Grants Awarded 2012

December 2012

GHRI recently received word of three new awards.

Efforts to Develop the Sentinel Initiative—Case  Identification, Validation, and Adjudication of Acute Kidney Injury (AKI)

A  five-month, $13,191 grant from the Food and Drug Administration. Major Goals:  To validate using an automated data algorithm to identify AKI with medical  records. The work is relevant to drug safety outcomes. The GHRI lead  investigator is Denise M. Boudreau.

Evaluating the Impact of Gene Expression Testing in Early-Stage  Breast Cancer

A five-month, $5,800 grant from the National  Institutes of Health. Major Goals: To explore the patient, tumor, and health  system attributes for patients undergoing Oncotype Dx testing in early-stage  breast cancer. The GHRI lead investigator is Denise M. Boudreau.

Population  Health Care Needs Profiling and Staffing Allocation Models

A four-month,  $54,240 grant from Group Health Cooperative. Major Goals: 1) Population  stratification, leveraging current data resources and research activities at GHRI—to  develop and apply methods to profile/stratify the clinical needs of adult and  pediatric populations in the group practice in relation to their morbidity  burden, socioeconomic status, and behavioral risks; 2) Best practice staffing  models and workforce staffing simulations—to determine optimal staffing models  for primary care to leverage the current research at Group Health’s MacColl  Institute that comprises in-depth qualitative assessments of primary care best  practices in workforce deployment; 3) Modeling—to develop a flexible staffing  model for primary care that can establish the optimal staffing mix for clinics  that considers the specific characteristics of each clinic’s membership as well  as logical operational constraints. The principal investigator is Robert  J. Reid.

November 2012

GHRI recently received word of eighteen new awards.

A Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE)

A one-year, $96,011 grant from the National Institutes of Health. Major goals: To determine whether routinely adding the prevalence of various imaging findings in patients without symptoms to lumbar spine imaging reports sent to primary care physicians decreases subsequent: 1) opioid prescriptions; 2) diagnostic testing; and 3) invasive therapies, follow-up visits and specialist referrals. The GHRI lead investigator is Daniel C. Cherkin.

Breast Cancer Screening and Outcomes—Role of Comorbidity

A one-year, $11,500 grant from the American Cancer Society. Major goals: To determine the effects of comorbidity on mammography screening outcomes using data from the Breast Cancer Surveillance Consortium linked with Medicare claims. The GHRI lead investigator is Diana L. Miglioretti.

Comparative Modeling: Informing Breast Cancer Control Practice and Policy

A one-year, $46,995 grant from the National Cancer Institute. Major goals: To provide Breast Cancer Surveillance Consortium screening data to inform CISNET breast cancer models. The GHRI lead investigator is Diana L. Miglioretti.

CRN4: Cancer Research Resources and Collaboration in Integrated Health Care Systems

A five-year, $2,571,379 grant from the National Cancer Institute. Major goals: To enhance the ability to conduct impactful, relevant cancer research in integrated health care systems that provide health care to over 10 million members. Activities include: data resource enhancement, career development of junior investigators, funding of promising pilot studies, and promotion of collaborations among research scientists. The GHRI lead investigator is Jessica Chubak.

Developing a Foundation and Framework for Team-based Care Measures in Primary Care

A two-year, $126,048 task order from the Agency for Healthcare Research and Quality. Major goals: The purpose of this project is to identify and outline the conceptual underpinnings of team-based primary health care, which must be completed before measures of team-based primary care can be explored, developed, and validated. It is anticipated that this project will serve as a starting point for future work in the area of team-based care measures. This project has four main goals: 1) Develop a theoretically sound conceptual framework for measurement of team-based care; 2) Identify and assess existing measures of team-based care; 3) Create a Web-based atlas of measures for evaluation, research, and quality improvement in team-based care in primary care; and 4) Develop a plan for next steps—refining and testing existing instrument(s), identifying prominent gaps in team-based measures, and priorities and directions for development of new measures to address identified gaps. The GHRI lead investigator is Michael L. Parchman.

Development of Rapid-Learning Networks in Primary Care

A three-year, $401,067 task order from the Agency for Healthcare Research and Quality (AHRQ). Major goals: With this Task Order, AHRQ aims to help Practice-Based Research Networks (PBRNs) fully mature from networks collaborating solely on research into rapid-learning primary care networks. The Abt/MacColl project team will continue support of the PBRN registry, website and extranet, while developing enhancements through research on current best practices, followed by the development, implementation, and evaluation of new strategies to support learning and improvement activities. The GHRI lead investigator is Judith Schaefer.

