Grants Awarded 2011

December 2011

GHRI recently received word of seven new awards.

Activating Patients to Reduce Osteoporosis  PrOpenSity (APROPOS)

A five-year, $261,328 grant from National Institutes  of Health. Major Goals: The Global Longitudinal Registry of Osteoporosis in  Women (GLOW) is an international prospective, longitudinal, observational study  of women 55 years of age and older, at risk for fracture. To use existing GLOW  participants (those with a prior fracture) in the United States not receiving  osteoporosis therapy to test a tailored direct-to-patient intervention to  increase the judicious use of anti-osteoporosis medication and bone mineral  density testing in this application: "Activating Patients to Reduce  OsteoPorOsis (APROPOS). The GHRI lead investigator is Andrea Z. LaCroix.

Adaptive Leadership Evaluation

 A  two-year, $150,000 grant from Group Health Foundation. Major Goals: To promote  an adaptive leadership style among physician leaders at Group Health at all  levels and to substantially increase their leadership skills in engaging their  teams in co-evolving processes, tactics, and directions that produce adaptive  successes in their relevant fields and contexts. The principal investigator is Robert  J. Reid.

ALL Cross-Site Evaluation Design

A  one-month, $25,000 grant from Kaiser Foundation Health Plan. Major Goals: To document  population clinical outcomes including, enrollment, clinical outcomes and  medication/treatment adherence; to document findings and make recommendations  for strengthening implementation and data capture processes among the grantees  (resulting in the foundation of a proposal for 2012 work) and to disseminate  results to key audiences. The principal investigator is Allen Cheadle.

Bariatric Surgery's Return on  Investment for Veterans and Veterans Health Administration

A three-year, $120,000 grant from Veterans Administration  (VA) Health Services Research & Development. Major Goals: To compare weight  change and resolution of diabetes, hypertension, hyperlipidemia, long-term  survival, and trends in VA health care utilization and VA expenditures between  veterans who had bariatric surgery and a matched cohort of severely obese  veterans who did not have bariatric surgery in 2000-2012. The GHRI lead  investigator is David E. Arterburn.

e-Communications and Improving Hypertension Control in  Community Practice—e-CHIP: Hispanics’ Use of Information Technology and  Electronic Communications

A four-month, $2,931 grant from Group Health  Research Institute Development Fund. Major Goal: To determine the ability of Hispanic  patients to participate in the e-CHIP intervention that includes Web-based  communications with a pharmacist. The principal investigator is Beverly B.  Green.

Efforts to Develop the Sentinel Initiative: Case  Identification, Validation, and Adjudication of Severe Liver Injury

A  one-year, $7,733 grant from the Food and Drug Administration. Major Goals:  Detection and analysis of adverse events related to regulated products in automated  health care data. To develop the sentinel initiative. The GHRI lead  investigator is Denise M. Boudreau.

Kaiser Permanente Specialty Care Initiative Evaluation  (Years 4 & 5)

A two-year, $156,790 grant from Kaiser Foundation  Hospitals Southern California Region. Major Goals: This joint evaluation of  California HealthCare Foundation and Kaiser Permanente initiatives to improve  access to specialty care seeks to answer three questions: How successful is the  overall initiative in improving access to specialty services in California? Which  strategies appear to be the most successful? Has the initiative created  stronger, sustainable coalitions? The principal investigator is Allen  Cheadle.

November 2011

GHRI recently received word of fifteen new awards.

Breast Cancer Surveillance Consortium (BCSC) Data  Resource—BCSC portion

A five-year, $7,455,058 contract from National  Cancer Institute. Major goals: To maintain the current high standards of the BCSC  database with no interruption in service to the scientific community. We will  continue to be a resource to the research community, providing scientific and  statistical expertise and conducting high-quality statistical analyses to advance  breast cancer research. We will expand outreach and dissemination, so that more  investigators are aware of this valuable resource and use it for their  research. We will develop new electronic interfaces and publicly available  datasets that meet the highest possible standards for caBIG compatibility to  facilitate efficient sharing of BCSC data and expand potential for  collaboration, increasing the value of this resource to the broader research  community. Our ultimate aim is to facilitate research that improves breast  cancer screening and reduces cancer burden and mortality. The principal  investigator is Diana L. Miglioretti.

Efforts to Develop the Sentinel Initiative—Signal Refinement  of a New Molecular Entity, Asenapine

A three-month, $21,444 grant  from the Food and Drug Administration. Major Goals: To develop a protocol for a  one-time evaluation of the association of Asenapine with severe  hypersensitivity reactions using Mini-Sentinel data sources. The GHRI lead  investigator is Andrea J. Cook.

Evaluation of National Applied Public Health Leadership  Training Program

A one-year, $50,000 grant from the CDC. Major  Goals: As a part of CDC's recent funding of multiple Community Transformation  Grants, an additional grant was made to the Public Health Institute (PHI) in Oakland, California  to develop and operate a National Applied Public Health Leadership Training  Program. PHI has contracted with GHRI's Center for Community Health and  Evaluation to join the program's leadership team and to design and implement an  evaluation of the program's efforts. The goals of the evaluation are to provide  information to improve the program and to assess its progress and success in  training four-person teams from 20 of the funded communities. The GHRI lead  investigator is William L. Beery.

