns of Funding, Governance and Publication\
\
Authors:\
Renee, Crichlow, MD FAAFP\
Robert, Lininger, BS\
Laura, Dimmler, PHd-C\
\
Context:\
The Federation of PBRNs has among there membership some of the more
active PBRNs in the country. Each voting member PBRN must have conducted
at least one study, be a primary care network, primarily located within
the United States, and have a provision for membership governance. As a
developing PBRN our intention was to evaluate and understand the
patterns of funding, governance and publication of established PBRNs.\
\
Objective:\
To evaluate what funding sources have sustained PBRN practice to date\
To determine spectrum of governance in PBRNs\
To evaluate patterns of publication and demonstrate which journals have
published PBRN research\
\
Design:\
Cross-Sectional Survey of Practice Based Research Networks\
All 54 member PBRNs from the Federation of Practice-Based Research
Networks were surveyed, data gathered, and preliminary results tallied. 
Information gathered included composition of membership; number of
clinicians/practices/patients served per member network; governance and
ownership of PBRNs; most common funding sources; topics of research;
pertinent papers published/national presentations given as a result of
that research.\
\
Current Challenges:\
Current challenges include completing Systematic Review of all journal
publications of research from the membership of the FPBRN and
categorizing these as to the types of PBRN studies involved\
\
Please describe the next steps you are planning for your study.\
We are systematically gathering the published research of the Federation
of Practice Based Research Network membership with the hopes of
categorizing these studies and subsequently determining if there are
patterns to the types of studies and publications that may come from a
particular composition of PBRN funding and governance.

Title: [top](#top)\
Universal Modeling of Primary Care Clinical Trials

Authors:\
Peterson, Kevin MD\
Delaney, Brendon MD\
Arvenitis, Theo PhD\
\
Context:\
We are developing tools to assist in the development of primary care
trials.  Our first step in this is to model the development and
performance of a clinical trial and translational study using Universal
Modeling Language.  Current models from CDISC and HL7 are designed
primarily from the perspective of typical pharmaceutical trials, and do
not address problems that are encountered in the primary care
environment.\
\
Objective:\
It would be valuable to receive feedback on the current models that we
have developed to see if there are additional features that need to be
included. This gorup would be valuable in addressing other types of use
cases that are encountered in primary care.\
\
Design:\
This is part of the ePCRN study.  We are first developing tools that
model the development of clinical trials.  We will then match these to
the National Library of Medicine UML vocabulary to provide semantic
interoperability.  We will then develop tools that will generate ASP
pages for standardized reporting forms for use in trials.\
\
Current Challenges:\
Development of modeling that is consistent with existing CDISC and RIM
models, but encompasses use cases found in primary care.\
\
Questions for Audience Consideration:\
Provide input on the models that we have developed.  Are there other use
cases that are needed in the modeling.

Title: [top](#top)\
Studies of Research Readiness in Primary Care\
\
Authors:\
Toni, Miles, MD, PhD\
Sharon, Barrer, RN\
Maggie, Steptoe, MLS\
Brian, Briscoe, BA\
Sukee Kim, MSW\
Stephanie, Garrett, MD\
\
Context:\
We are in the process of recruiting practices to develop a PBRN in our
area. We are seeking to build a network that is representative of the
primary care sites in a 16 county area including metropolitan
Louisville, Ky and points west. We are also interested in developing
methods that permit data collection during the process of care delivery
without disruption of the visit. Finally, we are interested in measuring
staff experience and attitudes surrounding the conduct of research in
their workplace.\
\
Objective:\
Questions:\
1. Can we efficiently collect \'pen and paper\' survey data from
patients in the exam room? This survey is a clock drawing task to screen
for cognitive impairment.\
2. Can we efficiently conduct a record linkage study between the
practices and the Kentucky Cancer Registry?\
3. Can we efficiently recruit patients for a study involving collection
of blood samples?\
4. How does the staff view the conduct of research before and after
these studies are completed at their sites?\
\
Design:\
To recruit practices for this network, we started with university-based
primary care sites (7) and then extended our outreach to the
institutions that provide care to the largest proportion of persons in
our area - the Federally Qualified Health Centers (2 sites), the
Veterans Administration (5 sites), private corporations (2 sentinel
sites in the 36 site Norton Healthcare System, 2 sites in the Baptist
Healthcare System). Together these practices serve almost 500,000
persons in the 1.2 million metropolitan area. They also cover the
spectrum of socioeconomic status and ethnicity.\
\
Current Challenges:\
1. Obtaining funding to continue this process.\
2. The lack of electronic medical records.\
3. Physicians at the sites are very welcoming but the pressure to see
patients and the fact that many of them are 45 years and older pose a
significant challenge to fully engaging them in the PBRN process. To
facilitate information flow we have implemented a process for returning
data to the practice within a month of completing data collection.\
\
Please describe the next steps you are planning for your study.\
Next steps:\
1. Complete the cognitive impairment prevalence estimate within the next
3 months.\
2. Send data from 4 test sites to the Kentucky Cancer Registry for
linkage with the NCI-SEER. The reports from SEER will be returned to the
practices so that physicians will have documentation for cancer
survivors.\
3. Complete the Pharmacogenetics Allelic Variation study in 2 test
sites. This study will return practice-level genetic variation data for
the 3 P450 enzymes that are responsible for almost 70% of all drug
metabolism.

Title: [top](#top)\
 Evaluation of Bias in Consented Practice-Based Research

Authors:\
Alexandra Ryan, MD

Roopa Seshadri, PhD\
Helen Binns, MD, MPH

Context:\
 Consent procedures and the anticipated burden of data gathering may
introduce bias into research studies.

Objective:\
 To identify differences between families who consented for study
participation and those who provided anonymous data only.

Design:\
 Cross-sectional survey.

Setting:\
 13 diverse practices of the Pediatric Practice Research Group.

Participants:\
 Consecutive sample of parents/guardians bringing children for care.

Intervention or Essential Feature of Study:\
 Parents were asked to consent to provide information on family health
behaviors by an in-office survey, 4 telephone calls, and review of their
children's medical records. Those not consenting could complete the
survey anonymously.

Outcome Measures:\
 Scores were developed for health behaviors and opinions on pediatrician
counseling. Health behaviors were grouped by number of healthy behaviors
reported (0, 1, 2, 3-5). Generalized linear models with random effect
for practice were used to select factors differing between consented and
anonymous groups at p\<.10. These factors were entered in a multivariate
model.

Results:\
Among 6617 eligible subjects approached, 4218 (64%) provided consent and
688 (10%) completed the survey anonymously. Subjects were: 89% mothers;
48% white, 13% African American, 34% Hispanic, 5% other; and 43%
Medicaid/uninsured. In the multivariate model, subjects who consented
were more likely to be mothers (odds ratio \[OR\] 1.4, 95% confidence
interval \[CI\] 1.1-1.8), aged £25 years (compared to 40+ years; OR 1.5,
95%CI 1.1-2.1), and Medicaid/uninsured (OR 1.3, 95%CI 1.0-1.7) and less
likely to be of "other" race/ethnicity (compared to Hispanics; OR 0.6,
95%CI 0.4-0.9). Groups reporting few or many healthy behaviors consented
less often than those who reported no healthy behaviors (OR 0.7, 95%CI
0.5-0.9 for all contrasts). Intracluster correlation for practice was
3.3%.

Conclusions:\
Significant differences exist between parents who consent to participate
in practice based research and those who refuse. These differences may
be unique to the research process and need consideration when performing
practice based research.

Title: [top](#top)\
Attitudes Regarding Physician Counseling on Gun Safety Practices: A
Comparison between Military and Civilian Parents

Authors:\
John M. Pascoe, MD, MPH\
Shalini G. Forbis, MD, MPH\
Adrienne Stolfi, MSPH\
Christopher A. Schlorman, BS\
Terence R. McAllister, MD\
\
Context:\
There may be important differences in parental attitudes between
civilian and military parents\' attitudes and behaviors regarding
firearms.\
\
Objective:\
To compare gun storage and safety attitudes and behaviors between
military and civilian parents\
\
Design:\
Cross-sectional, two-page survey about parental firearms attitudes and
behaviors\
\
Setting:\
Dayton Primary Care Practice-Based Research Network (PBRN) includes the
primary care pediatric practice at Wright Patterson Air Force Base
(N=574) and civilian pediatric practices in the Greater Dayton area
(N=451)\
\
Participants:\
Convenience sample of parents whose children receive their primary
health care from practices within the Dayton Primary Care PBRN\
\
Intervention or Essential Feature of Study:\
N/A\
\
Outcome Measures:\
N/A\
\
Results:\
Military parents (MP) were more educated, 85%\>high school education
(civilian parents \[CP\] 52%\>HS education, p=0.00).  18% of CPs and 27%
of MP reported at least one gun in the home (p=0.00).  CPs were more
likely to report that the child\'s doctor had talked about guns than MPs
(11% v 6%, p=0.00).  CPs were also more likely to believe that
physicians should ask about guns in the home (78% v 61%, p=0.00), advise
about gun storage (88% v 64%, p=0.00) and advise about removal of guns
from the home (48% v 24%, p=0.00).  MPs were more likely to report that
the child had been taught gun safety by a parent (93% v 77%, p=0.00). 
However, children of CPs were more likely to be taught gun safety
through a formal course (17% v 7%, p=0.00).  All of the above
differences remained significant and in the same direction when solely
analyzing parents who had guns at home.\
\
Conclusions:\
Civilian parents are more likely to believe that physicians should ask
about gun presence and advise about gun storage than military parents. 
Military parents are more likely to report that children have been
taught gun safety by a parent.

Title: [top](#top)\
Primary Care Patients Self Reported Health Behavior Risks and Interest
in Change

Authors:\
Annette Sokolnicki, BS\
Jodi Holtrop, Phd\
David Weismantel, MD,MS\
\
Context:\
The health behaviors of tobacco use, physical inactivity, unhealthy
diet, and risky alcohol drinking are the top causes of death in the U.S.
Assessments of patient\'s risks and interests in behavioral improvement
in these areas is needed within primary care.  This data is collected as
the baseline assessment of a study to test the use of a practice
referral system for connecting with community health behavior resources
in three communities in Michigan.\
\
Objective:\
The aim of the project is to evaluate the self-reported health behavior
risks of patients and their interest change.\
\
Design\
The survey assesses basic demographic information, height, weight, age,
gender, risk regarding the four behaviors, and if at risk, interest in
change.\
\
Settings:\
A health behavior patient survey is being distributed to 200 consecutive
adult patients in 15 GRIN practices.  The practices vary from rural
population to urban/suburban population and have a wide range of
socioeconomic characteristics.\
\
Participants:\
Male and female adult patients presenting for a visit in one of the
study practices.\
\
Current Challenges:\
1)      Prevalence of tobacco use, physical inactivity, unhealthy diet,
and risky alcohol drinking in the participating practices.\
2)      Patient\'s interests in making health behavior improvements.\
3)      Relationship of health behaviors to demographic and background
characteristics including gender, age, educational level, and BMI.\
\
Please describe the next steps you are planning for your study.\
The surveys are being completed as part of the Prescription for Health
(P4H) initiative funded by the Robert Wood Johnson Foundation.  In
Michigan, our P4H project is titled the CHERL (Community Health Educator
Resource Liaison) Project. The aim of the CHERL project is it to
determine if providing a CHERL helps practices help their patients
change risky behaviors by connecting patients to available services in
the community or directly providing behavior change support.   This
baseline survey provides a snapshot of each practice\'s patient
population, and will inform practices of their  \"at risk\" patient
population and interests in change.

Title: [top](#top)

HHS Quick Guide to Health Literacy

Authors:

Stacy Robison MPH, Cynthia Baur PhD, Carmela Lomonaco PhD

According to the Institute of Medicine, approximately one-half of the
adult population lacks the needed literacy skills to use the U.S.
healthcare system. Low literacy has been linked to poor health outcomes.
Studies demonstrate that patients with high blood pressure, diabetes,
asthma, or HIV/AIDS who have limited health literacy skills have less
knowledge of their illness and its management. Several studies have
shown that individuals with limited health literacy have lower adherence
to anticoagulation therapy and worse glycemic control. Patients with
limited health literacy skills may have difficulty with seemingly simple
tasks such as reading a prescription drug label. These same patients are
routinely encountered in clinical settings, positioning primary care
providers on the front lines of this public health challenge. It is
critical that primary care providers consider health literacy skills in
their research and practice. The *Quick Guide to Health Literacy* was
developed by the Office of Disease Prevention and Health Promotion at
the U.S. Department of Health and Human Services and contains
information for primary care providers on how to incorporate health
literacy improvement into clinical practice. The strategies in the
*Quick Guide* reflect the current body of research in health literacy
and health communication, including the use of plain language,
culturally and linguistically appropriate communication, user-centered
design for information and services, evaluation of communication
effectiveness, and advocacy. To date, responses to the problem of low
health literacy have focused on individual level factors that create
barriers to improved health literacy. Although these efforts are
critical, improving health literacy requires *systemic* changes to
healthcare and public health practice. The *Quick Guide to Health
Literacy* includes tools for primary care providers to assess the impact
of health literacy on their practice and identify appropriate
systems-level interventions to improve the health literacy of their
patients.

Title: [top](#top)\
Cardiovascular Disease, Perceived Discrimination, Social Support, and
Sense of Personal Control\
\
Author:\
Roberto Cardarelli, DO, MPH\
Kathryn Cardarelli, PhD\
Ana Chiapa, MS\
\
Context:\
Accruing evidence supports the hypothesis that psychosocial factors are
related to cardiovascular disease (CVD) mortality and morbidity.
However, a limited number of studies have investigated the
pathophysiologic pathways and mechanisms through which these
associations occur. Small but sustained elevated levels of
glucocorticoids may be associated with hypertension, increased lipid
levels, and insulin resistance, all known risk factors for CVD.
Perceived discrimination, social support, and sense of control may be
psychosocial factors that contribute to CVD. Studies have found that
women who reported more experiences of discrimination were more likely
to have coronary artery calcification, compared to women who did not
experience discrimination. Social support in times of stress has been
found to attenuate blood pressure and cortisol reactivity, while low
support was associated with higher epinephrine levels. Therefore, a more
thorough understanding of the association between psychosocial factors
and cardiovascular pathophysiologic mechanisms and pathways is needed.\
\
Objective:\
To assess whether experiences of perceived discrimination, social
support, sense of personal control, and other psychosocial factors are
associated with cardiovascular serum markers and calcium scores.\
\
Design:\
The study uses a cross-sectional design and involves 4 different testing
procedures. An interview will take place using previously validated
instruments that measure perceived discrimination, social support, sense
of control, and other psychosocial factors. Lab analysis will include a
complete metabolic panel, standard lipids and traditional/ emerging risk
factors for CVD. Calcium scores will be obtained through a multi-slice
CAT scan. A total of 200 participants will be recruited from member
clinics throughout the North Texas area.\
\
Current Challenges:\
Completing the IRB process.\
\
Please describe the next steps you are planning for your study.\
Finalize study procedures, obtain IRB approval, and start the study.

Title: [top](#top)\
Methylmercury Exposure Assessment within a PBRN\
\
Author:\
Laura Anderko RN PhD\
\
Context:\
Mercury is a highly toxic metal that poses a serious threat to health.
Dietary fish intake is the most important source of human exposure to
methylmercury. Because of the increased popularity of fish as a source
of dietary protein, a significant percentage of the U.S. population may
be at risk of methylmercury-induced health problems. Nearly 90% of the
U.S. population consumes fish on a regular basis and the EPA estimates
that over 600,000 children born every year are exposed to unsafe levels
of toxic mercury in utero.\
\
Objective:\
This study is designed to evaluate fish consumption patterns and mercury
body burdens among clients of selected member agencies located in the
Great Lakes Region, for the Midwest Nursing Centers Consortium Research
Network (MNCCRN) an AHRQ sponsored PBRN. Correlations of fish
consumption with body burdens, as well as comparison of body burdens
among clients to national exposure data (e.g., NHANES) will be
conducted.\
\
Design:\
The proposed study will be based on a pilot study conducted by selected
MNCCRN centers in 2004/2005. Health professions students will
participate in the screening effort, and will receive training on
environmental exposure assessment and screening procedures. All center
clients will be asked about their interest in participation and
consented. A brief dietary questionnaire will explore: Fish consumption
(type of fish and quantity of fish consumed per meal) and any
self-reported neurological complaints. Hair samples will be collected
and analyzed to determine levels of methylmercury.\
\
Current Challenges:\
Multiple IRB protocols across several academic nursing centers and
selection of labs for conducting the hair analyses.\
\
Goals for Session/Questions for Audience Consideration:\
To explore the potential interest of primary care providers to assess
for methylmercury toxicity and a proposed PBRN study based on pilot
study findings that includes student training for methylmercury exposure
assessment and screening in primary care settings.