Duration of protection following Tdap vaccine

A one-year, $159,454 grant from the CDC. Major goals: Provide CDC with dataset on use of pertussis vaccines and incidence of pertussis in the Group Health population. Collaborate with the CDC to analyze data, interpret results, and disseminate findings. The principal investigator is Michael L. Jackson.

Efforts to Develop the Sentinel Initiative

Mini-Sentinel is a pilot project sponsored by the U.S. Food and Drug Administration (FDA) to create an active surveillance system - the Sentinel System - to monitor the safety of FDA-regulated medical products. [http://mini-sentinel.org] Mini-Sentinel uses pre-existing electronic healthcare data from multiple sources. GH is one such data provider. Mini-Sentinel is part of the full FDA Sentinel Initiative which is exploring a variety of approaches for improving the Agency’s ability to quickly identify and assess safety issues. The current goals are to update and add to the Mini-Sentinel Common Data Model, run queries on questions related to drug safety, develop and evaluate methods for active safety surveillance, and work through the “nuts and bolts” of designing safety assessments using multiple existing electronic healthcare data systems. GHRI recently received four grants from the FDA related to this project:

• Establish Capacity for Timely Response to Mini-Sentinel Coordinating Center Activities (Queries, Modular Programs): A one-year, $106,496 grant.
• Infrastructure Year 4 Core Co-Lead: A one-year, $76,856 grant.
• Support Summary Tables, Query Tool and MP Testing: A one-year, $54,928 grant.
• Update MSDD Quarterly: A one-year, $132,422 grant.

The GHRI lead investigator for these grants is Denise M. Boudreau.

Feasibility Assessment for a Retrospective Cohort Study of Risk of Hip Fractures Associated with High-Dose, Long-term Proton Pump Inhibitor (HD-PPI) Use or H2 Receptor

A five-month, $11,243 grant from the Food and Drug Administration. Major goals: To explore feasibility of a future cohort study of proton pump exposure and hip fracture, including assembling a cohort of new users of proton pump inhibitors and H2 receptor antagonists, characterizing the cohort, exploring the availability of specimens for genotyping, and proposing a unified set of innovative methods for a future study. The GHRI lead investigator is Sascha Dublin.

Knowledge Synthesis Center for Genomic Applications

A one-year, $99,899 grant from the CDC. Major goals: Two systematic reviews under subcontract to Kaiser Permanente Northwest (Evelyn Whitlock). One is on familial hypercholesterolemia; the other on family history and colorectal cancer risk. The GHRI lead investigator is Nora Henrikson.

PharmaSmart Preliminary Data

A nine-month, $20,280 grant from PharmaSmart. Major goals: To get preliminary data of use of the PharmaSmart BP Kiosk in a pharmacy/clinic setting and to use this data to apply for a grant in March from the Patient-Centered Outcomes Research Institute. We will use this machine for identifying patients with uncontrolled hypertension eligible for team care in community clinic settings and to enroll them in a study. The principal investigator is Beverly B. Green.

Protocol 1012-11 and 1013-12

A one-year, $81,293 grant from Integrated Diagnostics. Major goals: Partner with Integrated Diagnostics to develop a plasma protein diagnostic test to differentiate the absence or presence of lung malignancy, and to identify a panel of plasma proteins that differentiate between malignancy and inflammatory disorders such as chronic granulomatous disease. The GHRI lead investigator is Katherine M. Newton.

Strategies and Opportunities to Stop Colon Cancer in Priority Populations

A five-year, $635,360 grant from the National Institutes of Health. Major goals: Across the United States, Federally Qualified Health Centers (FQHCs) serve nearly 19 million patients annually. Racial and ethnic minorities, along with low-income and medically underserved populations, increasingly rely on these clinics for primary care services. Colorectal cancer (CRC) screening rates are extremely low among these patients. We will develop and test a culturally tailored, health care system-based program to improve CRC screening rates in FQHCs, using the OCHIN community-based collaborative network of over 200 FQHCs. The GHRI lead investigator is Beverly B. Green.

Vaccine Safety Datalink (VSD) Project—VSD Anaphylaxis Study

A one-year, $23,650 task order from the CDC. Major goals: To participate in and contribute electronic data and analyze data abstracted from medical records at the CDC in order for CDC to lead a population-based evaluation of the incidence of anaphylaxis and severe allergic reactions following vaccination among all age groups. The principal investigator is Lisa A. Jackson.