Group Health Community Needs Assessment

A  six-month, $38,519 grant from Group Health Cooperative. Major Goals: To assess  existing community needs assessments in Group Health's service area. To conduct  needs assessment for Group Health, including primary and secondary data collection  and analysis, and report on findings. The principal investigator is William  L. Beery.

Institute for Translational Health Science (UL1)—Primer  Research Toolkit, Enhancement and Sustainability

A  one-year, $262,827 grant from National   Center for Research  Resources. Major Goals: (1) Conduct a formal evaluation of the  ResearchToolkit.org web site, including review of para-data (web hits, pages  viewed, most/least download pages) and user surveys. (2) Based on the evaluation,  feedback gathered in the process of disseminating the toolkit, and emergent  products from the CE KFC members, develop and post new content that is  responsive to the needs of our target audiences, including resources specific  to community-based members. (3) Review and refresh existing content to ensure  that resources are still vital and pertinent, and the associated hyperlinks are  functional. The GHRI lead investigator is Sarah M. Greene.

Regional Evaluation for Kaiser Permanente Mid Atlantic State Community Health Initiative

A two-year,  $148,024 grant from Kaiser Foundation Health Plans Mid-Atlantic States. Major  Goals: The GHRI Center for Community Health and Evaluation (CCHE) will provide  evaluation services to help Kaiser Permanente Mid-Atlantic States Community  Benefit achieve the goals of the Healthy Eating Active Living Community Health  Initiative. In summary, CCHE will: Manage the contract with MayaTech Corporation,  the local evaluation firm, to ensure the evaluation services and deliverables  are high quality and meet the needs of Kaiser Permanente and the communities; document  intermediate and long-term outcomes at both the strategy and community-level,  including reach, strength, dose, sustainability, and impact; support data  collection activities (photovoice, population surveys); provide formative  feedback for program improvement; and disseminate results to key audiences. The  principal investigator is Allen Cheadle.

Risk-Based Breast Cancer Screening in Community Settings

A  five-year, $19,092,335 grant from the National Cancer Institute. There are seven  projects within this PO1:

• Core B—GH Registry: Major Goals: The Group Health Research Institute       mammography registry will provide common data elements to the Biostatistical Data Management Core, which provides centralized coordination of data collection, management, and analysis. Our primary goals are to collect high-quality common data elements from risk factors ascertainment through cancer outcomes. The principal investigator is Diana L. Miglioretti. The GHRI lead investigator is Diana Buist.
• Risk-Based Breast Cancer Screening in Community Settings—Administrative Core: Major Goals: The Administrative Core will coordinate logistics and finances, develop effective communication strategies for collecting data, and establish mechanisms to encourage and facilitate data sharing with non-program investigators. The principal investigator is Diana L. Miglioretti.
• Risk-Based Breast Cancer Screening in Community Settings: Biostatistical Data       Management (BDM) Core: Major Goals: The BDM Core will provide centralized coordination of data collection, management, and analysis. Our primary goals are ensuring consistency across projects and providing appropriate resources to all investigators. Increases in efficiency will be achieved by the use of common datasets and by having a common data management and analytic team supporting all projects. The principal       investigator is Diana L. Miglioretti.
• Risk-Based Breast Cancer Screening in Community Settings—Comparative Effectiveness (CE) Core: Major Goals: The CE Core brings together specialized       multidisciplinary expertise and established population modeling groups in  a centralized resource to efficiently support the comparative effectiveness aims of all three projects. The principal investigator is Diana L. Miglioretti.
• Risk-Based Breast Cancer Screening in Community Settings—Project 1: Major       Goals: To improve prediction of breast cancer and breast cancer subtypes among women of varying age and race/ethnicity and to evaluate whether predicted risk can be used to optimize screening outcomes. The principal investigator is Diana L. Miglioretti.
• Risk-Based Breast Cancer Screening in Community Settings—Project 2: Major Goals: To identify appropriate screening modalities and strategies to optimize early detection of breast cancer. The principal investigator is Diana L. Miglioretti.
• Risk-Based Breast Cancer Screening in Community Settings—Project 3: Major Goals: To understand whether advanced screening technologies are reaching diverse groups       in the community and to identify determinants of access based on a woman’s individual risk. The principal investigator is Diana L. Miglioretti.

Studying Colorectal Cancer Effectiveness of Screening Strategies (SuCCESS)

A five-year, $2,540,015 grant from National Cancer  Institute. Major Goals: Provide the backbone of our SuCCESS PROSPR Research Center  (PCR), facilitating communication between projects and between the SuCCESS PCR  and the PROSPR Statistical Coordinating Center (SCC), facilitating trans-network activities, and providing administrative support across projects. Study the  comparative effectiveness of different screening mechanisms for colorectal cancer (CRC), including patient preferences, adherence to regimens, and  provider variability that impact effectiveness. Create an adenoma registry and  use this to examine adenoma characteristics, effectiveness of surveillance given adenoma characteristics, and differences in adenoma characteristics by  age, gender, and adenoma location. The principal investigator is Carolyn M.  Rutter.

