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Northwestern University Clinical and Translational Sciences Institute CommunityEngaged Research Cent

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On CBPR and PBR topics. One held so far. Kushner on Chronic Care Model. Will occur ... Some Examples of Adult PBR Research at NU- Thanks to Dave Baker. UPQUAL: ... – PowerPoint PPT presentation

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Title: Northwestern University Clinical and Translational Sciences Institute CommunityEngaged Research Cent


1
Northwestern University Clinical and
Translational Sciences Institute
Community-Engaged Research Center
  • Katherine Kaufer Christoffel, MD, MPH
  • Director, Community-Engaged Research Center
  • Jen Kauper-Brown, MPH
  • Co-Director, Community-Based Participatory
    Research Program
  • March 12, 2008

2
Statement on Conflicts of Interest
  • We have no conflicts to declare.

3
(No Transcript)
4
Our Mission
The Community-Engaged Research Center is
committed to improving community health by
facilitating collaborative research partnerships
that include Chicago-area organizations,
community-based clinicians and Northwestern
University academic partners.
5
Starting Points for NUCATS Work With Community
  • To understand improve health
  • Must work in community setting, where people live
  • Resident health influences include
  • Health care of community residents
  • Life outside the health care system
  • Points of contact with residents include
  • Primary care settings
  • Non health care delivery settings
  • Churches, schools, prisons

6
CERC Organization
NUCATS Administration
NU Community Engagement Council
  • Other NUCATS Centers
  • Translational Innovation
  • Clinical Research
  • Biomedical Informatics
  • Clinical Research Education

Community-Engaged Research Center (CERC)
CERC External Advisory Committee
Practice-Based Research Program
Community-Based Participatory Research Program
7
CERC Programs and Activities
  • Programs
  • Practice-Based Research Program
  • Community-Based Participatory Research Program
  • Activities
  • Northwestern University Community Engagement
    Council
  • Seminar Series
  • Visiting Professorships
  • Research Workshops
  • Seed Grants

8
Northwestern University Community Engagement
Council
  • Open to anyone who works at NU on anything
    related to community
  • Faculty, trainees, staff
  • Information sharing, maybe more
  • Quarterly meetings
  • Has met once so far
  • Next meeting in April

9
Education
  • Seminar series
  • On CBPR and PBR topics
  • One held so far
  • Kushner on Chronic Care Model
  • Will occur q 1-2 months
  • Visiting Professorships
  • None scheduled yet

10
Research Workshops
  • Designed for
  • Faculty, fellows, others
  • Community physicians
  • Community organizations
  • More than one of the above
  • So far
  • CBPR for community orgs (Jen will discuss)
  • Geospatial analysis 3/14 at CNT
  • Others in planning stages

11
Seed Grants
  • Goals
  • Support community-campus relationship building
  • Collect pilot data
  • Upcoming calls for proposals soon
  • PBR
  • CBPR

12
PBRP
13
Why PBR?
  • Primary Care pts
  • Unselected, common conditions
  • Range of severity
  • Avoid Berksons Bias re chronic conditions
  • Pts stop coming to the mecca
  • Unique research topics, e.g.,
  • Delivery of primary care
  • Preventive care, chronic disease management
  • Primary care pts and provider characteristics
  • Educational needs of primary care pts

14
Practice-Based Research Program
NU Clinical and Translational Researchers
  • Other NUCATS Elements
  • Regulatory Support
  • Biomedical informatics
  • Career Development
  • Clinical Research Center

CERC
Helen Binns, MD, MPH and Adolfo Ariza,
MD Interim Co-Directors

Practice-Based Research Program
Executive Director Practice-Based Research Program
REACH/NMH Hospital Network David Baker, MD, MPH,
Director
Evanston Northwestern Healthcare Network Thomas
Gavagan, MD Director
Pediatric Practice Research Group Helen Binns,
MD, MPH, Director
Practice
Practice
Practice
Practice
Practice
Practice
Practice
Practice
Research projects are encouraged between practice
networks
15
Some Examples of Adult PBR Research at NU-Thanks
to Dave Baker
16
UPQUAL Utilizing Precision Performance
Measurement to Improve Quality
  • Develop test new EMR tools to help MDs order
    recommended tests or meds
  • Allow easy documentation of reasons for not
    ordering tests or prescribing meds
  • Improve quality measurement
  • ID of pts w gaps in care for outreach
  • Being conducted in two of our PBRNs

17
Documentation of Patient Reasons Used to Improve
Care
  • Information recorded by MD is automatically sent
    to care manager
  • i.e., Patient declines care (e.g., cancer
    screening, vaccination)
  • Care manager provide further education and
    outreach if physician desires
  • i.e., Patient cannot afford care
  • Care manager contacts patient to find ways to
    afford care (eg, free med programs)

18
UPQUAL Study Sites and Team
  • REACH NMFF GIM clinic
  • (NMFF) Dave Baker, Steve Persell, Nancy Dolan
  • (IT) Darren Kaiser, Dale Sanders, Jason Thompson
  • ENH 2 FM and 2 IM clinics
  • (IM) Janu Khandekar
  • (FM) Russell Robertson, Tom Gavagan,
  • (IT) Tom Smith, Steve Smith, Sue Levi

19
Pediatric Practice Research Group
Examples-Thanks to Helen Binns and Adolfo Ariza
20
Seconds for Care Frequency of Discussions
  • Healthy Families Healthy Children Study
  • N185, 2-10 y
  • 6 practices
  • Well child visits
  • Events and actions timed by observers on handheld
    computers