Vaccine Safety Datalink (VSD) Project—VSD Project Infrastructure Activities

A six-year, $4,996,977 grant from the CDC. Major goals: To design and conduct Phase 1, 2, 3 and 4 clinical trials and clinical studies of candidate vaccines and therapeutics, as well as conduct other evaluations and analyses for vaccines against infections diseases. The principal investigator is Lisa A. Jackson.

October 2012

GHRI recently received word of fifteen new awards.

Addressing Cancer Disparities in Patient with Limited English Proficiency (LEP)

A one-year, $140,236 grant from the Group Health Foundation. Major goals: To train certified medical interpreters to deliver pre-approved, scripted colorectal cancer screening messages at the time of a medical encounter to patients with LEP. The principal investigator is Leo S. Morales.

Assessing Predictive Modeling for Use within Group Health to Identify Enrollees at Risk for Hospitalization and Death

A two-month, $35,907 grant from Group Health Cooperative. Major goals: To evaluate the feasibility of applying a Veterans' Affairs predictive model of one-year mortality and hospitalizations to the Group Health Group Practice Division and network enrollee populations. The principal investigator is Paul A. Fishman.

Considering Healthier Drinking Options in Collaborative Care—Supplement

A two-year, $168,885 grant from National Institute of Alcohol Abuse and Alcoholism. Major goals: To conduct a small mixed-methods study that will allow us to learn from these patients who attend an enrollment visit and are interested in support to change their drinking but do not enroll. Specifically, we seek to understand these patients’ needs and motivations, as well as the qualities of alcohol-related services that would be attractive to them. The principal investigator is Katharine A. Bradley.

Descriptive Study of Risk Factors for Tibia Shaft Revision Surgery in a Population Based Setting—Supplement

A two-year, $92,872 grant from Amgen. Major goals: Supplemental project to a parent study titled “Risk factors for tibia revision surgery.” The supplement will use data collected in the parent study to create a case-finding algorithm for tibia shaft fractures undergoing initial surgery and tibia shaft fractures undergoing surgical revision. Algorithms will be validated at Kaiser Permanente Northwest (KPNW). The validated case-finding algorithms will be used to estimate the incidence of tibia fracture surgical revisions at Group Health and KPNW. Last, the analyses proposed in the parent study will be expanded to include a multivariable model for risk factors of surgical revision. The principal investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative—Using Supplemental Information for Improved Confounder Adjustment

A one-year, $237,051 grant from the Food and Drug Administration. Major goals: To develop recommendations for methods to incorporate supplemental information into prospective drug safety surveillance, focusing particularly on 2-phase and related study designs. To recommend criteria to assess the performance of these designs; to develop a framework to determine which confounders should be assessed; and to summarize what is already known about the likely nature and magnitude of confounding arising in pharmaco-epidemiologic studies. The GHRI lead investigator is Sascha Dublin.

Health Care Systems Research Collaboratory—Coordinating Center

A five-year, $880,290 grant from National Center for Complementary and Alternative Medicine. Major goals: The Coordinating Center will also serve as the national, central resource for the activities of the Health Care Systems Research Collaboratory program. It will offer technical and policy guidelines and best practices, support implementation of demonstration projects, widely disseminate resources and learnings, and facilitate participation by health systems, their staff, and patients in the initiative's activities. The GHRI lead investigator is Eric B. Larson.

Indigenous Wellness Research Institute (IWRI) National Center of Excellence

A five-year, $44,433 grant from the National Center on Minority Health and Health Disparities. Major goals: 1) Developing an integrated, comprehensive, and centralized trans-disciplinary research infrastructure that builds on the successes of IWRI’s research, training activities, and community capacity building; 2) cultivating existing and establishing novel partnerships with American Indian/Alaska Native (AIAN) tribal communities and other organizations to facilitate truly collaborative research; 3) developing new and enhancing existing research training activities at IWRI that prepare researchers to conduct scientifically rigorous and culturally grounded health research; and 4) strengthening and consolidating AIAN engagement, outreach, and institutional partnerships. The GHRI lead investigator is Leo S. Morales.

Mental Health Research Network (MHRN) Supplement—Suicidal Ideation and Suicidal Behavior

A one-year, $100,228 grant from the National Institute of Mental Health. Major goals: Supplemental budget requested to provide additional funding for a MHRN study to examine the association between the FDA warning regarding suicidality during antidepressant treatment and subsequent changes in antidepressant use and the incidence of suicide attempts requiring hospitalization over nine years. The principal investigator is Gregory E. Simon.