Survival by Molecular Subtype in the Absence of Screening  and Treatment (DR 189)

A one-year, $9,996 grant from Georgetown University.  Major Goals: To estimate breast cancer survival by molecular subtype (ER/HER2)  in the absence of screening. Use Breast Cancer Surveillance Consortiaum data to  sample from a conditional multinomial distribution of the probability of being  ER+/HER2+, ER+/HER2-, ER-/HER2+, or ER-/HER- conditioned on age and tumor stage  (local, regional, distant), stratified by mode of detection (screen-detected,  interval between screening examinations or symptomatically if never screened)  and screening pattern (annual, biennial, irregular, no screening). The GHRI  lead investigator is Diana L. Miglioretti.

October 2011

GHRI recently received word of twelve new awards.

Efforts to Develop the Sentinel Initiative: Infrastructure Year 3

A one-year, $357,939 grant from the Food and Drug  Administration (FDA). Major Goals: Participate in FDA Mini-Sentinel Data Core  activities and workgroups as well as lead such activities on behalf of the  non-Kaiser HMORN sites. The goal of Mini-Sentinel is to use automated health care data to evaluate medical product safety. The GHRI lead investigator is Denise  M. Boudreau.

Feasibility of Studying Adverse Events Associated with  Bisphosphonate Use

A two-month, $4,704 grant from Food and Drug Administration. Major Goals: To determine the feasibility of studying the  association between bisphosphonate exposure and the risks of (1) Atypical  subtrochanteric and diaphyseal femoral fractures and; (2) Esophageal cancer. The  GHRI lead investigator is Denise M. Boudreau.

HEAL Zones Initiative Evaluation

A  four-year, $1,662,955 grant from Kaiser Foundation Hospitals. Major Goals: To  document intermediate and long-term outcomes at both the strategy and  community-level, including reach, strength, dose, sustainability, and impact. To  provide formative feedback for program improvement. To disseminate results to  key audiences. The principal investigator is Allen Cheadle.

Heath Risk Assessment Using Real-Time Clinical Data

A  two-year, $328,000 grant from National Institute on Aging. Major Goals:  Advances in health information technology significantly improve our ability to  identify population based health status and clinical need through more  accurate, timely, and clinically relevant measures. We propose to develop and  test a risk assessment model that uses real-time clinical data from an  electronic medical record. We will test the hypothesis that the ability to  assess population risk using clinical expressions of medical need will be more  accurate than measures derived purely from diagnostic or pharmacy data and be  more relevant in guiding clinical practice. The principal investigator is Paul  A. Fishman.

Identification of Severe Cutaneous Reactions and Genomic  Risk Factors in Users of Anti-epileptic Drugs

A  one-year, $67,171 grant from Food and Drug Administration. Major Goals: To use  the electronic health records covering a substantial proportion of the United States  population to identify severe, potentially life-threatening cutaneous reactions  among users of anti-epileptic medication. We will also demonstrate the  feasibility and outline the steps needed for a large-scale pharmacogenomic  study of these drug-related adverse events. The GHRI lead investigator is Robert  Penfold.

Kaiser Tamoxifen and Mammographic Density Study

A  one-year, $31,048 grant from National Cancer Institute. Major Goals: To  estimate the association between reduction inmammographic density (between  pre-treatment mammograms and mammograms taken 10 to 18 months after initiating  tamoxifen therapy.

Modeling Breast Cancer Recurrence Using New Statistical  Methods for Semi-Markov Processes

A three-year, $237,219 grant  from National Cancer Institute. Major Goals: The major goals of this research  are to develop statistical methods for estimation of Semi-Markov processes and  to use this novel approach to model rates of and risk factors for breast cancer  recurrence. We will use data from the Breast Cancer Surveillance Consortium to  compare performance of our proposed statistical methods to existing methods and  to estimate effects of modifiable factors on the risk of breast cancer  recurrence. The GHRI lead investigator is Rebecca Hubbard.

Online Biopsychosocial Assessment and Intervention for  Alcohol Misuse

A one-year, $43,797 grant from National Institute  of Alcohol Abuse and Alcoholism. Major Goals: To evaluate online patient  assessment systems including how to present the results to patient’s medical  providers in a useful manner. The GHRI lead investigator is Katharine A.  Bradley.

Population Based Descriptive Study Characterizing Tibial  Diaphyseal Fractures

A two-year, $287,778 grant from AMGEN. Major Goals:  Identify a representative sample of tibial shaft fractures using a combination  of IDC-9-CM codes and NLP, which is useful for mining valuable, research-grade  information from clinical text in EMR. Characterize tibial shaft fractures according  to patient demographics, comorbidities, fracture severity (Gustilo  classification), treatment (types of fixation used), and healing complications  (nonunion, malunion, revision surgeries). The principal investigator is Leslie  Spangler.

Risk of Non-Hodgkin's Lymphoma in Relation to Tricyclic  Antidepressant Use

A one-year, $80,000 grant from National Cancer  Institute. Major Goals: To assess the association between use of tricyclic  antidepressants, overall and grouped by duration, dose, recency, and type, with  the risk of non-Hodgkin's lymphoma (NHL); to assess whether the association, if  any, differs by NHL subtype. The principal investigator is Jessica Chubak.