Martin et al, J Pediatr 2008, in press
21
Seconds for Care Time on Topic
Martin L, et al, J Pediatr 2008, in press
22
Typical Pediatric Visit Observation of Visit
Content
  • Children 2-10 years
  • 4 practices
  • Well child visits
  • n174 visits with child ?5th BMI percentile
  • Events and actions timed by observers collecting
    data on handheld computers

Ariza et al. PPRG
23
Typical Pediatric Visit Observation of Visit
Seconds by Content
Seconds
60
Ariza et al. PPRG
24
CBPR-P
25
Background
  • Why CBPR?
  • What is CBPR?- definition, principles, spectrum
    of engagement
  • Benefits of CBPR
  • Description of NU CBPR Program
  • Resources/opportunities for academic partners

26
Why are we here?
  • Persistence of health disparities
  • Limitations of current research approaches
  • Growing appreciation of the value of
    partnerships, Community engaged research movement
  • Greater demand by communities for equity and
    research relevance

27
Defining Community-Based Participatory Research
(CBPR)
  • A collaborative approach to research that
    equitably involves all partners in the research
    process and recognizes the unique strengths that
    each brings.  CBPR begins with a research topic
    of importance to the community and has the aim of
    combining knowledge with action and achieving
    social change...
  • W K Kellogg Community Health Scholars Program

28
CBPR Key Principles
  • Recognizes community as a unit of identity
  • Builds on strengths resources within community
  • Facilitates collaboration in all phases of
    research
  • Integrates knowledge action for mutual benefit
    of all partners

Israel BA, EngE, Schulz AJ, and Parker EA eds.
(2005) Methods in community-based participatory
research for health. Jossey-Bass San Francisco,
CA.
29
CBPR Key Principles (contd)
  • Promotes co-learning empowering process
  • Involves a cyclical and iterative process
  • Addresses health from positive ecological
    perspectives
  • Disseminates findings knowledge gained to all
    partners

Israel BA, EngE, Schulz AJ, and Parker EA eds.
(2005) Methods in community-based participatory
research for health. Jossey-Bass San Francisco,
CA.
30
What is the difference?
  • Traditional
  • PI-generated/ initiated
  • Research on
  • PI in control
  • Limited sharing of resources
  • Researcher is expert
  • Project ends when data are analyzed
  • CBPR
  • Collaboratively generated/designed
  • Research with
  • Shared governance/ ownership
  • Shared resources/
  • Honors comm knowledge
  • Makes sure what is learned is used

31
Benefits/Value Added of CBPR Approach
  • Enhances relevance and quality of data
  • Strengthens intervention design/implementation,
    Recruitment and Retention
  • Knowledge gained/interventions/resources benefit
    community
  • Increases trust between partners
  • Potential to translate findings to guide further
    interventions policy change

32
Growing Legitimacy Current Reality
  • Increasing funding, diversity of study,
    publishing, training/resources
  • But
  • Predominant model NOT partnership
  • Relationships based on individuals/funding
  • Communities realizing their power
  • Big differences btwn mature early partnerships

33
CBPR Case Example Detroit Urban Research Center
Project Community Action Against Asthma Goal To
understand and address environmental triggers of
childhood asthma Funder NIEHS Partners
Multiple CBOs, community members at large,
Detroit Health Dept, Henry Ford Health System,
UM-Schools of Medicine Public Health
http//www.sph.umich.edu/urc/
34
CAAA Background/ Research Components
  • Epidemiological Outdoor air quality _at_ community
    schools, indoor at schools/ house-holds, health
    outcome data for enrolled children
  • Household-level intervention Home visits w/
    edn- staggered randomized design. Household
    assessment/questionnaires w/caregivers kids
  • Neighborhood-level intervention Community
    organizing w/residents to reduce
    neighborhood-level environmental stressors

35
CAAA Partnership Components
  • Formation/Mobilization
  • Identifying the Problem
  • Research Design and Project Start-up
  • Implementation
  • Recruitment of Participants Development of Data
    Collection Methods
  • Baseline Data Collection Intervention
    Implementation
  • Ongoing evaluation/reflection/sustainability

36
CBPR Program _at_ NU
  • Goal Supports promotes engaged research
    between Chicago community organizations and
    Northwestern academic partners that respects
    community input and builds upon strengths of
    involving community partners in all aspects of
    research
  • Long-term relationships with community groups
  • Lead to action/improvements in health
  • Programs goals/objectives jointly defined by
    steering committee  

37
CBPR-P Steering Committee
38
CBPR-P Activities/ Programs
  • Seed Grants- 1st RFP in March
  • Partnership building
  • CBPR implementation
  • Capacity Building/Training
  • For NU faculty/staff/students and community
    partners
  • Collaborative research partnerships, Basics of
    Research, Methods, Dissemination
  • Partnership Facilitation
  • Networking events, Individual brokering

39
CBPR-P Activities/ Programs
  • Info Clearinghouse
  • Website, CERC Connections newsletter
  • Technical Assistance
  • Proposal preparation
  • Partnership design/support
  • Community Networkers
  • Liaisons for bi-directional communication

40
Resources _at_ www.ccph.info
  • Online Clearinghouse Sample CBPR course syllabi,
    publications, related projects/events
  • CBPR Partnership Curriculum
  • Faculty Promotion and Tenure Tools Online
    toolkit for faculty, sample policies
  • IRB Resources
  • CBPR, PT, Ethics/IRB Listservs

41
CERC Contact Information
  • CERC
  • Michelle Melin-Rogovin
  • m-melin-rogovin_at_northwestern.edu
  • 312-503-5050
  • CBPR Questions
  • Jen Kauper-Brown
  • j-kauper-brown_at_northwestern.edu
  • 312-503-2942
  • http//www.nucats.northwestern.edu/centers/cerc/in
    dex.html
  • Located in Rubloff moving to 11th floor in May
    2008
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