[]{#Presenters .anchor}**List of Presenters** [top](#top)

  ------------ ------------- --------------------------- -------------------------
  **Last       **First       **PBRN Affiliation**        **Session**
  Name**       Name**                                    

  Alving       Barbara                                   Roadmap Plenary

  Anderko      Laura         MNCCRN                      Poster

  Angier       Heather       ORPRN                       Poster

  Ariza        Adolfo        PPRG                        Poster

  Bratzler     Dale                                      QI Plenary

  Bolling      Christopher   CPRG                        IIB - Pediatric Research

  Cardarelli   Roberto       The North Texas Primary     Poster
                             Care PBRN                   

  Crichlow     Renee         Frontier Rural Research     Poster
                             Network, FRRN               

  Curry        William       Penn State Ambulatory Care  IIIC - Engaging
                             Network                     Clinicians

  Day          Julie         Utah Health Research        Poster
                             Network                     

  Devers       Kelly         ACORN                       IVB - Colorectal Cancer

  Dickinson    Miriam        CaReNet                     Monday Methods Workshop

  Dulin        Michael       MAPPR                       Poster

  Eberl        Margaret      UNYNET                      Poster

  Fagnan       Lyle          ORPRN                       IIC - Rural PBRNs

  Farley       Eugene        ASPN                        PBRN Pioneers Plenary

  Fernald      Douglas       CaReNet                     Poster

  Firshein     Janet                                     Monday QI Workshop

  Forjuoh      Samuel        CenTexNet                   IIID - Research in
                                                         Progress

  Gaffney      Cecelia       CECH                        Monday Methods Workshop

  Gaffney      Cecelia       CECH                        IC - Nutrition & Obesity

  Gaffney      Cecelia       CECH                        Poster

  Garbutt      Jane          WU PAARC                    Poster

  Grasmick     Michael       Wisconsin Research and      IVA - Health Literacy
                             Education Network           

  Haggerty     Robert        PROS                        PBRN Pioneers Plenary

  Handley      Margaret      UCSF Collaborative Research Health Disparities
                             Network                     Plenary

  Handley      Margaret      UCSF Collaborative Research IVA - Health Literacy
                             Network                     

  Hickner      John          PBRN Resource Center        Roadmap Plenary

  Hickner      John          PBRN Resource Center        Poster

  James        Aimee         KPEPR (Kansas)              IVD - Engaging Medical
                                                         Students Workshop

  Johnson      Deborah       Dartmouth-Northern New      IVC - Chronic Care Model
                             England COOP Project        

  Kho          Abel          Indiana University Medical  Monday HIT Workshop
                             Group PBRN                  

  Kho          Abel          Indiana University Medical  Poster
                             Group PBRN                  

  Krist        Alex          Ambulatory Care Outcomes    IVC - Chronic Care Model
                             Network (ACORN)             

  Kuo          Grace         SPUR-Net                    ID - Medication Safety

  Labuda       Susan         Northeastern Ohio Network   Poster
  Schrop                     (NEON)                      

  Legare       France        Laval University            IIIC - Engaging
                                                         Clinicians

  Lemieux      Jeff                                      Monday QI Workshop

  Levy         Barcey        Iowa Research Network       IVB - Colorectal Cancer

  Lin          Ge            Baylor College of Medicine  Poster

  Line         Laura         Data Mart Network -         Poster
                             National Nursing Centers    
                             Consortium                  

  Loranger     Linda                                     Monday QI Workshop

  Love         Margaret      Kentucky Ambulatory Network IIIC - Engaging
                             (KAN)                       Clinicians

  Lynch        John          ProHealth Physicians        IIID - Research in
                                                         Progress

  Manning      Brian         AAFP NRN                    Poster

  McCann       Mary Ellen                                Monday Operations
                                                         Workshop

  McKee        M. Diane      NYC RING                    Health Disparities
                                                         Plenary

  McKee        M. Diane      NYC RING                    Poster

  Miles        Toni          Metro Louisville PBRN       Poster
  ------------ ------------- --------------------------- -------------------------

(List of Presenters Continued)

  ------------ ----------- ---------------------- ------------------------------
  Mold         James       OKPRN                  QI Plenary

  Mouton       Charles     DC PrimCare            IVA - Health Literacy

  Nagykaldi    Zsolt       OKPRN                  IIC - Rural PBRNs

  Neale        Victoria    MetroNet               IIIA - Research Integrity
                                                  Workshop

  O'Grady      Michael                            Monday QI Workshop

  Parnes       Bennett     CaReNet                IIID - Research in Progress

  Pascoe       John        Dayton Primary Care    IIB - Pediatric Research
                           PBRN                   

  Pascoe       John        Dayton Primary Care    Poster
                           PBRN                   

  Peterson     Kevin       MAFPRN                 Roadmap Plenary

  Peterson     Kevin       MAFPRN                 Poster

  Prunuske     Jacob       Utah Health Research   IVB - Colorectal Cancer
                           Network                

  Rothemich    Stephen     ACORN                  IVC - Chronic Care Model

  Rust         George      Southeast Regional     Health Disparities Plenary
                           Clinicians' Network    

  Ryan         Alexandra                          Poster

  Sarter       Barbara     LANet                  IC - Nutrition & Obesity

  Singh        Gurdev      UNYNET                 ID - Medication Safety

  Sloane       Philip      NC-FP-RN               IC - Nutrition & Obesity

  Sokolnicki   Annette     GRIN                   Poster

  Sommers      Lucia       UCSF Collaborative     IIIC - Engaging Clinicians
                           Practice Network       

  Vernacchio   Louis       SCOR Network           IIB - Pediatric Research

  Wallace      James       ORPRN                  ID - Medication Safety

  Wasson       John        The Dartmouth-Northern PBRN Pioneers Plenary
                           New England COOP       
                           Project                

  Wasson       John        The Dartmouth-Northern IID - Technology & Practice
                           New England COOP       Change Workshop
                           Project                

  Westfall     John        High Plains Research   IIIB - Community Participation
                           Network                Workshop

  Williams     Robert      RIOS Net               Roadmap Plenary

  Zafar        Atif        PBRN Resource Center   Monday HIT Workshop

  Zittleman    Linda       High Plains Research   IIC - Rural PBRNs
                           Network                
  ------------ ----------- ---------------------- ------------------------------

[]{#Participants .anchor} [top](#top)