Systemic Sulfonamide Use During Pregnancy and the Risk of  Selected Congenital Abnormalities in the Offspring

A  two-year, $139,898 grant from Food and Drug Administration. Major Goals: To  measure the association between exposure to sulfonamides during pregnancy and  congenital abnormalities in the offspring. To maintain all data, data linkages,  standardized datasets, and organizational structure, created in the MEPREP  pilot program. To evaluate the efficiency of conducting in-depth  epidemiological studies using data, data linkages, standardized datasets, and  organizational structure created by the Medication Exposure in Pregnancy Risk  Evaluation Program (MEPREP) pilot program. The principal investigator is Sascha  Dublin.

Using the Primary Care Workforce More Effectively

A  five-month, $149,989 contract from the Robert Wood Johnson Foundation. Major  Goals: To identify and carefully study high functioning primary care sites with  interesting team models and use of staff. What we learn from them will be used  to construct a toolkit that can then be tested in Phase II of this work in  learning communities of primary care sites involved in practice transformation.  The principal investigator is Edward H. Wagner.

September 2011

GHRI recently received word of nine new awards.

Breast Cancer Surveillance Consortium Data Resource

A  five-year, $7,820,497 grant from the National Cancer Institute. Major Goals: To  maintain the current high standards of the Breast Cancer Surveillance  Consortium (BCSC) database with no interruption in service to the scientific  community. To continue to be a resource to the research community, providing  scientific and statistical expertise and conducting high-quality statistical  analyses to advance breast cancer research. To expand outreach and  dissemination, so that more investigators are aware of this valuable resource and  use it for their research. To develop new electronic interfaces and publicly  available datasets that meet the highest possible standards for caBIG  compatibility. To support the BCSC Steering Committee, facilitating efficient  sharing of BCSC data and expand potential for collaboration, increasing its  value to the broader research community. Our ultimate aim is to facilitate  research that improves breast cancer screening and reduces cancer burden and  mortality. The principal investigator is Diana L. Miglioretti.

Community Health Initiative National Cross-site Phase II  Evaluation

A four-year, $1,493,534 grant from Kaiser Foundation  Health Plan. Major Goals: To conduct a national cross-site evaluation of phase  II of Kaiser Permanente's Community Health Initiative. The principal  investigator is Allen Cheadle.

Comparative Effectiveness of Pre-operative Breast MRI on  Surgery and Outcomes

A five-year, $1,112,160 grant from the National  Cancer Institute. Major Goals: To use the linkage of the Breast Cancer  Surveillance Consortium (BCSC) with Medicare claims data to examine pre-operative  breast MRI influence on surgical treatment approaches among breast cancer  patients, specifically those with mastectomy and breast-conserving surgery. The  GHRI lead investigator is Rebecca Hubbard.

Comparison of CAM and Conventional Mind-Body Therapies for  Chronic Back Pain

A four-year, $3,059,547 grant from National Center for Complementary and Alternative  Medicine. Major Goals: (1) To determine if Mindfulness-Based Stress Reduction  (MBSR) is an effective adjunct to usual care for persons with chronic back  pain. (2) To compare the effectiveness of MBSR and group Cognitive-Behavioral  Therapy (CBT) in decreasing pain-related functional limitations and pain  bothersomeness. (3) To identify the mediators of any observed effects of MBSR  and group CBT on pain-related functional limitations and pain bothersomeness.  The principal investigator is Daniel C. Cherkin.

Enhancing Family-Based Behavioral Pediatric Obesity Treatment via Social Networks

A two-year, $434,284 grant from  National Heart, Lung, and Blood Institute. Major Goals: This exploratory pilot  project addresses the failure of pediatric obesity treatment to lead to  sustained health behavior change and capitalizes on parents' naturally  occurring social networks to create a more supportive social environment for  weight management. The major goals of the project are: To develop a Social  Network Engagement (SNE) Intervention that will be integrated into a standard  treatment program for childhood overweight, and to conduct a pilot trial of SNE  to assess its feasibility and take steps toward a full-scale evaluation. The  principal investigator is Paula Lozano.

Evaluation of Group Health's Integrated Care and Facility Design Initiative

A five-month, $46,955 grant from Group Health  Foundation. Major Goals: The principal investigator is Robert J. Reid.

Genetic Discovery and Application in a Clinical Setting—Continuing  a Partnership

A four-year, $3,202,373 grant from National Human  Genome Research Institute. Major Goals: The Seattle e-MERGE project aims to  bring personal genomics to practice settings by taking advantage of the  extensive electronic medical record (EMR) and biorepository of Group Health  Cooperative, including a 33-year pharmacy database and longitudinal data on an  aging population. The principal investigator is Eric B. Larson.

Kentucky Oral Health Coalition Training

A two-month, $10,000 grant from Barren River  District Health Department. Major Goals: To provide an evaluation training to the  24 coalitions participating in the Kentucky Oral Health Project. The principal  investigator is Maggie Jones.

Modeling Vaccination Strategies for Serogroup A  Meningococcal Disease in Africa

A  five-month, $50,253 grant from CDC. Major Goals: To adapt an existing model for  Haemophilus influenzae type b (Hib) to Neisseria meningitidis serogroup A  (MenA); the model will then be used to predict the effects of various MenA  vaccination strategies in Africa. The GHRI lead investigator is Michael  Jackson.