Patient-Centered System Redesign

A three-year, $155,101 grant from National Science Foundation. Major goals: To design a reference model as well as a suite of specialized models to describe an Evidence‑based patient-centered health care system; to help identify the elements of a health care system, the processes of each element, and the relationship and interaction between the elements. The GHRI lead investigator is Paul A. Fishman.

Pragmatic Trial of Population-based Programs to Prevent Suicide Attempt

A five-year, $5,470,814 grant from the National Institutes of Health. Major Goals: To use a factorial design to examine two alternative strategies for secondary prevention of suicide attempt: one strategy focused on risk assessment and care management and another focused on development of emotion regulation skills. The principal investigator is Gregory E. Simon.

Research Planning Grant—Integrating Oral Health & Tobacco Quitline Services

A one-year, $246,881 grant from the National Institute of Dental and Craniofacial Research (NIDCR). Major goals: The major goal of this NIDCR planning grant is to prepare final intervention and study materials for a future randomized clinical trial to evaluate the effectiveness of an integrated oral health promotion/tobacco cessation counseling program delivered through tobacco quitlines. Following creation of these materials, we will submit a U01 application to NIDCR to request support for this trial. The principal investigator is Jennifer B. McClure.

Scalable and Robust Clinical Text De-Identification Tools

A three-year, $856,431 grant from the National Library of Medicine. Major goals: 1) To develop a generic, easily-implemented protocol for local application of open-source de-identification software to redact HIPAA identifiers from different types of clinical text; 2) to develop standard metrics and evaluation methods for assessing under-marking of HIPAA identifiers in any type of clinical text de-identified by any method; 3) to conduct an experiment to assess the performance of the automated protocol developed in Aim 1 using the evaluation metrics developed in Aim 2 applied to different types of clinical text. The principal investigator is David Carrell.

Targeted Intervention for Bipolar Smokers

A two-year, $40,795 career-development grant from the National Institute on Drug Abuse. Research activities include a pilot trial to evaluate the feasibility and acceptability of offering an Acceptance and Commitment Therapy (ACT)-based counseling program in conjunction with nicotine replacement therapy to smokers with bipolar I disorder. The GHRI lead investigator is Jennifer B. McClure.

The Genetics of Drug-Induced Serious Adverse Events

A three-month, $14,950 grant from the Serious Adverse Events Consortium. Major goals: This funding will allow Group Health Research Institute to conduct final analyses of the Extreme Weight Gain (EWG) Phase I/Phase II electronic databases and will yield a complete manuscript that is ready for submission to a peer-reviewed journal. Prepared jointly with Geisinger Health System, the manuscript will describe the process we developed for identifying the EWG phenotype and characterize the true prevalence of EWG in users of antipsychotic drugs within our health plan populations. The principal investigator is David E. Arterburn.

Use of acetaminophen (APAP) and Awareness Around APAP Dose-Related Toxicity-Supplement

A four-month, $18,571 grant from Johnson & Johnson. Major goals: To conduct a study in collaboration with Johnson & Johnson that provides detailed information on the use of APAP and awareness around APAP dose-related toxicity. This information will be used to predict the proportion of patients at high risk for APAP overdose (e.g., users of narcotic analgesics that contain APAP). The principal investigator is Denise M. Boudreau.

September 2012

GHRI recently received word of eighteen new awards.

Breast and Ovary Cancer Clinical Validation Center—Administrative Supplement

A two-year, $70,820 grant from the National Cancer Institute. Major goals: To demonstrate the potential value of using tumor markers as a means of distinguishing aggressive breast cancers from those that will likely not progress. Fred Hutchinson Cancer Research Center would perform pathological analysis on a select batch of specimens in order to compare patients’ treatment and status post-diagnosis (via medical records). The GHRI lead investigator is Diana S. Buist.

Case Studies of New Dental Providers: How Do They Work in Real Time?

A four-month, $43,008 grant from the Pew Charitable Trusts. Major goals: To better understand the impact of new dental providers by creating case studies of how they function in actual practice settings. The principal investigator is Allen Cheadle.

Cognitive Outcomes and Neuropathology in Older Adults Following Critical Illness

A two-year, $75,627 grant from the National Institute on Aging. Major goals: To investigate the association of cognitive outcomes of subjects in the Adult Changes in Thought (ACT) cohort with critical illness and related physiologic derangements, and to study the neuropathological findings in cohort members to determine if critical illness is associated with evidence of increased vascular brain injury. The GHRI lead investigator is Eric B. Larson.