+-----------------------------------+-----------------------------------+
| > **Alan Adelman, MD**            | > **Natalie Alter**               |
| >                                 | >                                 |
| > **Penn State Ambulatory         | > **Agency for Healthcare         |
| > Research Network**              | > Research and Quality**          |
| >                                 | >                                 |
| > Network Director                | > Program Support Specialist      |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Hershey Medical Center          | > 540 Gaither Road, Rm 6121       |
| >                                 | >                                 |
| > Department of Family &          | > Rockville, MD 20850             |
| > Community Medicine              | >                                 |
| >                                 | > **Phone:** 301-427-1569         |
| > 500 University Dr, H154         | >                                 |
| >                                 | > **E-mail:**                     |
| > Hershey, PA 17033               | > Natalie.Alter@ahrq.hhs.gov      |
| >                                 |                                   |
| > **Phone:** 717-531-8187         |                                   |
| >                                 |                                   |
| > **E-mail:** aadelman@psu.edu    |                                   |
+-----------------------------------+-----------------------------------+
| > **Laura Anderko, PhD**          | > **Heather Angier, BA**          |
| >                                 | >                                 |
| > **MNCCRN**                      | > **Oregon Rural Practice-based   |
| >                                 | > Research Network (ORPRN)**      |
| > Deputy Director                 | >                                 |
| >                                 | > Network Staff                   |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > P.O. Box 413                    | >                                 |
| >                                 | > OHSU                            |
| > Milwaukee, WI 53201             | >                                 |
| >                                 | > 3181 SW Sam Jackson Park Road,  |
| > **Phone:** 414-229-2313         | > L-222                           |
| >                                 | >                                 |
| > **E-mail:** landerko@uwm.edu    | > Portland, OR 97239              |
|                                   | >                                 |
|                                   | > **Phone:** 503-494-1579         |
|                                   | >                                 |
|                                   | > **E-mail:** angierh@ohsu.edu    |
+-----------------------------------+-----------------------------------+
| > **Cheryl Austein Casnoff, MPH** | > **Andrew Bazemore, MD**         |
| >                                 | >                                 |
| > **HRSA**                        | > **AAFP**                        |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > 5600 Fishers Lane               | > 1350 Connecticut Ave., N.W.     |
| >                                 | >                                 |
| > 7C22                            | > Suite 201                       |
| >                                 | >                                 |
| > Rockville, MD 20857             | > Washington, DC 20036            |
| >                                 | >                                 |
| > **Phone:** 301-443-0210         | > **Phone:** 202-331-3360         |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:** abazemore@aafp.org  |
| > caustein-casnoff@hrsa.gov       |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Susan Beidler, PhD**          | > **Jennifer Benz, BA**           |
| >                                 | >                                 |
| > **Florida Atlantic University** | > **PBRN Resource Center**        |
| >                                 | >                                 |
| > **Address:**                    | > Research Analyst                |
| >                                 | >                                 |
| > Florida Atlantic University     | > **Address:**                    |
| >                                 | >                                 |
| > 3045 Wedgewood Blvd             | > NORC                            |
| >                                 | >                                 |
| > Delray Beach, FL 33445          | > 1350 Connecticut Ave NW         |
| >                                 | >                                 |
| > **Phone:** 561-516-1544         | > Ste. 500                        |
| >                                 | >                                 |
| > **E-mail:** sbeidler@fau.edu    | > Washington, DC 20036            |
|                                   | >                                 |
|                                   | > **Phone:** 202-887-0216         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > benz-jennifer@norc.org          |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Jeralyn Bernier, MD           | > **Steve Bernstein, MS**         |
| > [top](#top)**                   | >                                 |
| >                                 | > **Agency for Healthcare         |
| > **CPRG**                        | > Research and Quality**          |
| >                                 | >                                 |
| > Network Director                | > Health Information Technology   |
| >                                 | > (HIT) Project Officer           |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > 3333 Burnet Ave                 | >                                 |
| >                                 | > 540 Gaither Road                |
| > Cincinnati, OH 45226            | >                                 |
| >                                 | > Rockville, MD 20850             |
| > **Phone:** 513-636-0145         | >                                 |
| >                                 | > **Phone:** 301-427-1581         |
| > **E-mail:**                     | >                                 |
| > jeralyn.bernier@cchmc.org       | > **E-mail:**                     |
|                                   | > Steve.Bernstein@ahrq.hhs.gov    |
+-----------------------------------+-----------------------------------+
| > **Helen Binns, MD**             | > **Josh Black, BS**              |
| >                                 | >                                 |
| > **Pediatric Practice Research   | > **MAPPR**                       |
| > Group**                         | >                                 |
| >                                 | > Affiliated Researcher           |
| > Network Director                | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > 5516 Central Ave.               |
| > Children\'s Memorial Hosp,      | >                                 |
| > Northwestern Univ               | > Charlotte, NC 28212             |
| >                                 | >                                 |
| > 2300 Children\'s Plaza          | > **Phone:** 704-446-7757         |
| >                                 | >                                 |
| > Box 157                         | > **E-mail:** josblack@uncc.edu   |
| >                                 |                                   |
| > Chicago, IL 60614               |                                   |
| >                                 |                                   |
| > **Phone:** 312-573-7782         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > hbinns@northwestern.edu         |                                   |
+-----------------------------------+-----------------------------------+
| > **Erin Blume, BS, RHIA**        | > **Dale Bratzler, DO, MPH**      |
| >                                 | >                                 |
| > **AMDA Foundation Research      | > **Oklahoma Foundation for       |
| > Network**                       | > Medical Quality**               |
| >                                 | >                                 |
| > Network Staff                   | > Principal Clinical Coordinator  |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > 10480 Little Patuxent Pkwy      | > 14000 Quail Springs Parkway,    |
| >                                 | > Suite 400                       |
| > Ste 760                         | >                                 |
| >                                 | > Oklahoma City, OK 73134         |
| > Columbia, MD 21044              | >                                 |
| >                                 | > **Phone:** 405-840-2891         |
| > **Phone:** 410-992-3137         | >                                 |
| >                                 | > **E-mail:**                     |
| > **E-mail:** eblume@amda.com     | > dbratzler@okgio.sdps.org        |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Linda Boise, PhD**            | > **Lynn Breer, PhD**             |
| >                                 | >                                 |
| > **Oregon Rural Practice-based   | > **Michigan Public Health        |
| > Research Network (ORPRN)**      | > Institute**                     |
| >                                 | >                                 |
| > Affiliated Researcher           | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > 2440 Woodlake Circle, Suite 100 |
| >                                 | >                                 |
| > Layton Aging & Alzheimer\'s     | > Institute for Nursing Centers   |
| > Disease Center                  | >                                 |
| >                                 | > Okemos, MI 48864                |
| > 3181 SW Sam Jackson Park Road,  | >                                 |
| > CR131                           | > **Phone:** 517-324-8397         |
| >                                 | >                                 |
| > Portland, OR 97239              | > **E-mail:** lbreer@mphi.org     |
| >                                 |                                   |
| > **Phone:** 503-494-6370         |                                   |
| >                                 |                                   |
| > **E-mail:** boisel@ohsu.edu     |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Helen Burstin, MD             | > **Jennifer Cantrell, PhD        |
| > [top](#top)**                   | > candidate**                     |
| >                                 | >                                 |
| > **Agency for Healthcare Reseach | > **Columbia University           |
| > and Quality**                   | > Ambulatory Care Research        |
| >                                 | > Network**                       |
| > Director of the Center for      | >                                 |
| > Primary Care, Prevention, and   | > Network Coordinator             |
| > Clinical Partnerships           | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > 722 West 168th St               |
| > 540 Gaither Road                | >                                 |
| >                                 | > New York, NY 10032              |
| > Rockville, MD 20850             | >                                 |
| >                                 | > **Phone:** 212-305-3613         |
| > **Phone:** 301-427-1565         | >                                 |
| >                                 | > **E-mail:** mjc68@columbia.edu  |
| > **E-mail:**                     |                                   |
| > Helen.Burstin@ahrq.hhs.gov      |                                   |
+-----------------------------------+-----------------------------------+
| > **Roberto Cardarelli, DO**      | > **Karen Carmody, MSN, FNP-C**   |
| >                                 | >                                 |
| > **NorTex**                      | > **CRAN**                        |
| >                                 | >                                 |
| > Network Director                | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > University of North Texas       | > 5305 Limestone Road             |
| > Health Science Center           | >                                 |
| >                                 | > Suite 203                       |
| > 3500 Camp Bowie Blvd.           | >                                 |
| >                                 | > Wilmington, DE 19808            |
| > Fort Worth, TX 76107            | >                                 |
| >                                 | > **Phone:** 302-235-7506         |
| > **Phone:** 817-735-0282         | >                                 |
| >                                 | > **E-mail:** karen@cran3.org     |
| > **E-mail:**                     |                                   |
| > rcardare@hsc.unt.edu            |                                   |
+-----------------------------------+-----------------------------------+
| > **Vickie Cater, BA**            | > **Ana Luz Chiapa, MS**          |
| >                                 | >                                 |
| > **PResNet**                     | > **NorTex**                      |
| >                                 | >                                 |
| > Network Coordinator             | > Network Coordinator             |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > 699 West Drive, RR 330          | > 3500 Camp Bowie Blvd.           |
| >                                 | >                                 |
| > Children\'s Health Services     | > Fort Worth, TX 76107            |
| > Research                        | >                                 |
| >                                 | > **Phone:** 817-735-2625         |
| > Indianapolis, IN 46202          | >                                 |
| >                                 | > **E-mail:** achiapa@hsc.unt.edu |
| > **Phone:** 317-278-0552         |                                   |
| >                                 |                                   |
| > **E-mail:** vcater@iupui.edu    |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Charles Christianson, MD**    | > **Frances Cockcroft, BSE**      |
| >                                 | >                                 |
| > **University of North Dakota**  | > **Arkansas Primary Care         |
| >                                 | > Research Collaborative for      |
| > Network Director                | > Quality Improvement**           |
| >                                 | >                                 |
| > **Address:**                    | > Network Staff                   |
| >                                 | >                                 |
| > Dept. of Family Medicine,       | > **Address:**                    |
| > University of North Dakota      | >                                 |
| >                                 | > University of Arkansas for      |
| > 501 North Columbia Road         | > Medical Sciences                |
| >                                 | >                                 |
| > Grand Forks, ND 58202           | > 521 Jack Stephens Drive         |
| >                                 | >                                 |
| > **Phone:** 701-777-3240         | > Little Rock, AR 72205           |
| >                                 | >                                 |
| > **E-mail:**                     | > **Phone:** 501-686-6606         |
| > cchristi@medicine.nodak.edu     | >                                 |
|                                   | > **E-mail:** tallen2@uams.edu    |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Lisa Cooper, MD [top](#top)** | > **Shirley Cowart**              |
| >                                 | >                                 |
| > **Johns Hopkins University**    | > **High Plains Research          |
| >                                 | > Network**                       |
| > PBRN RC Steering Committee      | >                                 |
| > Member                          | > Clinician/Network Committee     |
| >                                 | > Member                          |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > Johns Hopkins                   | >                                 |
| >                                 | > 324 North Birch St.             |
| > 7017 Garden Walk                | >                                 |
| >                                 | > Yuma, CO 80759                  |
| > Columbia, MD 21044              | >                                 |
| >                                 | > **Phone:** 970-848-2491         |
| > **Phone:** 410-531-1522         | >                                 |
| >                                 | > **E-mail:** scowart@plains.net  |
| > **E-mail:**                     |                                   |
| > lisa.cooper@jhmi.edu            |                                   |
+-----------------------------------+-----------------------------------+
| > **Linda Crew, MBA**             | > **Timothy Cuerdon, PhD**        |
| >                                 | >                                 |
| > **Clemson University**          | > **ACPNet**                      |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > Clemson University              | > **Address:**                    |
| >                                 | >                                 |
| > 101 Edwards Hall                | > 190 North Independence Mall     |
| >                                 | > West                            |
| > Joseph F. Sullivan Center       | >                                 |
| >                                 | > Philadelphia, PA 19106-1572     |
| > Clemson, SC 29634               | >                                 |
| >                                 | > **Phone:** 215-351-2826         |
| > **Phone:** 864-656-3076         | >                                 |
| >                                 | > **E-mail:**                     |
| > **E-mail:** lcrew@clemson.edu   | > tcuerdon@acponline.org          |
+-----------------------------------+-----------------------------------+
| > **William Curry, MD, MS**       | > **Marcia S. Dahlman**           |
| >                                 | >                                 |
| > **Penn State Ambulatory Care    | > **The University of Texas       |
| > Network**                       | > Health Science Center at San    |
| >                                 | > Antonio**                       |
| > Clinician or Steering Committee | >                                 |
| > Member                          | > Network Staff                   |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > M. S. Hershey Medical Center    | > 7703 Floyd Curl Drive, MSC 7794 |
| >                                 | >                                 |
| > Penn State College of Medicine  | > San Antonio, TX 78229-3900      |
| >                                 | >                                 |
| > 500 University Drive            | > **Phone:** 210-567-3044         |
| >                                 | >                                 |
| > Hershey, PA 17033               | > **E-mail:** dahlman@uthscsa.edu |
| >                                 |                                   |
| > **Phone:** 717-531-8736         |                                   |
| >                                 |                                   |
| > **E-mail:** wcurry@psu.edu      |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Paul Darden, MD**             | > **Julie Day, MD**               |
| >                                 | >                                 |
| > **Medical Unviersity of South   | > **Utah Health Research          |
| > Carolina**                      | > Network**                       |
| >                                 | >                                 |
| > Network Director                | > Clinician/Network Committee     |
| >                                 | > Member                          |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > Medical Unviersity of South     | >                                 |
| > Carolina                        | > University of Utah Health Care: |
| >                                 | > Community Clinics               |
| > 135 Rutledge Ave                | >                                 |
| >                                 | > 127 S. 500 E. Suite 140         |
| > PO Box 250561                   | >                                 |
| >                                 | > Salt Lake City, UT 84102        |
| > Charleston, SC 29425            | >                                 |
| >                                 | > **Phone:** 801-587-6307         |
| > **Phone:** 843-876-8512         | >                                 |
| >                                 | > **E-mail:**                     |
| > **E-mail:** hasegawa@musc.edu   | > julie.day@hsc.utah.edu          |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Kelly Devers, PhD             | > **L. Miriam Dickinson, PhD**    |
| > [top](#top)**                   | >                                 |
| >                                 | > **SNOCAP, AAFP**                |
| > **ACORN**                       | >                                 |
| >                                 | > **Address:**                    |
| > Affiliated Researcher           | >                                 |
| >                                 | > PO Box 6508 MS-F496             |
| > **Address:**                    | >                                 |
| >                                 | > Aurora, CO 80045                |
| > Virginia Commonwealth           | >                                 |
| > University                      | > **Phone:** 303-724-9711         |
| >                                 | >                                 |
| > P. O. Box 980251                | > **E-mail:**                     |
| >                                 | > miriam.dickinson@uchsc.edu      |
| > 1200 E. Broad Street            |                                   |
| >                                 |                                   |
| > Richmond, VA 23298-0251         |                                   |
| >                                 |                                   |
| > **Phone:** 804-828-9625         |                                   |
| >                                 |                                   |
| > **E-mail:** kjdevers@vcu.edu    |                                   |
+-----------------------------------+-----------------------------------+
| > **Kristen diDonato,**           | > **Rowena Dolor, MD**            |
| >                                 | >                                 |
| > **CRAN**                        | > **Duke Primary Care Research    |
| >                                 | > Consortium**                    |
| > Information Systems             | >                                 |
| >                                 | > Network Director                |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > 5305 Limestone Road             | >                                 |
| >                                 | > Duke University Medical Center  |
| > Wilmington, DE 19808            | >                                 |
| >                                 | > 2400 Pratt Street               |
| > **Phone:** 302-235-7506         | >                                 |
| >                                 | > Durham, NC 27705                |
| > **E-mail:** kristen@cran3.org   | >                                 |
|                                   | > **Phone:** 919-668-8627         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > rowena.dolor@duke.edu           |
+-----------------------------------+-----------------------------------+
| > **Michael Dulin, MD**           | > **Michael Dyer, JD**            |
| >                                 | >                                 |
| > **MAPPR**                       | > **Address:**                    |
| >                                 | >                                 |
| > Network Director                | > AACOM                           |
| >                                 | >                                 |
| > **Address:**                    | > 5550 Friendship Boulevard       |
| >                                 | >                                 |
| > Carolinas Medical Center        | > Suite 310                       |
| >                                 | >                                 |
| > 5516 Central Ave                | > Chevy Chase, MD 20815           |
| >                                 | >                                 |
| > Charlotte, NC 28269             | > **Phone:** 301-968-4152         |
| >                                 | >                                 |
| > **Phone:** 704-446-7740         | > **E-mail:** MDyer@aacom.org     |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > mich                            |                                   |
| ael.dulin@carolinashealthcare.org |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Gregory Eberhart, MD**        | > **Margaret Eberl, MD, MPH**     |
| >                                 | >                                 |
| > **Dayton Primary Care Practice  | > **University at Buffalo**       |
| > Based Research Network**        | >                                 |
| >                                 | > Affiliated Researcher           |
| > Clinician/Network Committee     | >                                 |
| > Member                          | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > University at Buffalo           |
| >                                 | >                                 |
| > Cornerstone Pediatrics          | > 462 Grider St - CC 125          |
| >                                 | >                                 |
| > 76 Remick Boulevard             | > Buffalo, NY 14215               |
| >                                 | >                                 |
| > Springboro, OH 45066            | > **Phone:** 716-898-3565         |
| >                                 | >                                 |
| > **Phone:** 937-885-4475         | > **E-mail:** mmeberl@buffalo.edu |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > greberhart@sbcglobal.net        |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Milton Eder, PhD              | > **Christina Esperat, PhD**      |
| > [top](#top)**                   | >                                 |
| >                                 | > **Texas Tech University**       |
| > **Access Community Health       | >                                 |
| > Network**                       | > Associate Dean For Research And |
| >                                 | > Practice                        |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > Access Community Health Network | >                                 |
| >                                 | > TTUHSC School of Nursisng       |
| > 1501 South California           | >                                 |
| >                                 | > 3601 4th Street                 |
| > Chicago, IL 60608               | >                                 |
| >                                 | > Stop 6264                       |
| > **Phone:** 773-257-6087         | >                                 |
| >                                 | > Lubbock, TX 79430-6264          |
| > **E-mail:** edem@sinai.org      | >                                 |
|                                   | > **Phone:** 806-743-3052         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > christina.esperat@ttuhsc.edu    |
+-----------------------------------+-----------------------------------+
| > **Lyle J Fagnan, MD**           | > **Terry Falco**                 |
| >                                 | >                                 |
| > **Oregon Rural Practice-based   | > **NJFMRN**                      |
| > Research Network (ORPRN)**      | >                                 |
| >                                 | > Program Administer              |
| > Network Director                | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > UMDNJ-Dept. of Family Medicne   |
| > 3181 SW Sam Jackson Park Road   | >                                 |
| >                                 | > 1 World\'s Fair Drive           |
| > L222                            | >                                 |
| >                                 | > Somerset, NJ 08873              |
| > Portland, OR 97239              | >                                 |
| >                                 | > **Phone:** 732-236-9101         |
| > **Phone:** 503-494-1582         | >                                 |
| >                                 | > **E-mail:** falcote@umdnj.edu   |
| > **E-mail:** fagnanl@ohsu.edu    |                                   |
+-----------------------------------+-----------------------------------+
| > **Eugene Farley, MD**           | > **Carrie Fascetti, LSW**        |
| >                                 | >                                 |
| > **University of Wisconsin**     | > **CARE-NET**                    |
| >                                 | >                                 |
| > **Address:**                    | > Network Coordinator             |
| >                                 | >                                 |
| > University of Wisconsin         | > **Address:**                    |
| >                                 | >                                 |
| > 2299 Spring Rose Road           | > UPMC Health System              |
| >                                 | >                                 |
| > Verona, WI 53593                | > 3811 OHara Street               |
| >                                 | >                                 |
| > **Phone:** 608-845-8724         | > 150 Webster Hall                |