August 2011

GHRI recently received word of thirteen new awards.

Annual Estimates of Influenza Vaccine Effectiveness for  Preventing Laboratory-Confirmed Influenza in the United States

A  five-year, $3,924,899 grant from CDC. Major Goals: Assess influenza vaccine  effectiveness in preventing laboratory-confirmed influenza infections among  children and adults with medically attended acute respiratory illness who  present for care in outpatient, urgent care, or emergency department settings.  The principal investigator is Lisa A. Jackson.

Bariatric Randomized Controlled Trial Feasibility Study

A  five-month, $80,000 grant from Group Health Research Institute Development  Fund. Major Goals: (1) Explore the feasibility for creating a cohort of  patients with Type II Diabetes undergoing gastric bypass or medical/lifestyle  intervention; (2) Examine utility of aforementioned cohort and resources  required for eventual full-scale trial execution and retention; (3) Examine a  sample subset for related metrics for future clinical trials. The principal  investigator is David E. Arterburn.

Campaign to Address Parental Vaccine Hesitancy—Parent  Evaluation

A five-year, $494,091 grant from the Group Health  Foundation. Major Goals: Develop a social marketing campaign that will be  designed to activate parents to be more aware of vaccination rates in their  communities and communicate positive messages about vaccination. The principal  investigator is Clarissa Hsu.

Campaign to Address Parental Vaccine Hesitancy—Provider  Evaluation of a Randomized Controlled Trial

A three-year, $1,198,557  grant from Group Health Foundation. Major Goals: Address vaccine hesitancy in Washington State by developing a training toolkit  for pediatric and family-practice providers to ensure they are able to address  parents’ concerns about vaccinating their children. The principal investigator  is David C. Grossman.

Creating a National Patient-Centered Medical Home (PCMH) Curriculum:  Diffusion of the Safety Net Medical Home Initiative

A  two-year, $233,380 grant from Commonwealth Fund. Major Goals: (1) To develop a  National Curriculum for quality coaches to teach the elements of the Patient  Centered Medical Home to Federally Qualified Health Centers. This will be built  on the work of the Safety Net Medical Home Initiative, utilizing the eight core  change concepts developed by that program. (2) To create a partnership with the  National Association of Community Health Centers, who will be launching a learning  institute to train leading federally qualified Health centers in the principles  of the PCMH. The principal investigator is Edward H. Wagner.

Development of a Group Health Disparities Report

A  five-month, $79,992 grant from Group Health Cooperative. Major Goals: To  develop a race, ethnicity, and language preference disparities report for Group  Health. The project will increase the scope of the current disparities analyses  to include pediatric members and to include measures of patient experiences  with care. The specific aims of the project are: To extend the current analyses  of disparities to include pediatric members, language preferences, and  patient-reported outcomes; and to conduct stratified analyses of disparities  using variables identified as key by quality of care leaders. The outcome of  this project will be a prototype disparities report for Group Health that can  serve as a tool for monitoring disparities over time and to guide future  efforts to reduce disparities in quality of care. The principal investigator is Leo S. Morales.

Evaluating Innovative Weight-Reduction Strategies for College Students

A three-year, $69,234 grant from National Institutes of  Health. Major Goals: To develop and test a protocol for creating social  networks to support healthy weight behaviors in college students. The GHRI lead  investigator is Paula Lozano.

Evaluation of Group Health's Integrated Care and Facility  Design Initiative

A one-year, $112,214 grant from Group Health Primary  Care Funds. Major Goals: To assess the impact of the integrated facility and  process redesign on patient experience, including patient reports of their  access (including wait times), interactions/connections with care teams,  privacy and confidentiality, whole-person orientation, coordination, safety,  and satisfaction with care. To assess the impact of facility redesign on  medical team functioning (including the core medical home processes),  productivity, burnout, and work satisfaction. To assess the impact of facility  and process redesign on personnel costs (e.g., costs related to time spent  traveling and searching, batching and queuing, rework), and on costs related to  inventory, transportation, and material management. To describe, and assess the  3P transformation process. The principal investigator is Robert J. Reid.

Evaluation Support and Provision of Technical Assistance

A  one-year, $210,000 grant from Foundation for a Healthy Kentucky. Major Goals:  Refine logic models, evaluation questions, and indicators for each of the four  initiatives being evaluated. Convene national advisory committee of experts to  help guide the evaluation. Increase capacity in Kentucky to conduct community-based  evaluation for future initiatives. Provide technical assistance to grantees to  build capacity for self-evaluation. The principal investigator is William L.  Beery.

REACH (Racial and Ethnic Approaches to Community Health)  Across the United States

A four-month, $10,000 grant from CDC. Major Goals: The mission of the  REACH coalition is to eliminate diabetes-related disparities among African  Americans, Asian Americans, Pacific Islanders, and Latinos/Hispanics living in King County.  REACH US provides training and technical assistance to community-based  organizations, clinics, faith-based organizations, and community groups on its  culturally tailored diabetes education and self-management curricula (REACH  model). The principal investigator is Allen Cheadle.