Comprehensive Primary Care Initiative

A five-year, $1,143,131 grant from the Centers for Medicare & Medicaid (CMS). Major goal: To supply ongoing, actionable, and timely feedback to practices; to market consortium leaders on their performance, and to help asses the effects that the Comprehensive Primary Care Initiative has on practice and patient behaviors, outcomes, and costs. The GHRI lead investigator is Robert J. Reid.

eMERGE Pharmacogenomics Supplement

A three-year, $749,577 grant from the National Human Genome Research Institute. Major goals: To genotype subjects for an array of gene markers specifically chosen because of their potential to effect how patients respond to medications. This will allow discovery of associations of how specific genotypes determine responses to commonly prescribed drugs as we also begin to explore how pharmacogenomic information can be incorporated into electronic health records. The principal investigator is Eric B. Larson.

Evaluation Framework for Total Health/Healthy Schools Project

A six-month, $66,611 grant from Kaiser Foundation Health Plan. Major goals: In collaboration, GHRI’s Center for Community Health and Evaluation and the Center for Weight and Health at the University of California, Berkeley with input from Kaiser Permanente’s (KP) Community Benefit/Program Office/Director of Program Evaluation and other internal KP partners, including Healthy Workforce, will develop a logic model and an evaluation framework for Tiers One through Three of the Total Health/Healthy Schools project; and develop evaluation requirements for the Total Health/Healthy Schools project. The principal investigator is Allen Cheadle.

Group Health Research Institute Fellowship Program 7/12 - 6/14

A two-year, $165,790 grant from the Group Health Foundation. Major goals: To provide post-doctoral training and career development to a promising researcher in the fields of epidemiology, biostatistics, or health services research. The post-doctoral researcher will develop a program of research related to the goals of GHRI, will participate in existing GHRI research projects, and will learn about and assist with future grant development. The principal investigator is Rebecca Hubbard.

Hybrid Strategies to Improve Health Care's Triple Aims: Lessons Learned in the Transformations of Two Health Systems

A two-year, $347,741 grant from The Commonwealth Fund. Major goals: To examine the recent of experiences of two previously closed-model integrated delivery systems, Group Health Cooperative in Washington state and Scott & White Healthcare in Texas, as they integrate with community providers and payers using a mix of payment and clinical strategies to improve their local market performance and health care's triple aims. The aims of this project are: to describe and contrast the system-level transformations, motivations, and strategies in two organizational case studies; to describe the impact of the transformation process on partnering organizations, providers, and patients; and to examine the effects of these changes on quality of care and cost performance. The principal investigator is Robert J. Reid.

Impact of Bariatric Surgery on Long-term Diabetes Remission and Complications

A four-year, $2,310,597 grant from the National Institute of Diabetes and Digestive and Kidney Diseases. Major goals: 1) To examine the relationship between diabetes remission and relapse after bariatric surgery on the development of microvascular complications among severely obese adults with diabetes. Microvascular outcomes will include renal disease (decreased glomerular filtration rate and micro/macroalbuminuria); and eye disease (diabetic retinopathy and clinically significant macular edema). 2) To examine the relationship between diabetes remission and relapse after bariatric surgery on the development of macrovascular complications among severely obese adults with diabetes. Macrovascular outcomes will include the following: cardiac ischemia, infarction, angioplasty/stent, or coronary bypass surgery; stroke or transient ischemic attack; and peripheral vascular disease-related ulceration, revascularization, or amputation. 3) To examine the relationship between the duration of diabetes remission after bariatric surgery and the risk of developing microvascular or macrovascular complications. 4) To characterize the independent effects of hypertension and dyslipidemia remission and relapse after bariatric surgery on microvascular and macrovascular complications. The principal investigator is David E. Arterburn.

Implementing Evidence‑based Treatments for Persistent Back Pain into Primary Care

A two-year, $440,000 grant from National Center for Complementary and Alternative Medicine. Major goals: To reduce the substantial gap between knowledge of effective treatments for persistent back pain and implementation of this knowledge into practice. To help identify and overcome obstacles to implementation, we will conduct a formative evaluation of the process of implementing back pain guidelines including complementary and alternative medical treatments and mind/body treatments for chronic back pain into primary care practice. This study will provide information that will be critical for the success of future efforts to bridge these gaps between research and practice. The principal investigator is Daniel C. Cherkin.

Kaiser Permanente Southern California Region Community Benefit HEAL Zones Evaluation

A four-year, $888,837 grant from Kaiser Foundation Hospitals Southern California Region. Major goals: To document intermediate and long-term outcomes at the strategy and community levels, 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.