| >                                 | >                                 |
| > **E-mail:** esfarley@wisc.edu   | > Pittsburgh, PA 15213            |
|                                   | >                                 |
|                                   | > **Phone:** 412-246-5283         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > christopherc@upmc.edu           |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Douglas Fernald, MA**         | > **Dale Fiedler, MS**            |
| >                                 | >                                 |
| > **CaReNet**                     | > **Southern Illinois Healthcare  |
| >                                 | > Foundation**                    |
| > Assistant Director              | >                                 |
| >                                 | > Network Director                |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > PO Box 6508 MS-F496             | >                                 |
| >                                 | > 5900 Bond Ave                   |
| > Aurora, CO 80045                | >                                 |
| >                                 | > Centreville, IL 62207           |
| > **Phone:** 303-724-9705         | >                                 |
| >                                 | > **Phone:** 618-332-5200         |
| > **E-mail:**                     | >                                 |
| > doug.fernald@uchsc.edu          | > **E-mail:**                     |
|                                   | > dfiedler@touchette.org          |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Rosemarie Filart, MD, MPH     | > **Carol Ford, MD**              |
| > [top](#top)**                   | >                                 |
| >                                 | > **NC MARCH**                    |
| > **NCRR Medical Officer**        | >                                 |
| >                                 | > Network Director                |
| > Clinician/Network Committee     | >                                 |
| > Member                          | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > UNC                             |
| >                                 | >                                 |
| > One Democracy Plaza             | > CB 7220                         |
| >                                 | >                                 |
| > 6701 Democracy Blvd             | > Chapel Hill, NC 27599-7220      |
| >                                 | >                                 |
| > Rm 918                          | > **Phone:** 919-966-2504         |
| >                                 | >                                 |
| > Bethesda, MD 20892              | > **E-mail:** caf@med.unc.edu     |
| >                                 |                                   |
| > **Phone:** 301-435-0178         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > filartr@mail.nih.gov            |                                   |
+-----------------------------------+-----------------------------------+
| > **Jean Ford, MD**               | > **Samuel Forjuoh, MD**          |
| >                                 | >                                 |
| > **John Hopkins University**     | > **CenTexNet**                   |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > Johns Hopkins                   | > **Address:**                    |
| >                                 | >                                 |
| > 615 N. Wolfe Street, Room E6650 | > Scott & White Santa Fe -        |
| >                                 | > Century Square                  |
| > Baltimore, MD 21205             | >                                 |
| >                                 | > 1402 West Ave H                 |
| > **Phone:** 443-287-5181         | >                                 |
| >                                 | > Temple, TX 76504                |
| > **E-mail:** jford@jhsph.edu     | >                                 |
|                                   | > **Phone:** 254-771-7695         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > sforjuoh@swmail.sw.org          |
+-----------------------------------+-----------------------------------+
| > **Chet Fox, MD**                | > **Amy Franklin, BA**            |
| >                                 | >                                 |
| > **UNYNET**                      | > **PBRN Resource Center**        |
| >                                 | >                                 |
| > Network Director                | > Network Staff                   |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > University at Buffalo Family    | > Indiana University              |
| > Medicine                        | >                                 |
| >                                 | > 1001 W. 10th Street             |
| > 33 Wansfell Rd                  | >                                 |
| >                                 | > WD OPW M200                     |
| > Amherst, NY 14226               | >                                 |
| >                                 | > Indianapolis, IN 46202          |
| > **Phone:** 716-332-3797         | >                                 |
| >                                 | > **Phone:** 317-630-7776         |
| > **E-mail:** chetfox@gmail.com   | >                                 |
|                                   | > **E-mail:** ammlilly@iupui.edu  |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Jane French, BA**             | > **Cecelia Gaffney, MEd**        |
| >                                 | >                                 |
| > **PBRN Resource Center &        | > **CECH - Clinicians Enhancing   |
| > ResNet**                        | > Child Health**                  |
| >                                 | >                                 |
| > Network Coordinator             | > Network Coordinator             |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Indiana University              | > NCCC, Rubin 7925                |
| >                                 | >                                 |
| > 1001 W. 10th Street             | > One Medical Center Dr.          |
| >                                 | >                                 |
| > WD OPW M200                     | > Lebanon, NH 03756               |
| >                                 | >                                 |
| > Indianapolis, IN 46202          | > **Phone:** 603-653-3641         |
| >                                 | >                                 |
| > **Phone:** 317-630-6348         | > **E-mail:**                     |
| >                                 | > cgaffney@dartmouth.edu          |
| > **E-mail:** jaafrenc@iupui.edu  |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Meghan Gannon, MSPH           | > **Jane Garbutt, MD**            |
| > [top](#top)**                   | >                                 |
| >                                 | > **WU PAARC**                    |
| > **ACPNet**                      | >                                 |
| >                                 | > Network Director                |
| > Network Coordinator             | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > 26 Kingsbury Place              |
| > 190 North Independence Mall     | >                                 |
| > West                            | > St Louis, MO 63112              |
| >                                 | >                                 |
| > Philadelphia, PA 19106-1572     | > **Phone:** 314-454-8613         |
| >                                 | >                                 |
| > **Phone:** 215-351-2847         | > **E-mail:**                     |
| >                                 | > jgarbutt@im.wustl.edu           |
| > **E-mail:**                     |                                   |
| > mgannon@acponline.org           |                                   |
+-----------------------------------+-----------------------------------+
| > **Dan Gaylin, MPA**             | > **Janice Genevro, PhD**         |
| >                                 | >                                 |
| > **PBRN Resource Center**        | > **Agency for Healthcare         |
| >                                 | > Research and Quality**          |
| > Co-Director                     | >                                 |
| >                                 | > Senior Prevention Integration   |
| > **Address:**                    | > Manager                         |
| >                                 | >                                 |
| > NORC                            | > **Address:**                    |
| >                                 | >                                 |
| > 1350 Connecticut Ave NW         | > 540 Gaither Road                |
| >                                 | >                                 |
| > Ste. 500                        | > Room 6119                       |
| >                                 | >                                 |
| > Washington, DC 20036            | > Rockville, MD 20850             |
| >                                 | >                                 |
| > **Phone:** 202-223-6364         | > **Phone:** 301-427-1627         |
| >                                 | >                                 |
| > **E-mail:** gaylin-dan@norc.org | > **E-mail:** jgenevro@ahrq.gov   |
+-----------------------------------+-----------------------------------+
| > **Bri Ghods, BS**               | > **Amy Gibson, MS,RN**           |
| >                                 | >                                 |
| > **Johns Hopkins University**    | > **Boys Town Pediatrics**        |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Johns Hopkins University        | > 1326 W Grenshaw                 |
| >                                 | >                                 |
| > 2809 Boston Street              | > Chicago, IL 60607               |
| >                                 | >                                 |
| > Suite 7, Room 111               | > **Phone:** 312-261-5572         |
| >                                 | >                                 |
| > Baltimore, MD 21224             | > **E-mail:**                     |
| >                                 | > gibsona@boystown.org            |
| > **Phone:** 410-522-6500 Ext.    |                                   |
| > 263                             |                                   |
| >                                 |                                   |
| > **E-mail:** bghods@jhmi.edu     |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Gregg Gilbert, DDS, MBA**     | > **Ron Gimbel, PhD**             |
| >                                 | >                                 |
| > **Dental PBRN**                 | > **PEARL**                       |
| >                                 | >                                 |
| > Network Director                | > Affiliated Researcher           |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > UAB-School of Dentistry         | > USUHS                           |
| >                                 | >                                 |
| > 1530 Third Avenue South         | > Preventive Medicine Department  |
| >                                 | >                                 |
| > SDB 109                         | > 4301 Jones Bridge Road          |
| >                                 | >                                 |
| > Birmingham, AL 35294-0007       | > Bethesda, MD 20814-4799         |
| >                                 | >                                 |
| > **Phone:** 205-975-8886         | > **Phone:** 301-295-3077         |
| >                                 | >                                 |
| > **E-mail:** ghg@uab.edu         | > **E-mail:** rgimbel@usuhs.mil   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Sarah L. Glavin, PhD          | > **Mary Jo Goolsby, EdD**        |
| > [top](#top)**                   | >                                 |
| >                                 | > **AANPNR**                      |
| > **NIH/NIDCR**                   | >                                 |
| >                                 | > Network Director                |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > NIH/NIDCR                       | >                                 |
| >                                 | > PO Box 12846                    |
| > 31 Center Drive Room 5B55       | >                                 |
| >                                 | > Austin, TX 78711                |
| > Bethesda, MD 20892              | >                                 |
| >                                 | > **Phone:** 512-276-5903         |
| > **Phone:** 301-594-4849         | >                                 |
| >                                 | > **E-mail:** mjgoolsby@aanp.org  |
| > **E-mail:**                     |                                   |
| > glavins@mail.nih.gov            |                                   |
+-----------------------------------+-----------------------------------+
| > **Jennifer Granger, MPH**       | > **Michael Grasmick, PhD**       |
| >                                 | >                                 |
| > **New England Clinicians        | > **Wisconsin Research and        |
| > Forum**                         | > Education Network**             |
| >                                 | >                                 |
| > Network Director                | > Network Staff                   |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Connecticut Primary Care        | > 777 S Mills St                  |
| > Association                     | >                                 |
| >                                 | > Madison, WI 53715               |
| > 90 Brainard Rd.                 | >                                 |
| >                                 | > **Phone:** 608-265-4597         |
| > Suite 101                       | >                                 |
| >                                 | > **E-mail:**                     |
| > Hartford, CT 06114              | >                                 |
| >                                 |  michael.grasmick@fammed.wisc.edu |
| > **Phone:** 860-727-0004         |                                   |
| >                                 |                                   |
| > **E-mail:** jgranger@ctpca.org  |                                   |
+-----------------------------------+-----------------------------------+
| > **Larry Green, MD**             | > **David Gribben, MPH**          |
| >                                 | >                                 |
| > **University of Colorado Health | > **Address:**                    |
| > Sciences Center**               | >                                 |
| >                                 | > Navy Medicine                   |
| > **Address:**                    | >                                 |
| >                                 | > 8715 Chorley Way                |
| > PO Box 6508, Mail Stop F496     | >                                 |
| >                                 | > Bristow, VA 20136               |
| > Aurora, CO 80045                | >                                 |
| >                                 | > **Phone:** 262-358-2603         |
| > **Phone:** 303-724-9771         | >                                 |
| >                                 | > **E-mail:**                     |
| > **E-mail:**                     | > dbgribben@us.med.navy.mil       |
| > larry.green@uchsc.edu           |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Robert Haggerty, MD**         | > **Ben Hamlin, MPH**             |
| >                                 | >                                 |
| > **University of Rochester**     | > **PBRN Resource Center**        |
| >                                 | >                                 |
| > **Address:**                    | > Sr. Research Analyst            |
| >                                 | >                                 |
| > University of Rochester         | > **Address:**                    |
| >                                 | >                                 |
| > 4485 Davidson Lamding Drive     | > NORC                            |
| >                                 | >                                 |
| > Canadaigua, NY 14424            | > 1350 Connecticut Ave NW         |
| >                                 | >                                 |
| > **Phone:** 585-394-8978         | > Ste. 500                        |
| >                                 | >                                 |
| > **E-mail:**                     | > Washington, DC 20036            |
| > murielh@rochester.rr.com        | >                                 |
|                                   | > **Phone:** 202-223-6366         |
|                                   | >                                 |
|                                   | > **E-mail:** hamlin-ben@norc.org |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Margaret Handley, PhD         | > **Robin Hansen, BA**            |
| > [top](#top)**                   | >                                 |
| >                                 | > **IRENE**                       |
| > **UCSF Collaborative Research   | >                                 |
| > Director**                      | > Network Coordinator             |
| >                                 | >                                 |
| > Network Director                | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > University of Iowa              |
| >                                 | >                                 |
| > UCSF SFGH 995 Potrero Ave Bldg  | > 200 Hawkins Drive               |
| > 83                              | >                                 |
| >                                 | > 01110-C PFP                     |
| > Dept of Family and Community    | >                                 |
| > Medicine                        | > Iowa City, IA 52242             |
| >                                 | >                                 |
| > San Francisco, CA 94110         | > **Phone:** 319-384-7763         |
| >                                 | >                                 |
| > **Phone:** 415-206-5333         | > **E-mail:**                     |
| >                                 | > robin-hansen@uiowa.edu          |
| > **E-mail:**                     |                                   |
| > handleym@fcm.ucsf.edu           |                                   |
+-----------------------------------+-----------------------------------+
| > **Tine Hansen-Turton, MA**      | > **Connie Haynes**               |
| >                                 | >                                 |
| > **NNCC Data Mart Network**      | > **High Plains Research          |
| >                                 | > Network**                       |
| > Network Director                | >                                 |
| >                                 | > Clinician/Network Committee     |
| > **Address:**                    | > Member                          |
| >                                 | >                                 |
| > NNCC                            | > **Address:**                    |
| >                                 | >                                 |
| > 260 S. Broad Str., 18th Fl.     | > 46011 Cty Rd 32                 |
| >                                 | >                                 |
| > Philadelphia, PA 19102          | > Haxtun, CO 80731                |
| >                                 | >                                 |
| > **Phone:** 215-731-7140         | > **Phone:** 970-774-6536         |
| >                                 | >                                 |
| > **E-mail:** tine@nncc.us        | > **E-mail:**                     |
|                                   | > connie@pctelcom.coop            |
+-----------------------------------+-----------------------------------+
| > **John Hickner, MD**            | > **Diane Hollingsworth, RN**     |
| >                                 | >                                 |
| > **Access Community Health       | > **MedStar Physician Partners**  |
| > Network**                       | >                                 |
| >                                 | > **Address:**                    |
| > **PBRN Resource Center**        | >                                 |
| >                                 | > MedStar Physician Partners      |
| > **Address:**                    | >                                 |
| >                                 | > 9600 Pulaski Park Drive         |
| > University of Chicago           | >                                 |
| >                                 | > Suite 103                       |
| > 5841 S. Maryland Ave            | >                                 |
| >                                 | > Baltimore, MD 21220             |
| > Suite 156 MC 7110               | >                                 |
| >                                 | > **Phone:** 443-725-8704         |
| > Chicago, IL 60615               | >                                 |
| >                                 | > **E-mail:**                     |
| > **Phone:** 773-834-6855         | > Diane.Hollingsworth@medstar.net |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > jhickner@uchicago.edu           |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Brenda Hudson, MA**           | > **Dorothy Hung, PhD**           |
| >                                 | >                                 |
| > **PBRN Resource Center**        | > **Columbia University           |
| >                                 | > Ambulatory Care Research        |
| > Operations Director             | > Network**                       |
| >                                 | >                                 |
| > **Address:**                    | > Affiliated Researcher           |
| >                                 | >                                 |
| > Indiana University              | > **Address:**                    |
| >                                 | >                                 |
| > 1001 West 10th Street           | > 722 West 168th St               |
| >                                 | >                                 |
| > WD OPW M200                     | > New York, NY 10032              |
| >                                 | >                                 |
| > Indianapolis, IN 46202          | > **Phone:** 212-342-0154         |
| >                                 | >                                 |
| > **Phone:** 317-630-8364         | > **E-mail:** dh2237@columbia.edu |
| >                                 |                                   |
| > **E-mail:** brlhudso@iupui.edu  |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Finie Hunter, MPH             | > **Thomas Irons, MD**            |
| > [top](#top)**                   | >                                 |
| >                                 | > **Brody Medical School at East  |
| > **DC PrimCare**                 | > Carolina University**           |
| >                                 | >                                 |
| > Network Coordinator             | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Howard University College of    | > Brody Medical School at East    |
| > Medicine                        | > Carolina Univ.                  |
| >                                 | >                                 |
| > 4215 First Street, SE #103      | > 525 Moye Boulevard              |
| >                                 | >                                 |
| > District of Columbia, DC 20032  | > Greenville, NC 27834            |
| >                                 | >                                 |
| > **Phone:** 202-806-9849         | > **Phone:** 252-744-2983         |
| >                                 | >                                 |
| > **E-mail:** finieh@hotmail.com  | > **E-mail:** ironst@ecu.edu      |
+-----------------------------------+-----------------------------------+
| > **Aimee James, PhD**            | > **Deborah J. Johnson, BA**      |
| >                                 | >                                 |
| > **KPEPR (Univ of Kansas Med     | > **Dartmouth Northern New        |
| > Ctr)**                          | > England COOP Project**          |
| >                                 | >                                 |
| > Affiliated Researcher           | > Network Coordinator             |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Dept of Preventive Med. and     | > Dartmouth Medical School        |
| > Public Health                   | >                                 |
| >                                 | > Butler Building, HB 7265        |
| > University of Kansas Medical    | >                                 |
| > Center                          | > Hanover, NH 03755               |
| >                                 | >                                 |
| > MS 1008, 3901 Rainbow Blvd      | > **Phone:** 603-650-1220         |
| >                                 | >                                 |
| > Kansas City, KS 66160           | > **E-mail:**                     |
| >                                 | > Deborah.J.Johnson@Dartmouth.edu |
| > **Phone:** 913-588-2747         |                                   |
| >                                 |                                   |
| > **E-mail:** ajames@kumc.edu     |                                   |
+-----------------------------------+-----------------------------------+
| > **Elizabeth Joy, MD**           | > **Mitchell Kaminski, MD**       |
| >                                 | >                                 |
| > **UHRN**                        | > **Crozer-Keystone PBRN**        |
| >                                 | >                                 |
| > Network Director                | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > University of Utah              | > Crozer-Chester Medical Center   |
| >                                 | >                                 |
| > Department of Family and        | > One Medical Center Boulevard,   |
| > Preventive Medicine             | > Suite 443                       |
| >                                 | >                                 |
| > 375 Chipeta Way, Suite A        | > Department of Family Medicine   |
| >                                 | >                                 |
| > Salt Lake City, UT 84108        | > Upland, PA 19013                |
| >                                 | >                                 |
| > **Phone:** 801-585-9075         | > **Phone:** 610-876-8814         |
| >                                 | >                                 |
| > **E-mail:** eajslc@aol.com      | > **E-mail:**                     |
|                                   | > mitchell.kaminski@crozer.org    |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Renee Kee, MS**               | > **Abel Kho, MD**                |
| >                                 | >                                 |
| > **Western New York**            | > **ResNet**                      |
| >                                 | >                                 |
| > Network Staff                   | > Investigator                    |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > 462 Grider Street               | > Regenstrief Institute           |
| >                                 | >                                 |
| > Buffalo, NY 14208               | > 1050 Wishard Blvd, 5th flr      |
| >                                 | >                                 |
| > **Phone:** 716-898-6213         | > Indianapolis, IN 46202          |
| >                                 | >                                 |
| > **E-mail:**                     | > **Phone:** 317-630-2528         |
| > reneekee@buffalo.edu            | >                                 |
|                                   | > **E-mail:** akho@iupui.edu      |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **John Kirk, MD [top](#top)**   | > **Alex Krist, MD**              |
| >                                 | >                                 |
| > **Dartmouth Northern New        | > **ACORN**                       |
| > England COOP Project**          | >                                 |
| >                                 | > Affiliated Researcher           |
| > Clinician/Network Committee     | >                                 |
| > Member                          | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > Virginia Commonwealth           |
| >                                 | > University                      |
| > DHMC                            | >                                 |
| >                                 | > P. O. Box 980251                |
| > 2286 Stoney Brook Rd            | >                                 |
| >                                 | > 1200 E. Broad Street            |
| > Grantham, NH 03753              | >                                 |
| >                                 | > Richmond, VA 23298-0251         |
| > **Phone:** 603-650-1070         | >                                 |
| >                                 | > **Phone:** 804-828-9625         |
| > **E-mail:**                     | >                                 |
| > john.kirk@dartmouth.edu         | > **E-mail:** ahkrist@vcu.edu     |
+-----------------------------------+-----------------------------------+
| > **Kimberly Krohn, MD, MPH**     | > **Grace Kuo, PharmD**           |
| >                                 | >                                 |
| > **North Dakota PBRN**           | > **SPUR-Net**                    |
| >                                 | >                                 |
| > Clinician/Network Committee     | > Network Director                |