Shared Decision Making Demonstration Project

A  one-year, $17,620 grant from Foundation For Informed Medical Decision Making  Inc., Major Goals: (1) To develop and maintain an evidence-based decision  support tool for morbidly obese patients considering bariatric surgery as a  method of promoting weight loss. (2) To serve as a reviewer for  HealthNewsReview.org. The principal investigator is David E. Arterburn.

Systems of Support (SOS) to Increase Colon Cancer Screening and Follow-Up

A  two-year, $582,930 grant from the National Cancer Institute. Major Goals:  Primary outcomes will be to compare effectiveness and cost-effectiveness of  each study condition. Analyses will be done at the patient level. Secondary  outcomes will include the quantitative results of the meta-analysis (overall,  and by subgroups of types of screening interventions, colorectal cancer  screening rates at the clinic level (by study participants and non-study  patients age eligible for screening and these combined), and a qualitative  assessment of the participatory process of designing and implementing clinic  interventions. Additionally, based on our overall outcomes of the parent grant,  year-3, and year-4 interventions, we will begin with our Cancer Prevention and  Control Research Network, Cancer Research Network, and state of Washington  State Colorectal Task Forces partners to develop a manual of effective  strategies to increase colorectal cancer screening and to plan further studies  for translating these into community practice. The principal investigator is Beverly  B. Green.

The Association between Sedative Hypnotic Insomnia Treatments and Motor Vehicle Crashes

A five-month, $11,686 grant from  University of Washington. Major Goals: To examine the  association between specific sleep agents and motor vehicle accidents by  linking Group Health automated data with Washington State  motor vehicle accidents via secure transmission. The principal investigator is Denise  M. Boudreau.

July 2011

GHRI recently received word of five new awards.

AHRQ 2012 Large Conference Grant—HMORN

A  two-year, $138,560 grant from the Agency for Healthcare Research and Quality.  Major Goals: To obtain funding to support 2012 and 2013 HMORN Annual  Conferences. The principal investigator is Katherine M. Newton.

Breast Cancer Detection Pathways—Understanding Imagery  Utilization in the Diagnosis of Breast Cancer Screening through to Biopsy

A  nine-month, $26,869 grant from GE Healthcare. Major Goals: To describe  alternative diagnostic imaging pathways women follow when they have a positive  screening mammogram or present with signs or symptoms consistent with breast  cancer. Using Breast Cancer Surveillance Consortia data, we will analyze the  use of imaging modalities and biopsy in the diagnostic work-up of suspected  breast cancer and will compare diagnostic outcomes between work-up pathways.  The principal investigator is Rebecca Hubbard.

Institutional and Translational Science Award  (UL1)—Eastern Washington Survey

A one-year, $62,227 grant from National Center for Research Resources. Major  Goals: To survey health and health care needs of Group Health members living in  Eastern Washington. The GHRI lead investigator  is Eric B. Larson.

Mini-Sentinel Task Order: Signal Refinement of Angioedema Events in Association with Use of Drugs that Act on the Renin-Angiotensin-Aldosterone System

A seven-month, $4,219 grant from  the Food and Drug Administration. Major Goals: To implement the distributed SAS  programs, review results of each program in consultation with the Mini-Sentinel Operations Center, and help troubleshoot site-specific problems that may arise. The GHRI lead  investigator is Denise M. Boudreau.

Spatiotemporal Spread of Newer Antipsychotics for Bipolar Disorder and PTSD

A three-year, $91,027 grant from National Institute  of Mental Health. Major Goals: Identify space-time cluster analysis that describes the spread of prescribing of second generation antipsychotics (SGAs) for two serious mental illnesses of high cost and priority to the Veterans Health Administration: bipolar disorder and Post Traumatic Stress Disorder. The  principal investigator is Robert Penfold.

June 2011

GHRI recently received word of nine new awards.

Assessing and Improving Mammography (AIM 2)

A one-year, $101,287 grant from American Cancer Society. Major Goals: To assess and improve mammography (AIM) project aims to help radiologists better read screening mammograms. We will look carefully at factors that affect how accurately they read mammograms. For instance, we want to see whether the United States  should increase the number of mammograms a radiologist must read each year to qualify to read mammograms. We also want to make a test set that can identify radiologists who might benefit from more training. Last, we will create and compare an in-person and a DVD training coursework. The principal investigator  is Diana S. Buist.

Assessing and Improving Mammography (AIM 2)

A one-year, $291,628 grant from American Cancer Society. Major Goals: (1) To examine whether the association between interpretive volume (screening, diagnostic, and total) and screening performance is modified whether or not radiologists work-up findings they recalled based on the initial screening exam. (2) To conduct an Angoff criterion-setting meeting with 10 expert radiologists to identify thresholds for identifying poor diagnostic mammography sensitivity, specificity, recall rate, PPV1, PPV2, and cancer detection rate. (3)  To examine the effect of interventions (live instructor led vs. self-paced DVD) on recall rates. The principal investigator is Diana L. Miglioretti.