KP SCAL—BCCQ Evaluation

A two-year, $220,115 grant from Kaiser Permanente Southern California. Major goals: To assess the following components of Building Clinic Capacity for Quality (BCCQ): 1) series-specific processes and outcomes; 2) effectiveness of technical assistance and coaching; 3) changes to clinic capacity and system improvements; and 4) clinic readiness factors that impact participation and success. The principal investigator is Maggie Jones.

Medications and Dementia Risk in Older Adults

A two-year, $432,342 grant from the Branta Foundation. Major goals: To study the association between three medication classes (opioid pain medications, benzodiazepine tranquilizers, and general anesthesia) and brain outcomes in older adults, including risk of dementia, cognitive trajectory, and neuropathologic changes. The principal investigator is Sascha Dublin.

Opioids and the Aging Brain: Dementia, Cognitive Decline and Neuropathology

A two-year, $160,000 grant from the National Institute on Aging (NIA). Major goals: To examine the association of prescription opioid use with late-life brain outcomes using data from an NIA-funded prospective cohort study, the Adult Changes in Thought (ACT) study. To investigate in a cohort of community-dwelling older adults within an integrated health care delivery system whether higher cumulative, long-term use of prescription opioids is associated with a) higher incidence of all-cause dementia or Alzheimer's disease; b) more rapid decline in global cognitive functioning, and c) a higher burden of Alzheimer's disease neuropathology (neuritic plaques, neurofibrillary tangles, and amyloid angiopathy). To determine the relationships of current or recent vs. distant opioid use with a) incidence of all-cause dementia or Alzheimer's disease; and b) global cognitive functioning. The principal investigator is Sascha Dublin.

PHI-CACTI Planning

A one-month, $14,720 grant from the Public Health Institute. Major Goals: Federal Community Transformation Grant funding is being used to support systems changes that increase linkages among clinicians and community health workers in 12 rural health systems. The goal of our evaluation is to assess the impact of these improved linkages on the health of low-income individuals with high blood pressure and high cholesterol. The GHRI lead investigator is Allen Cheadle.

Research Planning Grant: Integrating Oral Health and Tobacco Quitline Services

A one-year, $246,881 grant from the National Institute of Dental and Craniofacial Research (NIDCR). Major goal: to prepare final intervention and study materials for a future randomized clinical trial that will evaluate the effectiveness of an integrated oral health promotion/tobacco cessation counseling program delivered through tobacco quitlines. Following creation of these materials, we will submit a U01 application to NIDCR to request support for this trial. The principal investigator is Jennifer B. McClure.

Rural Health Information Technology (RHIT) Project

A three-year, $74,847 grant from Eastern Washington Critical Access Hospital Network. Major goals: to document the progress made in achieving the three RHIT project goals; to assess the impact of the project on clinical process and outcome measures; to provide formative feedback useful for program improvement. The principal investigator is Allen Cheadle.

United Way Strengthening Our Communities Wellness Project Evaluation

A nine-month, $15,000 grant from United Way of King County. Major goals: To document the implementation of the program, including numbers of people served and services provided; to assess the outcomes of the program, including connections to services, self-reported self-efficacy and health status, clinical indicators, and health care utilization. The principal investigator is Allen Cheadle.

August 2012

GHRI recently received word of eleven new awards.

CHILD Registry Project Phase 2

A two-month, $14,837 grant from the Group Health Foundation. Major Goals: Aim 1) Characterize potential sources of error in CHILD data compared to Group Health Cooperative data, including mismatches in coding and potential children who had vaccines at Group Health but who were not in the dataset from CHILD. Aim 2) Complete several analyses of interest using CHILD data, including trends over time in method of upload and trends in completeness by county. Aim 3) Describe practices who are using “optional” fields in CHILD (manufacturer/lot number, physician) according to location practice size (number of vaccines), and method of upload. The principal investigator is David C. Grossman.

Cognitive Outcomes and Neuropathology in Older Adults Following Critical Illness

A two-year, $75,627 grant from the National Institute on Aging. Major Goals: To investigate the association of cognitive outcomes of subjects in the ACT cohort with critical illness, and with related physiologic derangements, and to study the neuropathological findings in cohort members to determine if critical illness is associated with evidence of increased vascular brain injury. The GHRI lead investigator is Eric B. Larson.