| > Member                          | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > Baylor College of Med.Dept.     |
| > University of North Dakota      | > Family & Community Med.         |
| >                                 | >                                 |
| > 1201 11th Avenue SW             | > 3701 Kirby Dr. Suite 600        |
| >                                 | >                                 |
| > Minot, ND 58701                 | > Houston, TX 77098-3926          |
| >                                 | >                                 |
| > **Phone:** 701-858-6700         | > **Phone:** 713-798-7712         |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:** gkuo@bcm.tmc.edu    |
| > kimkrohn@medicinel.nodak.edu    |                                   |
+-----------------------------------+-----------------------------------+
| > **Susan Labuda-Schrop, MS**     | > **Ronald Labuguen, MD**         |
| >                                 | >                                 |
| > **NEON - Northeastern Ohio      | > **LANet**                       |
| > Network**                       | >                                 |
| >                                 | > Clinician/Network Committee     |
| > Network Staff                   | > Member                          |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Northeastern Ohio Universities  | > 16825 Windward Ave.             |
| > College of Medicine-Dept of     | >                                 |
| > Family Medicine                 | > Cerritos, CA 90703              |
| >                                 | >                                 |
| > 4209 State Route 44, P.O. Box   | > **Phone:** 562-924-5095         |
| > 95                              | >                                 |
| >                                 | > **E-mail:** rlabuguen@aol.com   |
| > Rootstown, OH 44272-0095        |                                   |
| >                                 |                                   |
| > **Phone:** 330-325-6769         |                                   |
| >                                 |                                   |
| > **E-mail:** sschrop@neoucom.edu |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **David Lanier, MD**            | > **Melanie Lawrence, MD**        |
| >                                 | >                                 |
| > **Agency for Healthcare         | > **Dartmouth Northern New        |
| > Research and Quality**          | > England COOP Project**          |
| >                                 | >                                 |
| > Associate Director of the       | > Network Director                |
| > Center for Primary Care,        | >                                 |
| > Prevention, and Clinical        | > **Address:**                    |
| > Partnerships                    | >                                 |
| >                                 | > Little Rivers Health Care       |
| > **Address:**                    | >                                 |
| >                                 | > PO Box 318                      |
| > 540 Gaither Road                | >                                 |
| >                                 | > Bradford, VT 05051              |
| > Rockville, MD 20850             | >                                 |
| >                                 | > **Phone:** 802-222-5562         |
| > **Phone:** 301-427-1567         | >                                 |
| >                                 | > **E-mail:**                     |
| > **E-mail:**                     | > melanie.lawrence@hitchcock.org  |
| > David.Lanier@ahrq.hhs.gov       |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **France Légaré, PhD            | > **Lisa Letourneau, MD**         |
| > [top](#top)**                   | >                                 |
| >                                 | > **Maine PINet**                 |
| > **Université Laval**            | >                                 |
| >                                 | > Network Director                |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > 10 de l\'espinay                | >                                 |
| >                                 | > MaineHealth                     |
| > Local D1 724                    | >                                 |
| >                                 | > 465 Congress St.                |
| > Quebec, Canada G1L 3L5          | >                                 |
| >                                 | > Suite 301                       |
| > **Phone:** 418-525-4437         | >                                 |
| >                                 | > Portland, ME 04101-3537         |
| > **E-mail:**                     | >                                 |
| > france.legare@mfa.ulaval.ca     | > **Phone:** 207-541-7521         |
|                                   | >                                 |
|                                   | > **E-mail:** letoul@mmc.org      |
+-----------------------------------+-----------------------------------+
| > **Barcey Levy, MD**             | > **Laura Line**                  |
| >                                 | >                                 |
| > **University of Iowa**          | > **NNCC Data Mart Network**      |
| >                                 | >                                 |
| > Affiliated Researcher           | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Dept of Family Medicine         | > NNCC                            |
| >                                 | >                                 |
| > 200 Hawkins Dr, 01292-E PFP     | > 260 S. Broad Str., 18th Fl.     |
| >                                 | >                                 |
| > Iowa City, IA 52242             | > Philadelphia, PA 19102          |
| >                                 | >                                 |
| > **Phone:** 319-384-7622         | > **Phone:** 267-765-2363         |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:** lline@nncc.us       |
| > barcey-levy@uiowa.edu           |                                   |
+-----------------------------------+-----------------------------------+
| > **Earlene Lipowski, PhD**       | > **Margaret Love, PhD**          |
| >                                 | >                                 |
| > **University of Florida**       | > **Kentucky Ambulatory Network   |
| >                                 | > (KAN)**                         |
| > **Address:**                    | >                                 |
| >                                 | > Affiliated Researcher           |
| > Box 100496                      | >                                 |
| >                                 | > **Address:**                    |
| > College of Pharmacy             | >                                 |
| >                                 | > Family and Community Medicine   |
| > University of Florida           | >                                 |
| >                                 | > K302, KY Clinic                 |
| > Gainesville, FL 32610           | >                                 |
| >                                 | > 740 S. Limestone                |
| > **Phone:** 352-273-6256         | >                                 |
| >                                 | > Lexington, KY 40536-0284        |
| > **E-mail:**                     | >                                 |
| > lipowski@cop.ufl.edu            | > **Phone:** 859-323-6747         |
|                                   | >                                 |
|                                   | > **E-mail:** mlove@email.uky.edu |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Cathy Luthman, BA**           | > **John Lynch, MPH**             |
| >                                 | >                                 |
| > **PResNet**                     | > **ProHealth**                   |
| >                                 | >                                 |
| > Network Director                | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > 4 Farm Springs Road             |
| >                                 | >                                 |
| > 699 West Drive, RR 330          | > Farmington, CT 06032            |
| >                                 | >                                 |
| > Children\'s Health Services     | > **Phone:** 860-284-5288         |
| > Research                        | >                                 |
| >                                 | > **E-mail:**                     |
| > Indianapolis, IN 46202          | > jlynch@prohealthmd.com          |
| >                                 |                                   |
| > **Phone:** 317-278-0552         |                                   |
| >                                 |                                   |
| > **E-mail:** cluthman@iupui.edu  |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Sherry Lyons, MA              | > **Gwendolyn Maddox, MSM**       |
| > [top](#top)**                   | >                                 |
| >                                 | > **AMDA Foundation Research      |
| > **Pediatric Practice Resarch    | > Network**                       |
| > Group (PPRG)**                  | >                                 |
| >                                 | > **Address:**                    |
| > Network Coordinator             | >                                 |
| >                                 | > 10480 Little Patuxent Parkway   |
| > **Address:**                    | >                                 |
| >                                 | > Suite 760                       |
| > Children\'s Memorial Hospital   | >                                 |
| >                                 | > Columbia, MD 21044              |
| > 2300 Children\'s Plaza          | >                                 |
| >                                 | > **Phone:** 410-992-3119         |
| > \# 157                          | >                                 |
| >                                 | > **E-mail:** gmaddox@amda.com    |
| > Chicago, IL 60614               |                                   |
| >                                 |                                   |
| > **Phone:** 312-573-7798         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > slyons@childrensmemorial.org    |                                   |
+-----------------------------------+-----------------------------------+
| > **Michael Magill, MD**          | > **Stacia Maher, MPH**           |
| >                                 | >                                 |
| > **Utah Health Research          | > **NYC RING**                    |
| > Network**                       | >                                 |
| >                                 | > Network Coordinator             |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > University of Utah School of    | >                                 |
| > Medicine                        | > 1300 Morris Park, Ave. Mazer    |
| >                                 | > 100                             |
| > 375 Chipeta Way                 | >                                 |
| >                                 | > Bronx, NY 10461                 |
| > Ste:A                           | >                                 |
| >                                 | > **Phone:** 718-428-3658         |
| > Salt Lake City, UT 84108        | >                                 |
| >                                 | > **E-mail:** smaher@aecom.yu.edu |
| > **Phone:** 801-581-4074         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > michael.magill@hsc.utah.edu     |                                   |
+-----------------------------------+-----------------------------------+
| > **Brian Manning, MPH**          | > **Dorothy Maxwell**             |
| >                                 | >                                 |
| > **American Academy of Family    | > **NIH**                         |
| > Physicians National Research    | >                                 |
| > Network**                       | > **Address:**                    |
| >                                 | >                                 |
| > Network Staff                   | > NIH/NIDCR/OSPA                  |
| >                                 | >                                 |
| > **Address:**                    | > 31 Center Drive                 |
| >                                 | >                                 |
| > 11400 Tomahawk Creek Parkway    | > Bldg. 31/Room 5B55              |
| >                                 | >                                 |
| > Leawood, KS 66211               | > Bethesda, MD 20892              |
| >                                 | >                                 |
| > **Phone:** 800-274-2237         | > **Phone:** 301-435-4735         |
| >                                 | >                                 |
| > **E-mail:** bmanning@aafp.org   | > **E-mail:**                     |
|                                   | > maxwelld@mail.nih.gov           |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Shelia McClure, PhD**         | > **Diane McKee, MD**             |
| >                                 | >                                 |
| > **NIH**                         | > **NYC RING**                    |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > 6701 Democracy Blvd. Room 932   | > **Address:**                    |
| >                                 | >                                 |
| > Bethesda, MD 20892-4874         | > Montefiore Medical Center       |
| >                                 | >                                 |
| > **Phone:** 301-451-6536         | > DFSM/Albert Einstein College of |
| >                                 | > Medicine                        |
| > **E-mail:**                     | >                                 |
| > mcclursh@mail.nih.gov           | > 1300 Morris Park Ave. 100 Mazer |
|                                   | >                                 |
|                                   | > Bronx, NY 10461                 |
|                                   | >                                 |
|                                   | > **Phone:** 718-430-2154         |
|                                   | >                                 |
|                                   | > **E-mail:** mckee@aecom.yu.edu  |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Isabelle Melese-d\'Hospital,  | > **Daniel Merenstein, MD**       |
| > PhD [top](#top)**               | >                                 |
| >                                 | > **CAPRICORN**                   |
| > **Children\'s National Medical  | >                                 |
| > Center**                        | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Children\'s National Medical    | > Georgetown University Hospital  |
| > Center                          | >                                 |
| >                                 | > 3750 Reservoir Road, NW         |
| > 2702 Ross Road                  | >                                 |
| >                                 | > 215 Kober Cogan Hall            |
| > Chevy Chase, MD 20815           | >                                 |
| >                                 | > Washington, DC 20007            |
| > **Phone:** 202-884-6861         | >                                 |
| >                                 | > **Phone:** 202-687-2745         |
| > **E-mail:** imelese@emscnrc.com | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > djm23@georgetown.edu            |
+-----------------------------------+-----------------------------------+
| > **David Meyers, MD**            | > **Kenneth Miller, PhD**         |
| >                                 | >                                 |
| > **Agency for Healthcare         | > **Address:**                    |
| > Research and Quality**          | >                                 |
| >                                 | > AACP                            |
| > Medical Officer, Center for     | >                                 |
| > Primary Care, Prevention, and   | > 1426 Prince Street              |
| > Clinical Partnerships           | >                                 |
| >                                 | > Alexandria, VA 22314            |
| > **Address:**                    | >                                 |
| >                                 | > **Phone:** 703-739-2330 Ext.    |
| > 540 Gaither Road                | > 1039                            |
| >                                 | >                                 |
| > Rockville, MD 20850             | > **E-mail:** kmiller@aacp.org    |
| >                                 |                                   |
| > **Phone:** 301-427-1634         |                                   |
| >                                 |                                   |
| > **E-mail:** DMeyers@ahrq.gov    |                                   |
+-----------------------------------+-----------------------------------+
| > **James Mold, MD**              | > **Jennifer Moore, RN, MS, BSN** |
| >                                 | >                                 |
| > **Oklahoma Physicians           | > **Michigan Public Health        |
| > Resource/Research Network       | > Institute**                     |
| > (OKPRN)**                       | >                                 |
| >                                 | > **Address:**                    |
| > Network Director                | >                                 |
| >                                 | > 2440 Woodlake Circle, Suite 100 |
| > **Address:**                    | >                                 |
| >                                 | > Institute for Nursing Centers   |
| > Department of Family and        | >                                 |
| > Preventive Medicine             | > Okemos, MI 48864                |
| >                                 | >                                 |
| > 900 NE 10th Street              | > **Phone:** 517-324-8390         |
| >                                 | >                                 |
| > Oklahoma City, OK 73104         | > **E-mail:** jmoore2@mphi.org    |
| >                                 |                                   |
| > **Phone:** 405-271-2370         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > james-mold@ouhsc.edu            |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Matthew Moore, B.A.**         | > **Jennifer Myers, MS**          |
| >                                 | >                                 |
| > **AANPRN**                      | > **Indiana University &          |
| >                                 | > Roudebush VA Hospital**         |
| > Network Coordinator             | >                                 |
| >                                 | > Network Director                |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > 7744 Northcross Drive           | >                                 |
| >                                 | > Department of Medicine          |
| > Apt N152                        | >                                 |
| >                                 | > 1481 W. 10th Street, HSR&D      |
| > Austin, TX 78757                | > (11H)                           |
| >                                 | >                                 |
| > **Phone:** 512-442-4262         | > Indianapolis, IN 46202          |
| >                                 | >                                 |
| > **E-mail:** mmoore@aanp.org     | > **Phone:** 317-554-0000 Ext.    |
|                                   | > 4407                            |
|                                   | >                                 |
|                                   | > **E-mail:** jsrumple@iupui.edu  |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Zsolt Nagykaldi, PhD          | > **Anne Victoria Neale PhD**     |
| > [top](#top)**                   | >                                 |
| >                                 | > **MetroNet**                    |
| > **Oklahoma Physicians           | >                                 |
| > Resource/Research Network       | > Affiliated Researcher           |
| > (OKPRN)**                       | >                                 |
| >                                 | > **Address:**                    |
| > Network Coordinator             | >                                 |
| >                                 | > 101 E. Alexandrine              |
| > **Address:**                    | >                                 |
| >                                 | > 2nd Floor                       |
| > 900 NE 10th Street              | >                                 |
| >                                 | > Detroit, MI 48201               |
| > Oklahoma City, OK 73104         | >                                 |
| >                                 | > **Phone:** 313-577-4160         |
| > **Phone:** 405-271-8000 Ext.    | >                                 |
| > 32212                           | > **E-mail:**                     |
| >                                 | > vneale@med.wayne.edu            |
| > **E-mail:** znagykal@ouhsc.edu  |                                   |
+-----------------------------------+-----------------------------------+
| > **Caitlin Oppenheimer, MPH**    | > **Haewon Park, MPH**            |
| >                                 | >                                 |
| > **PBRN Resource Center**        | > **CAPRICORN**                   |
| >                                 | >                                 |
| > Survey & Methodology Director   | > Network Coordinator             |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > NORC                            | > 3750 Reservoir Road, NW         |
| >                                 | >                                 |
| > 1350 Connecticut Ave NW         | > 220 Kober Cogan                 |
| >                                 | >                                 |
| > Ste. 500                        | > Washington, DC 20007            |
| >                                 | >                                 |
| > Washington, DC 20036            | > **Phone:** 202-687-0426         |
| >                                 | >                                 |
| > **Phone:** 202-223-6340         | > **E-mail:** hp47@georgetown.edu |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > oppenheimer-caitlin@norc.org    |                                   |
+-----------------------------------+-----------------------------------+
| > **Bennett Parnes, MD**          | > **Kevin Peterson, MD**          |
| >                                 | >                                 |
| > **CaReNet**                     | > **MAFPRN**                      |
| >                                 | >                                 |
| > Network Director                | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > UCHSC                           | > University of Minnesota         |
| >                                 | >                                 |
| > P.O. Box 6508-Mailstop F496     | > Department of Family Medicine   |
| >                                 | >                                 |
| > Aurora, CO 80045-0508           | > 925 Delaware St. SE, Suite 220  |
| >                                 | >                                 |
| > **Phone:** 303-724-9709         | > Minneapolis, MN 55414           |
| >                                 | >                                 |
| > **E-mail:**                     | > **Phone:** 612-624-3116         |
| > stephanie.mitchell@uchsc.edu    | >                                 |
|                                   | > **E-mail:** peter223@umn.edu    |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Bonita Pilon, PhD**           | > **Michelle Proser, MPP**        |
| >                                 | >                                 |
| > **Vanderbilt University**       | > **National Association of       |
| >                                 | > Community Health Centers,       |
| > **Address:**                    | > Inc.**                          |
| >                                 | >                                 |
| > Nurse Managed Centers           | > **Address:**                    |
| >                                 | >                                 |
| > Vanderbilt University School of | > 1400 Eye Street, NW, Suite 330  |
| > Nursing                         | >                                 |
| >                                 | > Washington, DC 20005            |
| > 461 21st Avenue South           | >                                 |
| >                                 | > **Phone:** 202-296-1960         |
| > Nashville, TN 37240             | >                                 |
| >                                 | > **E-mail:** mproser@nachc.com   |
| > **Phone:** 615-322-1561         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > bonnie.pilon@vanderbilt.edu     |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Jacob Prunuske, MD            | > **Fred Rachman, MD**            |
| > [top](#top)**                   | >                                 |
| >                                 | > **Address:**                    |
| > **Utah Health Research          | >                                 |
| > Network**                       | > Alliance of Chicago Community   |
| >                                 | > Health Services                 |
| > Clinician/Network Committee     | >                                 |
| > Member                          | > 1440 North Dayton St            |
| >                                 | >                                 |
| > **Address:**                    | > Suite 308                       |
| >                                 | >                                 |
| > University of Utah              | > Chicago, IL 60622               |
| >                                 | >                                 |
| > Dept. of Family & Preventive    | > **Phone:** 312-274-0068         |
| > Medicine                        | >                                 |
| >                                 | > **E-mail:**                     |
| > 375 Chipeta Way, Suite A        | > frachman@alliancechicago.org    |
| >                                 |                                   |
| > Salt Lake City, UT 84108        |                                   |
| >                                 |                                   |
| > **Phone:** 801-581-7234         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > jacob.prunuske@hsc.utah.edu     |                                   |
+-----------------------------------+-----------------------------------+
| > **Laura Failla Reilly, MSW,     | > **Sallie Rixey, MD**            |
| > MBA**                           | >                                 |
| >                                 | > **CAPRICORN**                   |
| > **New England Clinicians        | >                                 |
| > Forum**                         | > Network Director                |
| >                                 | >                                 |
| > Clinician/Network Committee     | > **Address:**                    |
| > Member                          | >                                 |
| >                                 | > Franklin Square Hospital        |
| > **Address:**                    | >                                 |
| >                                 | > 9101 Franklin Sq Drive          |
| > Holyoke Health Center           | >                                 |
| >                                 | > 205                             |
| > 230 Maple Street                | >                                 |
| >                                 | > Baltimore, MD 21237             |
| > PO Box 6260                     | >                                 |
| >                                 | > **Phone:** 443-777-2037         |
| > Holyoke, MA 01041-6260          | >                                 |
| >                                 | > **E-mail:**                     |
| > **Phone:** 413-420-2163         | > lois.garland@midstar.net        |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > laura.reilly@hhcinc.org         |                                   |
+-----------------------------------+-----------------------------------+
| > **Chartay Robinson**            | > **Mary Rodriquez**              |
| >                                 | >                                 |
| > **SouthSide Health              | > **High Plains Research          |
| > Collaborative**                 | > Network**                       |
| >                                 | >                                 |
| > Network Coordinator             | > Clinician/Network Committee     |
| >                                 | > Member                          |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > The University of Chicago       | >                                 |
| > Hospitals                       | > 311 Walnut                      |
| >                                 | >                                 |
| > 5633 South Maryland             | > Fort Morgan, CO 80701           |
| >                                 | >                                 |
| > 3rd Floor                       | > **Phone:** 970-867-9767         |
| >                                 | >                                 |
| > Chicago, IL 60637               | > **E-mail:**                     |
| >                                 | > sewgoody57@yahoo.com            |
| > **Phone:** 773-834-9770         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| >                                 |                                   |
|  chartay.robinson@uchospitals.edu |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Stephen Rothemich, MD, MS**   | > **Nancy Rothman, EdD**          |