Evaluation  of three Kaiser Permanente Southern California Community Benefit Initiatives

A one-year, $145,507 grant from Kaiser Foundation Hospitals Southern California Region. Major Goals: To design and  conduct evaluation of Kaiser Permanente Southern California's HEAL Zones  initiative. The principal investigator is Allen Cheadle.

Evaluation of three Kaiser Permanente Southern California Community Benefit Initiatives

A three-year, $291,462 grant from Kaiser Foundation Hospitals Southern California Region. Major Goals: (1) Document the intermediate and long-term outcomes of patients participating in the ALL  (Aspirin, Lisinopril, and Lovastin) program. (2) Document the clinic level systems changes among health centers participating in the ALL program. (3) Document  the processes, successes, and challenges of the ALL HEART initiative. (4)  Provide formative feedback for program improvement. (5) Disseminate results to key audiences. The principal investigator is Allen Cheadle.

Food Environment, Diet Quality, and Disparities in Obesity II

A five-year, $122,310 grant from  National Institute of Diabetes and Digestive and Kidney Diseases. Major Goals: (1)  To determine the relative impact of socioeconomic position (SEP) variables, access to food sources, and diet quality and diet cost on prevalent obesity. A  secondary aim will be to determine the relative impact of SEP, food access, and diet quality and cost on weight gain over an 18-month period. (2) To assess how access to different food sources and food prices affect food purchases and diet quality across SEP strata, with special attention to  lower-income groups. One hypothesis is that food-store choice and distance traveled to food sources will depend on SEP. Another is that SEP, food prices, and retail store choice will influence diet quality. Multivariate regression models will assess the relative contribution of store proximity versus price to diet quality measures. Similar analyses will be conducted for foods consumed away from home. These analyses will help build the primary model of disparities  outlined in Aim 1. (3) To compare self-report data obtained through interviews  and surveys to objective measures. Self reports of food shopping and restaurant destinations, and food-place logs will be compared to GPS traces over 1 week.  Food expenditure reports will be compared to food and restaurants receipts and  to scanner data. Individual level estimates of diet cost will be generated  based on three 24-hour food recalls and food-frequency questionnaire data, both  linked with local supermarket food prices. Self reports of SEP variables will  be compared to residential property values. The GHRI lead investigator is Andrea  J. Cook.

Health Profile Comparative Effectiveness

A two-month, $5,800 grant from University of Washington.  Major Goals: To determine the use of the Health Profile among enrollees who have a primary care physician within Group Health versus a primary care  physician within the network. The principal investigator is Karen Wernli.

Healthcare Georgia Foundation Evaluation Resource Center Phase II

A two-year, $379,667 grant from Healthcare Georgia Foundation. Major Goals: Implementation of evaluation capacity-building program at Healthcare Georgia Foundation. The principal investigator is William L. Beery.

Two California Convergence Case Studies

A  seven-month, $24,274 grant from The California Endowment. The Partnership for the Public's Health (funded by The California Endowment) is procuring the production of two descriptive case studies on the California Convergence. The  principal investigator is Allen Cheadle.

Validating a Childhood Vaccine Registry

A three-month, $13,974 grant from Group Health Foundation. Major Goals: To evaluate Washington State's CHILD Profile immunization  Registry (CPIR) as a potential source of data for use in public health research. We will assess the completeness and validity of key data elements in  the CPIR, such as dates of vaccination, vaccine antigens, and vaccine provider details. To assess the accuracy of CPIR data by linking CPIR records for Group Health enrollees with Group Health's own immunization records and determining the agreement between these two data sources. The principal investigator is David C. Grossman.

May 2011

GHRI recently received word of seven new awards.

Collaborative Care for Primary Care Patients with Alcohol Use Disorders

A five-year, $3,235,606 grant from the National  Institute of Alcohol Abuse and Alcoholism. Major Goals: The study will offer patients with alcohol misuse a patient-centered intervention including the  efficacious treatments for severe alcohol misuse (medications and/or monitoring  medical conditions) to evaluate whether collaborative care improves outcomes  for patients with severe alcohol misuse or alcohol use disorders who are not willing to enter specialized treatment. The team-based intervention will involve repeated visits with a nurse trained in motivational interviewing who  will work collaboratively with patients’ primary care physicians and a team of addiction medicine consultants to provide patients with individualized  treatment. The principal investigator is Katharine A. Bradley.

Effectiveness of Health Care System Outreach for Breast Cancer Screening

A two-year, $469,998 grant from the American Cancer Society. Major Goals: (1) Compare the effectiveness of person-centered birthday-reminder letters to mammogram-specific reminder letters on adherence to breast cancer screening recommendations among an insured population of women, ages 40-74; (2)  Examine the effect of the time between receipt of the reminder letter and due date for breast cancer screening on adherence to screening recommendations among an insured population of women, ages 40-74. The principal investigator is Diana S. Buist.