Efforts to Develop the Sentinel Initiative: Birth Certificate Data Matching for the Post-Licensure Rapid Immunization Safety Monitoring (PRISM) Program

A one-year, $39,523 grant from the Food and Drug Administration. Major Goals: To expand the data available for post-marketing vaccine safety surveillance by investigating and supporting matching of health plan data to birth certificate and fetal death certificate data for Data Partners within the MiniSentinel Project; to identify and prioritize states for matching; to gather information about feasibility and requirements; to examine and revise standard file structures and matching guidelines; and to support one or more Data Partners to conduct birth certificate data matching and populate a MiniSEntinel file with these data. The GHRI lead investigator is Sascha Dublin.

Efforts to Develop the Sentinel Initiative: Evaluating the Impact of the FDA's Regulatory Action on Long-Acting Beta2-Adrenergic Agonists (LABAs)

A seven-month, $5,720 grant from the Food and Drug Administration. Major Goals: To assess the impact of the 2010 LABA regulatory action on LABA drug utilization patterns by looking at the following: trends of asthma medication used in an asthma cohort before and after the 2010 FDA regulatory actions on LABA; trends of LABA initiation in an asthma cohort before and after the 2010 FDA regulatory actions on LABA; assess combination ICS/LABA product initiation among new users of LABA before and after the 2010 FDA regulatory actions on LABA; assess the appropriateness of LABA initiation among new users of LABA before and after the 2010 FDA regulatory actions of LABA; describe the episode of LABA use among new users of LABA before and after the 2010 FDA regulatory actions on LABA; describe step down therapy after LABA discontinuation before and after the 2010 FDA regulatory actions on LABA. The GHRI lead investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative: Task Order 4: Foundational Elements Activity—Clinical Data Assessment

A one-year, $8,584 grant from the Food and Drug Administration. Major Goals: To more fully understand the usability of clinical data for M-S surveillance activities; to assess selected Year 2 clinical data; to characterize the data, to perform quality checks for missingness, ranges of values and frequencies. The GHRI lead investigator is Denise M. Boudreau.

Evaluation of Quality Measures for Brief Alcohol Interventions

A two-year, $357,100 grant from National Institute of Alcohol Abuse and Alcoholism. Major Goals: To evaluate existing quality indicators developed by the Veterans Health Administration, The Joint Commission, and the American Medical Association to measure the quality of care for alcohol misuse. The principal investigator is Katharine A. Bradley.

Feasibility of Downloading and Aggregating Bone Density Results Directly from Group Health Clinical Densitometry Machines

A two-month, $28,107 grant from AMGEN. Major Goals: Aim 1) After determining resources and methods at Group Health and other health plans for accessing DXA-related measures from clinical densitometry machines, develop best methods for extracting these data and exporting them to analysis datasets at Group Health/Group Health Research Institute (GHRI). Aim 2) Pilot exporting bone mineral density (BMD) data from at least one of the four Western Washington Group Health clinical DXA sites to a GHRI SAS dataset. Include a minimum of the previous 12 months of BMD results. Here, the aim will be to export data from as many of the Group Health DXA sites as possible and to include data for as long a time frame as possible. The principal investigator is Delia Scholes.

Fellowship Application—Feasibility of Online Interventions for Population-Based Suicide Prevention

A two-year, $158,086 grant from American Foundation for Suicide Prevention. Major Goals: Develop and pretest an online intervention version of dialectical behavior therapy skills for use with suicidal individuals receiving outpatient care in health care settings. The principal investigator is Ursula Whiteside.

Impact of Bariatric Surgery on Long-term Diabetes Remission and Complications

A four-year, $2,310,597 grant from National Institute of Diabetes and Digestive and Kidney Diseases. Major Goals:

• To examine the relationship between diabetes remission and relapse after bariatric surgery on the development of microvascular complications among severely obese adults with diabetes. Microvascular outcomes will include the following: renal disease; decreased glomerular filtration rate and micro/macroalbuminuria and eye disease; diabetic retinopathy and clinically significant macular edema.
• To examine the relationship between diabetes remission and relapse after bariatric surgery on the development of macrovascular complications among severely obese adults with diabetes. Macrovascular outcomes will include the following: cardiac ischemia, infarction, angioplasty/stent, or coronary bypass surgery; stroke or transient ischemic attack; and peripheral vascular disease-related ulceration, revascularization, or amputation.
• To examine the relationship between the duration of diabetes remission after bariatric surgery and the risk of developing microvascular or macrovascular complications.
• To characterize the independent effects of hypertension and dyslipidemia remission and relapse after bariatric surgery on microvascular and macrovascular complications.

The principal investigator is David E. Arterburn.