| >                                 | >                                 |
| > **ACORN**                       | > **NNCC Data Mart Network**      |
| >                                 | >                                 |
| > Network Director                | > Affiliated Researcher           |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Virginia Commonwealth           | > Dept. of Nursing, CHP           |
| > University                      | >                                 |
| >                                 | > Temple University               |
| > P. O. Box 980251                | >                                 |
| >                                 | > 2207 N. Broad St. 602-00        |
| > 1200 E. Broad St.               | >                                 |
| >                                 | > Philadelphia, PA 19140          |
| > Richmond, VA 23298-0251         | >                                 |
| >                                 | > **Phone:** 215-707-5436         |
| > **Phone:** 804-828-9625         | >                                 |
| >                                 | > **E-mail:** rothman@temple.edu  |
| > **E-mail:** srothemich@vcu.edu  |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Alexandra Ryan, MD            | > **Jody Sachs, DPM**             |
| > [top](#top)**                   | >                                 |
| >                                 | > **NCCR/NIH**                    |
| > **Pediatric Practice Research   | >                                 |
| > Group**                         | > Network Director                |
| >                                 | >                                 |
| > Affiliated Researcher           | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > NCCR/NIH                        |
| >                                 | >                                 |
| > 2300 Children\'s Plaza          | > 6701 Democracy Blvd             |
| >                                 | >                                 |
| > Department of General Academic  | > Room 917                        |
| > Pediatrics                      | >                                 |
| >                                 | > Bethesda, MD 20892-20817        |
| > Box 16                          | >                                 |
| >                                 | > **Phone:** 301-435-0802         |
| > Chicago, IL 60614               | >                                 |
| >                                 | > **E-mail:**                     |
| > **Phone:** 773-386-6737         | > sachsjg@mail.nih.gov            |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| >                                 |                                   |
|  alexandrar@childrensmemorial.org |                                   |
+-----------------------------------+-----------------------------------+
| > **Barbara Sarter, PhD**         | > **Michael Sayre, PhD**          |
| >                                 | >                                 |
| > **LANet**                       | > **NIH Natl Ctr for Research     |
| >                                 | > Resources**                     |
| > Affiliated Researcher           | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > NIH Natl Ctr for Research       |
| > USC Dept of Family Med          | > Resources                       |
| >                                 | >                                 |
| > 1420 San Pablo Street           | > 6701 Democracy Blvd, Rm 924     |
| >                                 | >                                 |
| > PMB B-205                       | > Bethesda, MD 20892              |
| >                                 | >                                 |
| > Los Angeles, CA 90033           | > **Phone:** 301-435-0760         |
| >                                 | >                                 |
| > **Phone:** 323-442-2719         | > **E-mail:** sayrem@mail.nih.gov |
| >                                 |                                   |
| > **E-mail:** sarter@usc.edu      |                                   |
+-----------------------------------+-----------------------------------+
| > **Patricia Schafer, PhD**       | > **Eva Schaff, MD**              |
| >                                 | >                                 |
| > **Midwest Nursing Centers**     | > **PResNet**                     |
| >                                 | >                                 |
| > Affiliated Researcher           | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Kirkhof College of Nursing      | > 699 West Drive, RR 330          |
| >                                 | >                                 |
| > Grand Valley State University   | > Children\'s Health Services     |
| >                                 | > Research                        |
| > 301 Michigan St. NE             | >                                 |
| >                                 | > Indianapolis, IN 46202          |
| > Grand Rapids, MI 49503          | >                                 |
| >                                 | > **Phone:** 317-630-7389         |
| > **Phone:** 616-331-7166         | >                                 |
| >                                 | > **E-mail:** eschaff@iupui.edu   |
| > **E-mail:** schaferp@gvsu.edu   |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Abigail Schlesinger, MD**     | > **Kendra Schwartz, MD**         |
| >                                 | >                                 |
| > **CARE-NET**                    | > **MetroNet**                    |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > UPMC                            | > **Address:**                    |
| >                                 | >                                 |
| > 3811 O\'Hara Street             | > 101 E. Alexandrine              |
| >                                 | >                                 |
| > 150 Webster Hall                | > 2nd Floor                       |
| >                                 | >                                 |
| > Pittsburgh, PA 15213            | > Detroit, MI 48201               |
| >                                 | >                                 |
| > **Phone:** 412-246-5283         | > **Phone:** 313-577-4160         |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:**                     |
| > schlesingerab@upmc.edu          | > kensch@med.wayne.edu            |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Annie Sheets Mervis, MSW      | > **Donna Shelley, MD**           |
| > [top](#top)**                   | >                                 |
| >                                 | > **Columbia University           |
| > **Utah Health Research          | > Ambulatory Care Research        |
| > Network**                       | > Network**                       |
| >                                 | >                                 |
| > **Address:**                    | > Affiliated Researcher           |
| >                                 | >                                 |
| > 127 S. 500 E.                   | > **Address:**                    |
| >                                 | >                                 |
| > Suite 140                       | > 722 West 168th St               |
| >                                 | >                                 |
| > Salt Lake City, UT 84102        | > New York, NY 10032              |
| >                                 | >                                 |
| > **Phone:** 801-587-6327         | > **Phone:** 212-305-0068         |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:** drs26@columbia.edu  |
| > annie.mervis@hsc.utah.edu       |                                   |
+-----------------------------------+-----------------------------------+
| > **Nancy Short, DrPH, RN**       | > **Gurdev Singh, PhD**           |
| >                                 | >                                 |
| > **Duke University**             | > **UNYNET**                      |
| >                                 | >                                 |
| > **Address:**                    | > Affiliated Researcher           |
| >                                 | >                                 |
| > DUMC 3322                       | > **Address:**                    |
| >                                 | >                                 |
| > Duke University School of       | > Room CC155, 462 Grider Street   |
| > Nursing                         | >                                 |
| >                                 | > UB Clinical Center              |
| > Hane House 283                  | >                                 |
| >                                 | > Buffalo, NY 14215               |
| > Durham, NC 27710                | >                                 |
| >                                 | > **Phone:** 716-898-5640         |
| > **Phone:** 919-684-0368         | >                                 |
| >                                 | > **E-mail:** gsingh4@buffalo.edu |
| > **E-mail:**                     |                                   |
| > short008@mc.duke.edu            |                                   |
+-----------------------------------+-----------------------------------+
| > **Ranjit Singh, PhD**           | > **Philip Sloane, MD**           |
| >                                 | >                                 |
| > **UNYNET**                      | > **NC-FM-RN**                    |
| >                                 | >                                 |
| > Affiliated Researcher           | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Room CC 155, 462 Grider Street  | > 203 Glenview Place              |
| >                                 | >                                 |
| > UB Clinical Center              | > Chapel Hill, NC 27514           |
| >                                 | >                                 |
| > Buffalo, NY 14215               | > **Phone:** 919-966-3711         |
| >                                 | >                                 |
| > **Phone:** 716-898-5647         | > **E-mail:** psloane@med.unc.edu |
| >                                 |                                   |
| > **E-mail:** rs10@Buffalo.edu    |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Doug Smith, PhD**             | > **Annette Sokolnicki, BS**      |
| >                                 | >                                 |
| > **Community Partners HealthNet, | > **GRIN**                        |
| > Inc (CPH)**                     | >                                 |
| >                                 | > Network Coordinator             |
| > Network Director                | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > MSU/Dept of Family Practice     |
| > P.O. Box 658                    | >                                 |
| >                                 | > B106 Clinical Center            |
| > Snow Hill, NC 28580             | >                                 |
| >                                 | > East Lansing, MI 48824          |
| > **Phone:** 252-747-8162 Ext.    | >                                 |
| > 205                             | > **Phone:** 517-353-0772 Ext.421 |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:**                     |
| >                                 | > Annette.Sokolnicki@ht.msu.edu   |
| dsmith@greenecountyhealthcare.com |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Lucia Sommers, DrPH           | > **Robert Spierer, MD**          |
| > [top](#top)**                   | >                                 |
| >                                 | > **NJFMRN**                      |
| > **UCSF Collaborative Research   | >                                 |
| > Network (CRN)**                 | > Network Director                |
| >                                 | >                                 |
| > Affiliated Researcher           | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > Monroe Medical Group            |
| >                                 | >                                 |
| > 2393 Filbert Street             | > 1 World\'s Fair Drive           |
| >                                 | >                                 |
| > San Francisco, CA 94123         | > Somerset, NJ 08873              |
| >                                 | >                                 |
| > **Phone:** 415-929-8111         | > **Phone:** 732-743-3387         |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:** docbobsp@aol.com    |
| > Lucia.Sommers@ucsf.edu          |                                   |
+-----------------------------------+-----------------------------------+
| > **Mark Stephens, MD**           | > **Thomas Stewart, BA**          |
| >                                 | >                                 |
| > **USUHS**                       | > **AAFP National Research        |
| >                                 | > Network**                       |
| > **Address:**                    | >                                 |
| >                                 | > Network Coordinator             |
| > 171 Dockside Drive              | >                                 |
| >                                 | > **Address:**                    |
| > Jacksonville, NC 28546          | >                                 |
| >                                 | > 11400 Tomahawk Creek Pkwy       |
| > **Phone:** 910-450-3138         | >                                 |
| >                                 | > Leawood, KS 66211               |
| > **E-mail:** mstephens@usuhs.mil | >                                 |
|                                   | > **Phone:** 913-906-6277         |
|                                   | >                                 |
|                                   | > **E-mail:** tstewart@aafp.org   |
+-----------------------------------+-----------------------------------+
| > **Ashley Strength, BA**         | > **Stanley Sulkowski, B.S.**     |
| >                                 | >                                 |
| > **MAPPR**                       | > **HamesNet**                    |
| >                                 | >                                 |
| > Network Coordinator             | > Affiliated Researcher           |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Carolinas Medical Center        | > Medical College of Georgia      |
| >                                 | >                                 |
| > 5516 Central Ave.               | > 1120 15th Street                |
| >                                 | >                                 |
| > Charlotte, NC 28212             | > HB 2062                         |
| >                                 | >                                 |
| > **Phone:** 704-446-7757         | > Augusta, GA 30912               |
| >                                 | >                                 |
| > **E-mail:**                     | > **Phone:** 706-721-2204         |
| > ashley                          | >                                 |
| .strength@carolinashealthcare.org | > **E-mail:** SSulkowski@mcg.edu  |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Andrew Sussman, PhD**         | > **Martha Swartz, PhD**          |
| >                                 | >                                 |
| > **RIOS Net**                    | > **APRNet**                      |
| >                                 | >                                 |
| > Network Director                | > Network Coordinator             |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > University of New Mexico        | > Yale School of Nursing          |
| >                                 | >                                 |
| > MSC 09 5040                     | > 100 Church St. South            |
| >                                 | >                                 |
| > 1 University of New Mexico      | > PO Box 9740                     |
| >                                 | >                                 |
| > Albuquerque, NM 87131           | > New Haven, CT 06536-0740        |
| >                                 | >                                 |
| > **Phone:** 505-272-5646         | > **Phone:** 203-737-5432         |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:**                     |
| > asussman@salud.unm.edu          | > martha.swartz@yale.edu          |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Marguerite Swietlik, MSN,     | > **Steven Szebenyi, MD**         |
| > CRNP [top](#top)**              | >                                 |
| >                                 | > **Capital Adirondack**          |
| > **PeRC - Pediatric Research     | >                                 |
| > Consortium, The Children\'s     | > Network Director                |
| > Hospital of Philadelphia**      | >                                 |
| >                                 | > **Address:**                    |
| > Network Director                | >                                 |
| >                                 | > 30 Century Hill Drive           |
| > **Address:**                    | >                                 |
| >                                 | > Latham, NY 12110                |
| > The Children\'s Hospital of     | >                                 |
| > Philadelphia                    | > **Phone:** 518-220-4606         |
| >                                 | >                                 |
| > 3535 Market St, suite 1382      | > **E-mail:**                     |
| >                                 | > szebenyi.stev                   |
| > Philadelphia, PA 19104          | en@foundationforhealthyliving.org |
| >                                 |                                   |
| > **Phone:** 267-426-5167         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > swietlik@email.chop.edu         |                                   |
+-----------------------------------+-----------------------------------+
| > **Clare Tanner, PhD**           | > **Leslie-Faith Taub, DNSc**     |
| >                                 | >                                 |
| > **Michigan Public Health        | > **American Academy of Nurse     |
| > Institute**                     | > Practitioners PBRN**            |
| >                                 | >                                 |
| > **Address:**                    | > Affiliated Researcher           |
| >                                 | >                                 |
| > 2440 Woodlake Circle, Suite 100 | > **Address:**                    |
| >                                 | >                                 |
| > Institute for Nursing Centers   | > UMDNJ                           |
| >                                 | >                                 |
| > Okemos, MI 48864                | > 5 Brunswick Street              |
| >                                 | >                                 |
| > **Phone:** 517-324-7381         | > Staten Island, NY 10314         |
| >                                 | >                                 |
| > **E-mail:** ctanner@mphi.org    | > **Phone:** 718-761-8752         |
|                                   | >                                 |
|                                   | > **E-mail:** taublm@umdnj.edu    |
+-----------------------------------+-----------------------------------+
| > **James Taylor, MD**            | > **William Tierney, MD**         |
| >                                 | >                                 |
| > **Puget Sound Pediatric         | > **PBRN Resource Center**        |
| > Research Network**              | >                                 |
| >                                 | > Co-Director                     |
| > Network Director                | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > Indiana University              |
| > Child Health Institute          | >                                 |
| >                                 | > 1001 West 10th Street           |
| > University of Washington        | >                                 |
| >                                 | > WD OPW M200                     |
| > Box 354920                      | >                                 |
| >                                 | > Indianapolis, IN 46202          |
| > Seattle, WA 91895               | >                                 |
| >                                 | > **Phone:** 317-630-6911         |
| > **Phone:** 206-616-1206         | >                                 |
| >                                 | > **E-mail:** wtierney@iupui.edu  |
| > **E-mail:**                     |                                   |
| > uncjat@u.washington.edu         |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Tricia Trinite, NP**          | > **Carole Upshur, EdD**          |
| >                                 | >                                 |
| > **Agency for Healthcare         | > **New England Clinicians        |
| > Research and Quality**          | > Forum**                         |
| >                                 | >                                 |
| > Director, Prevention            | > Affiliated Researcher           |
| > Implementation                  | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > Dept Family Medicine            |
| > Agency for Healthcare Research  | >                                 |
| > and Quality                     | > UMass Medical School            |
| >                                 | >                                 |
| > 540 Gaither Rd                  | > 55 Lake Ave North               |
| >                                 | >                                 |
| > Gaithersburg, MD 20878          | > Worcester, MA 01655             |
| >                                 | >                                 |
| > **Phone:** 301-427-1583         | > **Phone:** 508-334-7267         |
| >                                 | >                                 |
| > **E-mail:** ttrinite@ahrq.gov   | > **E-mail:**                     |
|                                   | > carole.upshur@umassmed.edu      |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Rebecca Van Vorst, MSPH       | > **Don Vena, BS**                |
| > [top](#top)**                   | >                                 |
| >                                 | > **The PEARL Network**           |
| > **Capital Adirondack**          | >                                 |
| >                                 | > Network Coordinator             |
| > Network Coordinator             | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > 401 N Washington Street         |
| > c/o Foundation for Healthy      | >                                 |
| > Living                          | > Suite 700                       |
| >                                 | >                                 |
| > 30 Century Hill Drive           | > Rockville, MD 20850             |
| >                                 | >                                 |
| > Latham, NY 12110                | > **Phone:** 301-251-1161 Ext.    |
| >                                 | > 160                             |
| > **Phone:** 518-220-4702         | >                                 |
| >                                 | > **E-mail:** dvena@emmes.com     |
| > **E-mail:**                     |                                   |
| > vanvorst.rebec                  |                                   |
| ca@foundationforhealthyliving.org |                                   |
+-----------------------------------+-----------------------------------+
| > **Louis Vernacchio, MD**        | > **James Wallace, BA**           |
| >                                 | >                                 |
| > **SCOR Network**                | > **Oregon Rural Practice-based   |
| >                                 | > Research Network (ORPRN)**      |
| > Network Staff                   | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > OHSU                            |
| > 1010 Commonwealth Avenue        | >                                 |
| >                                 | > 3181 SW Sam Jackson Road        |
| > Boston, MA 02215-1201           | >                                 |
| >                                 | > OHSU-L222                       |
| > **Phone:** 617-734-6006         | >                                 |
| >                                 | > Portland, OR 97239              |
| > **E-mail:**                     | >                                 |
| > lvernacchio@slone.bu.edu        | > **Phone:** 971-645-5867         |
|                                   | >                                 |
|                                   | > **E-mail:** wallacej@ohsu.edu   |
+-----------------------------------+-----------------------------------+
| > **Joan Walter, JD, PA-C**       | > **Maranda Ward, MPH**           |
| >                                 | >                                 |
| > **Samueli Institute**           | > **CAPRICORN**                   |
| >                                 | >                                 |
| > **Address:**                    | > Network Staff                   |
| >                                 | >                                 |
| > 1150 Kersey Road                | > **Address:**                    |
| >                                 | >                                 |
| > Silver Spring, MD 20902         | > 3750 Reservoir Road, NW         |
| >                                 | >                                 |
| > **Phone:** 703-299-4814         | > 218 Kober Cogan Hall            |
| >                                 | >                                 |
| > **E-mail:** jwalter@siib.org    | > Washington, DC 20007            |
|                                   | >                                 |
|                                   | > **Phone:** 202-687-0925         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > mcw35@georgetown.edu            |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Michael Ward, MD**            | > **Richard Wasserman, MD**       |
| >                                 | >                                 |
| > **NIH**                         | > **PROS**                        |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > NIH Clinical Center             | > **Address:**                    |
| >                                 | >                                 |
| > NIH/NIAMS                       | > One South Prospect Street       |
| >                                 | >                                 |
| > Building 10 CRC, Room 4-1339    | > Arnold 5455                     |
| >                                 | >                                 |
| > 10 Center Drive, MSC 1468       | > Burlington, VT 05401            |
| >                                 | >                                 |
| > Rockville, MD 20892             | > **Phone:** 802-847-4611         |
| >                                 | >                                 |
| > **Phone:** 301-496-7263         | > **E-mail:**                     |
| >                                 | > richard.wasserman@uvm.edu       |
| > **E-mail:** wardm1@mail.nih.gov |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **John Wasson, MD [top](#top)** | > **James Werner, PhD**           |
| >                                 | >                                 |
| > **Dartmouth Northern New        | > **Research Association of       |
| > England COOP Project**          | > Practices (RAP)**               |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > Dartmouth Medical School        | > **Address:**                    |
| >                                 | >                                 |
| > 7265 Butler Bldg.               | > Department of Family Medicine   |
| >                                 | >                                 |
| > Dartmouth Medical School        | > Case Western Reserve University |
| >                                 | >                                 |
| > Hanover, NH 03755-3862          | > 10900 Euclid Ave.               |
| >                                 | >                                 |
| > **Phone:** 603-650-1823         | > Cleveland, OH 44106-7136        |
| >                                 | >                                 |
| > **E-mail:**                     | > **Phone:** 216-368-2996         |
| > john.h.wasson@dartmouth.edu     | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > james.werner@case.edu           |
+-----------------------------------+-----------------------------------+
| > **Robert Wesley, MA**           | > **Jack Westfall, MD**           |
| >                                 | >                                 |
| > **Southern Illinois University  | > **High Plains Research          |
| > School of Medicine**            | > Network**                       |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > Southern Illinois University,   | > **Address:**                    |
| > School of Medicine              | >                                 |
| >                                 | > PO Box 6508 MS-F496             |
| > PO Box 19604                    | >                                 |
| >                                 | > 12474 E. 19th Ave. Bldg. 402    |
| > Springfield, IL 62794-9604      | >                                 |
| >                                 | > Aurora, CO 80045                |
| > **Phone:** 217-545-5770         | >                                 |
| >                                 | > **Phone:** 303-724-9712         |
| > **E-mail:** ddow@siumed.edu     | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > jack.westfall@uchsc.edu         |
+-----------------------------------+-----------------------------------+
| > **Sharon Weyer, NP**            | > **Robert Williams, MD**         |
| >                                 | >                                 |
| > **Research Association of       | > **RIOS Net**                    |