Friend to Friend–Colorectal Cancer Screening Discussions among Members of Social Networks (Cancer Research Network Across Health Care Systems)

A one-year grant from National Cancer Institute. Major Goals: To explore the feasibility and acceptability of electronic cancer screening message transmission between members of a social network (1) to learn more about and describe existing practices surrounding friend-to-friend and within-family discussions of colorectal cancer screening through interviews with participants  at Fallon/Meyers, Kaiser Permanente Hawaii and Kaiser Permanente Georgia; (2) to identify potential barriers to communication about colorectal cancer screening  in friend-to-friend and with-family networks; (3) to determine participant's preferences for (a) message content and (b) mode of transmission (e.g. in person, e-mail, social networking sites, etc.) when discussing colorectal cancer screening. Findings from this pilot study will provide a strong foundation for the development of an intervention testing the effectiveness of electronic friend-to-friend colorectal cancer screening messages in older adults. The principal investigator is Edward H. Wagner.

Health Impact Assessment

A three-year, $399,309 grant from the Robert Wood Johnson Foundation. Major Goals: To identify and analyze elements critical for successful conduct and application of a Health Impact Assessment. The GHRI lead investigator is William L. Beery.

Group Health Initiative

A  one-year, $75,000 grant from Group Health Cooperative. Major Goals: Design and propose a continuing evaluation of process, progress, and success for community benefit efforts. The principal investigator is William L. Beery.

Pharmaco-neuropathology of Brain Aging and Dementia

A five-year, $328,000 grant from National Institute on Aging. Major Goals: To test the hypothesis that some commonly used pharmaceuticals are associated with suppressed pathological features of neuro-degeneration in cognitively normal  individuals, those with prodromal dementia, and those with incident dementia.  The GHRI lead investigator is Rebecca Hubbard.

K12 MRI Analysis

A two-month, $9,175 grant from University of Washington. Major Goals: To determine how breast MRI is used in women with a personal history of breast cancer. We will evaluate the recurrence and mortality rates among women who received  breast MRI in addition to mammography vs mammography alone during surveillance after their diagnosis of breast cancer. The principal investigator is Karen  Wernli.

April 2011

GHRI recently received word of four new awards.

Clonal Bacterial Diagnostics

A  four-month, $35,962 grant from University of Washington. Major Goals: To show that we are able to pick a limited set of genetic loci for the pathogen that can be used as markers for a sufficiently high-resolution genotyping of the current strains, using the strain data and patient data. The GHRI lead investigator is Delia Scholes.

Feasibility Assessment for Characteristics of Tibia and Hip Fractures Study

A two-month, $28,912 grant from AMGEN. Major Goals:  To characterize hip and tibia fractures in Group Health Cooperative enrollees.  The principal investigator is Leslie Spangler.

Mammographic Breast Density and Ovarian Cancer

A  two-year, $160,000 grant from National Cancer Institute. Major Goals: (1) To estimate the association between mammographic breast density and incident ovarian cancer risk among more that 800,000 women aged 40-79 years who participated in the Breast Cancer Surveillance Consortium during 1996-2008 and  by age; (2) to determine if the association between mammographic breast density and incident ovarian cancer risk is modified by ovarian cancer histology; and (3)  to determine whether the modeling of covariates with missing values alters  results. The principal investigator is Karen Wernli.

Validation of Medicare Claims Data for Mammography

A  two-year, $256,531 grant from National Cancer Institute. Major Goals: The goal of this project is to use recently linked Breast Cancer Surveillance Consortium and Medicare claims data to validate algorithms for using Medicare claims to identify key elements related to mammography. We will evaluate algorithms for  identifying diagnostic and screening mammograms, digital mammography, and computer assisted detection, and for assessing mammogram results using Medicare claims. The GHRI lead investigator is Rebecca Hubbard.

March 2011

GHRI recently received word of four new awards.

Advanced Illness Management Quality Improvement for Contracted Clinicians and their Patients

A one-year, $98,497 grant from the GHRI Development Fund. Major Goals: To determine what quality measures for palliative care are important to physicians contracted to Group Health. The  principal investigator is Elizabeth Loggers.

Cognitive Behavioral Therapy for Arthritis Pain and  Insomnia in Older Adults

A three-year, $65,093 grant from National Institute on Aging. Major Goals: To address whether cognitive behavioral therapy will indirectly improve cognitive performance, by way of the intervention's beneficial effects on pain and on sleep quality. We are requesting additional funding to support the extra costs of adding a cognitive assessment to our study protocol. The GHRI lead investigator is Michael R. Von Korff.

Efforts to Develop the Sentinel Initiative: Incorporating PRISM into FDA's Routine Vaccine Safety Monitoring System

A  one-year, $170,000 grant from Food and Drug Administration. The GHRI lead investigator is Jennifer C. Nelson.

SAEC Phase II GWAS Study

A  two-year, $247,501 grant from Serious Adverse Events Consortium (SAEC). Major Goals: The work of Phase II will build on the work completed in Phase I, demonstrating that existing electronic infrastructures can support efficient identification of serious adverse events (SAEs) among health plan members. We will continue refining the phenotype of adults or children who experience  extreme weight gain while taking antipsychotic medications developed in Phase I. Using this phenotype, we will identify and recruit cases of extreme weight-gaining and non-weight-gaining controls among antipsychotic medication users in two large  health plans and care delivery systems, Group Health and Geisinger Health System, to participate in a whole genome association study. We will also work to build future partnerships with SAEC that is centered on implementation projects aimed at reducing rates of SAEs among genetically at-risk patients. The GHRI lead investigator is David E. Arterburn.