| > Practices (RAP)**               | >                                 |
| >                                 | > Network Director                |
| > Affiliated Researcher           | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > Dept of Family and Community    |
| > 11001 Cedar Ave                 | > Medicine                        |
| >                                 | >                                 |
| > Cleveland, OH 44106-7136        | > MSC09 5040                      |
| >                                 | >                                 |
| > **Phone:** 330-336-3227         | > 1 University Of New Mexico      |
| >                                 | >                                 |
| > **E-mail:**                     | > Albuquerque, NM 87131           |
| > sharon.weyer@case.edu           | >                                 |
|                                   | > **Phone:** 505-272-2165         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > rlwilliams@salud.unm.edu        |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Steven Woolf, MD, MPH**       | > **Bonnie Yankaskas, PhD**       |
| >                                 | >                                 |
| > **ACORN**                       | > **NC AINSCO**                   |
| >                                 | >                                 |
| > Affiliated Researcher           | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Virginia Commonwealth           | > Dept Radiology                  |
| > University                      | >                                 |
| >                                 | > CB# 7515                        |
| > P. O. Box 980251                | >                                 |
| >                                 | > 106 Mason Farm Rd               |
| > 1200 E. Broad Street            | >                                 |
| >                                 | > Chapel Hill, NC 27599-7515      |
| > Richmond, VA 23298-0251         | >                                 |
| >                                 | > **Phone:** 919-966-6936         |
| > **Phone:** 804-828-9625         | >                                 |
| >                                 | > **E-mail:** bcy@med.unc.edu     |
| > **E-mail:** swoolf@vcu.edu      |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Jennifer Zaccagino, MT        | > **Atif Zafar, MD**              |
| > [top](#top)**                   | >                                 |
| >                                 | > **PBRN Resource Center**        |
| > **CAPRICORN**                   | >                                 |
| >                                 | > Information Technology          |
| > Network Staff                   | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > Indiana University              |
| > Georgetown Family Medicine      | >                                 |
| >                                 | > 1001 W. 10th Street             |
| > 3750 Reservoir Rd, NW           | >                                 |
| >                                 | > WD OPW M200                     |
| > 216 Kober Cogan                 | >                                 |
| >                                 | > Indianapolis, IN 46202          |
| > Washington, DC 20007            | >                                 |
| >                                 | > **Phone:** 317-554-0000 Ext.    |
| > **Phone:** 202-687-1275         | > 2067                            |
| >                                 | >                                 |
| > **E-mail:**                     | > **E-mail:** azafar@iupui.edu    |
| > foleyj2@georgetown.edu          |                                   |
+-----------------------------------+-----------------------------------+
| > **Suzanne Zerger, MA**          | > **Linda Zittleman, MSPH**       |
| >                                 | >                                 |
| > **National Healthcare for the   | > **High Plains Research          |
| > Homeless Council**              | > Network**                       |
| >                                 | >                                 |
| > **Address:**                    | > Network Coordinator             |
| >                                 | >                                 |
| > 915 King Street West            | > **Address:**                    |
| >                                 | >                                 |
| > Ste.308                         | > PO Box 6508 MS-F496             |
| >                                 | >                                 |
| > Toronto, ON M6K3M2              | > 12474 E. 19th Ave. Bldg. 402    |
| >                                 | >                                 |
| > **Phone:** 647-435-4616         | > Aurora, CO 80045                |
| >                                 | >                                 |
| > **E-mail:** szerger@nhchc.org   | > **Phone:** 303-724-9716         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > linda.zittleman@uchsc.edu       |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > []{#Addendum_Participants       | > **Natalie Alter**               |
| > .anchor}**Keith Allen, MD, MPH  | >                                 |
| > [top](#top)**                   | > **Agency for Healthcare         |
| >                                 | > Research and Quality**          |
| > **KUMC**                        | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > 540 Gaither Road                |
| > 3901 Rainbow Blvd               | >                                 |
| >                                 | > Rockville, MD 20850             |
| > MS 4010                         | >                                 |
| >                                 | > **Phone:** 301-427-1569         |
| > Kansas City, KS 66160           | >                                 |
| >                                 | > **E-mail:**                     |
| > **Phone:** 913-588-1956         | > natalie.alter@ahrq.hhs.gov      |
| >                                 |                                   |
| > **E-mail:** agreiner@kumc.edu   |                                   |
+-----------------------------------+-----------------------------------+
| > **Laura Anderko, PhD**          | > **John Beasley, MD**            |
| >                                 | >                                 |
| > **NCRN**                        | > **IFPCRN**                      |
| >                                 | >                                 |
| > Deputy Director                 | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > University of Wisconsin         |
| >                                 | >                                 |
| > P.O. Box 413                    | > Dept of Family Medicine         |
| >                                 | >                                 |
| > Milwaukee, WI 53201             | > 777 South Mills Street          |
| >                                 | >                                 |
| > **Phone:** 414-229-2313         | > Madison, WI  53715              |
| >                                 | >                                 |
| > **E-mail:** landerko@uwm.edu    | > **Phone:** 608-263-7373         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > jbeasley@fammed.wisc.edu        |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Christopher Bolling, MD**     | > **Dale Bratzler, DO, MPH**      |
| >                                 | >                                 |
| > **CPRG**                        | > **Oklahoma Foundation for       |
| >                                 | > Medical Quality**               |
| > Research Director               | >                                 |
| >                                 | > QIOSC Medical Director          |
| > **Address:**                    | >                                 |
| >                                 | > **Address:**                    |
| > 3333 Burnet Ave, ML 2011        | >                                 |
| >                                 | > 14000 Quail Springs Parkway,    |
| > Cinninnati Children\'s Hospital | > Suite 400                       |
| > Medical Center                  | >                                 |
| >                                 | > Oklahoma City, OK 73134         |
| > Cincinnati, OH 45229            | >                                 |
| >                                 | > **Phone:** 405-840-2891         |
| > **Phone:** 513-636-4506         | >                                 |
| >                                 | > **E-mail:**                     |
| > **E-mail:**                     | > dbratzler@okgio.sdps.org        |
| > christopher.bolling@cchmc.org   |                                   |
+-----------------------------------+-----------------------------------+
| > **Carol Cain, PhD [top](#top)** |                                   |
| >                                 |                                   |
| > **AHRQ**                        |                                   |
| >                                 |                                   |
| > **Address:**                    |                                   |
| >                                 |                                   |
| > AHRQ                            |                                   |
| >                                 |                                   |
| > 540 Gaither Rd                  |                                   |
| >                                 |                                   |
| > Rockville, MD 20850             |                                   |
| >                                 |                                   |
| > **Phone:** 301-427-1622         |                                   |
| >                                 |                                   |
| > **E-mail:** ccain@ahrq.gov      |                                   |
+-----------------------------------+-----------------------------------+
| > **Walter Calmbach, MD**         | > **Barbara Cohen, MPA**          |
| >                                 | >                                 |
| > **STARNet**                     | > **CMS**                         |
| >                                 | >                                 |
| > Network Director                | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > 7500 Security Blvd              |
| >                                 | >                                 |
| > University of Texas Health      | > Baltimore, MD 21244             |
| > Science Center                  | >                                 |
| >                                 | > **Phone:** 410-786-4457         |
| > Family & Community Medicine     | >                                 |
| >                                 | > **E-mail:**                     |
| > 7703 Floyd Curl Dr, Mail Code   | > barbara.cohen@cms.hhs.gov       |
| > 7794                            |                                   |
| >                                 |                                   |
| > San Antonio, TX 78229-3900      |                                   |
| >                                 |                                   |
| > **Phone:** 210-567-4550         |                                   |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > calmbach@uthscsa.edu            |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Lisa Cooper, MD**             | > **Renee Crichlow, MD**          |
| >                                 | >                                 |
| > **Johns Hopkins University**    | > **Frontier Rural Research       |
| >                                 | > Network (FRRN)**                |
| > PBRN RC Steering Committee      | >                                 |
| > Member                          | > Network Director                |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Johns Hopkins                   | > Montana Family Practice         |
| >                                 | > Residency Program               |
| > 2024 East Monument St           | >                                 |
| >                                 | > 123 S 27^th^ St Suite B         |
| > Baltimore, MD 21205             | >                                 |
| >                                 | > Billings, MT 59101              |
| > **Phone:** 410-614-3659         | >                                 |
| >                                 | > **Phone:** 406-247-3306         |
| > **E-mail:**                     | >                                 |
| > lisa.cooper@jhmi.edu            | > **E-mail:**                     |
|                                   | > reneec4@u.washington.edu        |
+-----------------------------------+-----------------------------------+
| > **William Curry, MD             | **Marge Degnon**                  |
| > [top](#top)**                   |                                   |
| >                                 | > **CORNET**                      |
| > **FPBRN**                       | >                                 |
| >                                 | > APA Exec Dir                    |
| > Affiliated Researcher           | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > 6728 Old McLean Village Drive   |
| > Penn State College of Medicine  | >                                 |
| >                                 | > McLean, VA 22102                |
| > F & C Medicine H154             | >                                 |
| >                                 | > **Phone:** 703-556-9222         |
| > 500 University Drive, PO Box    | >                                 |
| > 850                             | > **Email:** marge@ambpeds.org    |
| >                                 |                                   |
| > Hershey, PA 17033-0850          |                                   |
| >                                 |                                   |
| > **Phone:** 717-531-8736         |                                   |
| >                                 |                                   |
| > **E-mail:** wcurry@psu.edu      |                                   |
+-----------------------------------+-----------------------------------+
| > **Nui Dhepyasuwan, MEd**        | > **Leslie Dunne, MPA**           |
| >                                 | >                                 |
| > **CORNET**                      | > **Address:**                    |
| >                                 | >                                 |
| > Network Coordinator             | > Society of General Internal     |
| >                                 | > Medicine                        |
| > **Address:**                    | >                                 |
| >                                 | > 2501 M. Street NW, Suite 575    |
| > 6728 Old McLean Village Drive   | >                                 |
| >                                 | > Washington, DC 20037            |
| > McLean, VA 22102                | >                                 |
|                                   | > **Phone:** 202-887-5150         |
| **Phone:** 703-556-9222           | >                                 |
|                                   | > **E-mail:** dunnel@sgim.org     |
| **E-mail:** nui@ambpeds.org       |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Susan Feigelman, MD**         | > **Lee Hargraves, PhD**          |
| >                                 | >                                 |
| > **CORNET**                      | > **UMass Medical School**        |
| >                                 | >                                 |
| > Affiliated Researcher           | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > UMass Medical School            |
| >                                 | >                                 |
| > University of Maryland          | > 30 Birch Drive                  |
| >                                 | >                                 |
| > 3720 Birchmere Court            | > Sterling, MA 01564              |
| >                                 | >                                 |
| > Owings Mills, MD 21117          | > **Phone:** 508-334-2082         |
| >                                 | >                                 |
| > **Phone:** 410-706-5289         | > **E-mail:**                     |
| >                                 | > lee.hargraves@hotmail.com       |
| > **E-mail:**                     |                                   |
| > sfeigelm@umaryland.edu          |                                   |
+-----------------------------------+-----------------------------------+
| > **Janie Heath, PhD              | > **Kathleen Kendrick, RN, MS,    |
| > [top](#top)**                   | > CS**                            |
| >                                 | >                                 |
| > **Georgetown University**       | > **AHRQ**                        |
| >                                 | >                                 |
| > Network Director                | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > 540 Gaither Road, Suite 3000    |
| >                                 | >                                 |
| > Georgetown University           | > Rockville, MD 20850             |
| >                                 | >                                 |
| > 1810 Duffield Lane              | > **Phone:** 301-427-1200         |
| >                                 | >                                 |
| > Alexandria, VA 22307            | > **E-mail:**                     |
| >                                 | > kathleen.kendrick@ahrq.hhs.gov  |
| > **Phone:** 202-687-7321         |                                   |
| >                                 |                                   |
| > **E-mail:** ejh@georgetown.edu  |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Robert Klutts, MPH**          | > **Bruce Leclair, MD**           |
| >                                 | >                                 |
| > **Southern Illinois Healthcare  | > **HamesNet**                    |
| > Foundation**                    | >                                 |
| >                                 | > Medical Director                |
| > Network Director                | >                                 |
| >                                 | > **Address:**                    |
| > **Address:**                    | >                                 |
| >                                 | > 1120 15th Street                |
| > 100 North 8th Street, Suite 256 | >                                 |
| >                                 | > HB-3030                         |
| > East St. Louis, IL 62201        | >                                 |
| >                                 | > Augusta, GA 30912               |
| > **Phone:** 618-874-8276         | >                                 |
| >                                 | > **Phone:** 706-721-0936         |
| > **E-mail:**                     | >                                 |
| > <rklutts@touchette.org>         | > **E-mail:** <bleclair@mcg.edu>  |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Carmela Lomonaco, PhD**       | > **Tess Miller, DrPH**           |
| >                                 | >                                 |
| > **SRCD/AAAS**                   | > **AHRQ**                        |
| >                                 | >                                 |
| > Executive Branch Fellow         | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > 540 Gaither Road                |
| >                                 | >                                 |
| > **Phone:**                      | > Rockville, MD 20850             |
| >                                 | >                                 |
| > **E-mail:**                     | > **Phone:** 301-427-1585         |
| > m                               | >                                 |
| scarmelagoes2washington@gmail.com | > **E-mail:**                     |
|                                   | > therese.miller@ahrq.hhs.gov     |
+-----------------------------------+-----------------------------------+
| > **Nancy Min, PhD [top](#top)**  | > **Matthew Moore, BA**           |
| >                                 | >                                 |
| > **University of Maryland**      | > **AANPNR**                      |
| >                                 | >                                 |
| > Principal Investigator          | > Network Coordinator             |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > University of Maryland Center   | > 7744 Northcross Drive           |
| > for Integrative Medicine        | >                                 |
| >                                 | > Apt N152                        |
| > 2200 Kernan Drive, The Mansion  | >                                 |
| >                                 | > Austin, TX 78757                |
| > Baltimore, MD 21207             | >                                 |
| >                                 | > **Phone:** 512-442-4262         |
| > **Phone:** 410-448-6493         | >                                 |
| >                                 | > **E-mail:** mmoore@aanp.org     |
| > **E-mail:**                     |                                   |
| > nmin@compmed.umm.edu            |                                   |
+-----------------------------------+-----------------------------------+
| > **Philip Morin, MS**            | > **Charles Mouton, MD, MS**      |
| >                                 | >                                 |
| > **IDEATel**                     | > **DC PrimCare**                 |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > Research Foundation SUNY        | > **Address:**                    |
| >                                 | >                                 |
| > SUNY Upstate Med. U.            | > Howard University College of    |
| >                                 | > Medicine                        |
| > 750 East Adams St.              | >                                 |
| >                                 | > 520 W. Street, NW               |
| > CWB 353                         | >                                 |
| >                                 | > Rm 2400                         |
| > Syracuse, NY 13210              | >                                 |
| >                                 | > Washington, DC 20059            |
| > **Phone:** 315-464-5729         | >                                 |
| >                                 | > **Phone:** 202-806-6300         |
| > **E-mail:** pmorin@norwich.net  | >                                 |
|                                   | > **E-mail:** cmouton@howard.edu  |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Charlotte Mullican, MPH**     | > **John Pascoe, MD, MPH**        |
| >                                 | >                                 |
| > **AHRQ**                        | > **Dayton Primary Care PBRN**    |
| >                                 | >                                 |
| > **Address:**                    | > Network Director                |
| >                                 | >                                 |
| > AHRQ Center for Primary Care,   | > **Address:**                    |
| > Prevention, and Clinical        | >                                 |
| > Partnerships                    | > Childrens Medical Center of     |
| >                                 | > Dayton                          |
| > 540 Gaither Road, Suite 6129    | >                                 |
| >                                 | > One Children\'s Plaza           |
| > Rockville, MD 20850             | >                                 |
| >                                 | > Dayton, OH 45404-1815           |
| > **Phone:** 301-427-1495         | >                                 |
| >                                 | > **Phone:** 937-641-3277         |
| > **E-mail:**                     | >                                 |
| > charlotte.mullican@ahrq.hhs.gov | > **E-mail:**                     |
|                                   | > john.pascoe@wright.edu          |
+-----------------------------------+-----------------------------------+
| > **Harold Perl, PhD**            | > **Amir Qaseem, MD, PhD, MHA**   |
| >                                 | >                                 |
| > **NIH**                         | > **American College of           |
| >                                 | > Physicians**                    |
| > **Address:**                    | >                                 |
| >                                 | > Director                        |
| > 6001 Executive Blvd             | >                                 |
| >                                 | > **Address:**                    |
| > Mas 9557                        | >                                 |
| >                                 | > 190 N. Independence Mall West   |
| > Bethesda, MD 20892-9557         | >                                 |
| >                                 | > Philadelphia, PA 19106          |
| > **Phone:** 301-443-9982         | >                                 |
| >                                 | > **Phone:** 215-351-2570         |
| > **E-mail:** hperl@mail.nih.gov  | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > aqaseem@acponline.org           |
+-----------------------------------+-----------------------------------+
| > **Michelle Roett, MD            | > **George Rust, MD, MPH**        |
| > [top](#top)**                   | >                                 |
| >                                 | > **Morehouse School of           |
| > **Georgetown University**       | > Medicine**                      |
| >                                 | >                                 |
| > **Address:**                    | > Health Disparities Panel        |
| >                                 | > Speaker                         |
| > Georgetown University           | >                                 |
| >                                 | > **Address:**                    |
| > 3028 Spice Bush Road            | >                                 |
| >                                 | > 720 Westview Drive              |
| > Laurel, MD 20724                | >                                 |
| >                                 | > NCPC 301                        |
| > **Phone:** 202-297-6189         | >                                 |
| >                                 | > Atlanta, GA 30310               |
| > **E-mail:**                     |                                   |
| > michelleroett@hotmail.com       | **Phone:** 404-756-5740           |
|                                   |                                   |
|                                   | > **E-mail:** grust@msam.edu      |
+-----------------------------------+-----------------------------------+
| > **Jody Sachs, DPM**             | > **Peggy Sleichter, RN**         |
| >                                 | >                                 |
| > **NCRR/NIH**                    | > **BUMED**                       |
| >                                 | >                                 |
| > Network Director                | > **Address:**                    |
| >                                 | >                                 |
| > **Address:**                    | > Bureau of Medicine and Surgery  |
| >                                 | > (BUMED)                         |
| > NCCR/NIH                        | >                                 |
| >                                 | > 9634 Nuthatch Dr                |
| > 6701 Democracy Blvd             | >                                 |
| >                                 | > Fairfax Station, VA 22039-3368  |
| > Room 917                        | >                                 |
| >                                 | > **Phone:** 202-762-3020         |
| > Bethesda, MD 20892-20817        | >                                 |
| >                                 | > **E-mail:**                     |
| > **Phone:** 301-435-0802         | > pmsleichter@us.med.navy.mil     |
| >                                 |                                   |
| > **E-mail:**                     |                                   |
| > sachsjg@mail.nih.gov            |                                   |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Vincenza Snow, MD**           | > **Sandy Specht, PhD**           |
| >                                 | >                                 |
| > **ACPNet**                      | > **Dayton Primary Care           |
| >                                 | > Practice-Based Research         |
| > Affiliated Researcher           | > Network**                       |
| >                                 | >                                 |
| > **Address:**                    | > Network Coordinator             |
| >                                 | >                                 |
| > 190 North Independence Mall     | > **Address:**                    |
| > West                            | >                                 |
| >                                 | > The Children\'s Medical Center  |
| > Philadelphia, PA 19106          | > of Dayton                       |
| >                                 | >                                 |
| > **Phone:**                      | > 508 Towncrest Drive             |
| >                                 | >                                 |
| > **E-mail:**                     | > Beavercreek, OH 45434           |
| > vincenza@acponline.org          | >                                 |
|                                   | > **Phone:** 937-641-4225         |
|                                   | >                                 |
|                                   | > **E-mail:**                     |
|                                   | > spechts@childrensdayton.org     |
+-----------------------------------+-----------------------------------+

+-----------------------------------+-----------------------------------+
| > **Joseph Stanford, MD, MSPH**   | > **Anne Trontell, MD, MPH**      |
| >                                 | >                                 |
| > **University of Utah**          | > **AHRQ**                        |
| >                                 | >                                 |
| > **Address:**                    | > **Address:**                    |
| >                                 | >                                 |
| > Div. of Epidemiology,           | > AHRQ COE                        |
| > Biostatistics, and Prevention   | >                                 |
| >                                 | > Room 6325                       |
| > NIH                             | >                                 |
| >                                 | > 540 Gaither Road                |
| > 9000 Rockville Pike             | >                                 |
| >                                 | > Rockville, MD 20850             |
| > Bethesda, MD 20892              | >                                 |
| >                                 | > **Phone:** 301-427-1607         |
| > **E-mail:**                     | >                                 |
| > sachsjg@mail.nih.gov            | > **E-mail:**                     |
|                                   | > anne.trontell@ahrq.hhs.gov      |
+-----------------------------------+-----------------------------------+

[]{#General_Information .anchor}

**General Information** **[top](#top)**

+-----------------------------------------------------------------------+
| The PBRN registration desk is located on the lobby level outside the  |
| Congressional Ballroom. Registration/Information Desk hours are as    |
| follows:                                                              |
|                                                                       |
| MONDAY, May 15 12:00 pm -- 5:00 pm                                    |
|                                                                       |
| TUESDAY, May 16 7:00 am -- 5:30 pm                                    |
|                                                                       |
| WEDNESDAY, May 17 7:30 am -- 3:00 pm                                  |
|                                                                       |
| **SPEAKER READY ROOM**                                                |
|                                                                       |
| The speaker ready room is located in the Chesapeake Room which is on  |
| the lobby level. Speakers should report to the speaker ready room at  |
| least two hours in advance of their session to ensure adequate time   |
| for loading presentations onto the specific meeting room laptop       |
| computers.                                                            |
|                                                                       |
| Hours for the speaker ready room are the same as for                  |
| registration/information as listed above.                             |
|                                                                       |
| **SESSIONS**                                                          |
|                                                                       |
| General sessions will be held in the Congressional Ballroom. Breakout |
| sessions will be held in the three (3) separate sections of the       |
| Congressional Ballroom (Congressional Salon 1, Congressional Salon 2, |
| and Congressional Salon 3) and the Pooks Hill/Kensington Room. All    |
| meeting space is located on the Lobby Level of the Bethesda Marriott. |
|                                                                       |
| **POSTER BOARD SESSIONS AND POSTER RECEPTION**                        |
|                                                                       |
| Poster board sessions and the poster reception on Monday evening will |
| be held in the Maryland Suite.                                        |
|                                                                       |
| **MEALS**                                                             |
|                                                                       |
| Luncheons on Tuesday and Wednesday will be served in the Grand        |
| Ballroom. There is a charge for the Luncheon Meal Package. Please     |
| inquire at the conference registration desk if you desire to purchase |
| the Meal Package once you are on-site.                                |
|                                                                       |
| Continental breakfast, morning and afternoon breaks, and the poster   |
| reception are open to everyone, and we urge you to attend. There is   |
| no charge associated with these specific food and beverage functions. |
+-----------------------------------------------------------------------+

[]{#Workplans .anchor}***Personal Workplan: Monday*** [top](#top)

**Workshop Session I:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**Workshop Session II:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**Workshop Session III:**

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***Personal Workplan: Tuesday:***

**Opening Remarks:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**PBRN Resource Center Update:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**PBRNs at the Interface of Research and Quality:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**Concurrent Session I**

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**Networking Lunch:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**PBRNs and Health Disparities Research::**

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**Concurrent Session II:::**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**Concurrent Session III:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**Additional Notes:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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***Personal Workplan: Wednesday***

**Concurrent Session IV:**

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

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**PBRNs and the NIH Roadmap Initiative:**

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**Networking Lunch:**

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**Funders' Fair:**

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**Wrap-Up:**

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**Additional Notes:**

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[]{#Presenter_Disclosure .anchor}**Presenter Disclosures**
[**top**](#top)

+-----------------------------------+-----------------------------------+
| The following speakers, session   |                                   |
| facilitators, and workshop        |                                   |
| moderators disclosed no actual or |                                   |
| potential conflict of interest in |                                   |
| regard to this program:           |                                   |
+-----------------------------------+-----------------------------------+
| Alan Adelman, MD, MS              | Steven Rothemich, MD, MS          |
|                                   |                                   |
| Laura Anderko, RN, PhD            | Barbara Sarter, PhD               |
|                                   |                                   |
| Christopher Bolling, MD           | Gurdev Singh, PhD                 |
|                                   |                                   |
| Dale Bratzler, DO                 | Philip Sloane, MD, MPH            |
|                                   |                                   |
| Lisa Cooper, MD, MPH              | Lucia Sommers, DrPH               |
|                                   |                                   |
| William Curry, MD, MS             | Tom Stewart, MD                   |
|                                   |                                   |
| Kelly Devers, PhD                 | William Tierney, MD               |
|                                   |                                   |
| Miriam Dickerson, PhD             | Louis Vernacchio, MD, MS          |
|                                   |                                   |
| Lyle Fagnan, MD                   | James Wallace                     |
|                                   |                                   |
| Eugene Farley, MD                 | Mort Wasserman, MD, MPH           |
|                                   |                                   |
| Janet Firshein                    | John Wasson, MD                   |
|                                   |                                   |
| Samuel Forjuoh, MD                | John Westfall, MD                 |
|                                   |                                   |
| Cecelia Gaffney, MEd              | Robert Williams, MD, MPH          |
|                                   |                                   |
| Dan Gaylin, MPA                   | Atif Zafar, MD                    |
|                                   |                                   |
| Michael Grasmick, PhD             | Linda Zittleman, MSPH             |
|                                   |                                   |
| K. Allen Greiner, MD, MPH         | John T. Lynch has disclosed that  |
|                                   | he is a paid employee of Pro      |
| Robert Haggerty, MD               | Health Physicians, INC.           |
|                                   |                                   |
| Margaret Handley, PhD             |                                   |
|                                   |                                   |
| John Hickner, MD, MSc             |                                   |
|                                   |                                   |
| Finie Hunter, MPH                 |                                   |
|                                   |                                   |
| Aimee James, PhD, MPH             |                                   |
|                                   |                                   |
| Deborah Johnson                   |                                   |
|                                   |                                   |
| Abel Kho, MD                      |                                   |
|                                   |                                   |
| Alex Krist, MD                    |                                   |
|                                   |                                   |
| Grace Kuo, PharmD                 |                                   |
|                                   |                                   |
| France Legare, MD, PhD            |                                   |
|                                   |                                   |
| Barcey Levy, MD, PhD              |                                   |
|                                   |                                   |
| Carmela Lomonaco, PhD             |                                   |
|                                   |                                   |
| Linda Loranger                    |                                   |
|                                   |                                   |
| Margaret Love, PhD                |                                   |
|                                   |                                   |
| Mary Ellen McCann                 |                                   |
|                                   |                                   |
| Diane McKee MD, MS                |                                   |
|                                   |                                   |
| David Meyers, MD                  |                                   |
|                                   |                                   |
| James Mold, MD, MPH               |                                   |
|                                   |                                   |
| Charles P. Mouton, MD, MS         |                                   |
|                                   |                                   |
| Zsolt Nagykaldi, PhD              |                                   |
|                                   |                                   |
| Victoria Neale, PhD               |                                   |
|                                   |                                   |
| Michael O'Grady, PhD              |                                   |
|                                   |                                   |
| Benett Parnes, MD                 |                                   |
|                                   |                                   |
| John Pascoe, MD                   |                                   |
|                                   |                                   |
| Kevin Peterson, MD, MPH           |                                   |
|                                   |                                   |
| Jacob Prunuske, MD                |                                   |
|                                   |                                   |
| Steven Rothemich, MD, MS          |                                   |
+-----------------------------------+-----------------------------------+