Kaiser Foundation Hospitals—Norther California Region - PHASE

A two-year, $200,000 grant from Kaiser Foundation Hospitals - Northern California Region. Major Goals: The purpose of the PHASE evaluation is to: Document the clinic-level system and institutional improvements, strategies, and process changes/implementation among health centers participating in the PHASE program; document population clinical outcomes including medication/treatment adherence, lifestyle changes, emergency room visit, in-patient admission utilization rates of patients participating in the PHASE program; provide formative feedback for program and process improvement; disseminate results to key audiences. The principal investigator is Allen Cheadle.

Pilot Study of Online Interventions for Population-based Suicide Prevention

A two-year, $680,000 grant from the National Institute of Mental Health. Major Goals: Development and piloting of an online suicide prevention intervention involving training in emotion regulation skills from dialectical behavior therapy. The principal investigator is Ursula Whiteside.

July 2012

GHRI recently received word of seven new awards.

Descriptive Study of Risk Factors for Tibia Shaft Revision Surgery in a Population-Based Setting

A two-year, $248,419 grant from AMGEN. Major Goals: We propose a case-control study design with the ultimate goal of comparing patient and fracture characteristics between cases undergoing surgical revision to repair a tibia-shaft fracture to controls undergoing only one surgery for tibia-shaft fracture repair. The principal investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative: Demonstrate Feasibility of New Sequential Methods in a Distributed Data Setting by Implementing them in Practice Using Mini-Sentinel Data

A one-year, $369,699 grant from Food and Drug Administration. Major Goals: The primary goal of this activity is to deliver code that will implement 1-2 versions of sequential regression within the Mini-Sentinel distributed database. The GHRI lead investigator is Andrea J. Cook.

Efforts to Develop the Sentinel Initiative: Signal Refinement of Metabolic Effects of Antipsychotics in Pediatric Population

An eight-month, $19,062 grant from Food and Drug Administration. Major Goals: To determine the risk of developing metabolic disorders in children and adolescents using antipsychotic medications. We will conduct sub-group analyses by age, sex, diagnosis, specific medication, and dose range. The GHRI lead investigator is Robert Penfold.

Evaluations of 2011 Funded Partnership for Innovation Projects (Hartley/Wicklund/Shors/Gupta/Danforth)

A two-year, $84,476 grant from Group Health Foundation (GHF). Major Goals: GHF funding covering the evaluation of five Partnerships for Innovation awards. The principal investigator is Paul A. Fishman.

Institute of Translational Health Sciences (ITHS)

A five-year, $1,408,945 grant from National Center for Research Resources. Major Goals: The Institute of Translational Health Sciences (ITHS) Community Outreach and Research Translation Core (CORT) partners with communities, tribes, and clinical practices to support and conduct research that improves health and well-being throughout the Washington, Wyoming, Alaska, Montana, Idaho region. Community engagement is crucial to speeding the translation of discovery and clinical applications into actual improvements in health. Research must be relevant to and informed by community needs to be adopted as practice. CORT strengthens such participation by building research networks inside these communities, by bringing community and academics together to brainstorm new research processes and programs, and by promoting uptake of research findings in diverse settings. The GHRI lead investigator is Leo S. Morales.

Organized Self-Management Support Services for Chronic Depression—Administrative Supplement

A one-year, $87,824 grant from National Institute of Mental Health. Major Goals: This study will be one of the first to evaluate rigorously the impact of group-based self management on potential cost savings. The results of this study are likely to be highly relevant to achieving the triple aims of health care reform: improving the experience of care, improving the health of populations, and reducing per capita costs of health care. The principal investigator is Evette J. Ludman.

Suicidal Ideation Onset Following Antidepressant Initiation

A two-year, $84,876 grant from American Foundation for Suicide Prevention. Major Goals: To determine risk of increased suicidal ideation and/or self-injurious behavior following the initiation of antidepressant medication therapy. The principal investigator is Robert Penfold.    

June 2012

GHRI recently received word of two new awards.

Health Care Improvement for Aging Women

A five-year, $872,562 grant from the National Institute on Aging. Major Goals: The purpose of this training program application is to prepare postdoctoral public health scientists—primarily epidemiologists, health services researchers, behavioral scientists, and academic clinicians—to produce evidence that will guide optimum, efficient, and cost-effective health care practices for older women in the future. The principal investigator is Andrea Z. LaCroix.

Healthcare Georgia Foundation Evaluation Resource Center Phase III

An eight-month, $110,000 grant from Healthcare Georgia Foundation. Major Goals: To support Phase III and completed development and implementation of the Healthcare Georgia Foundation Evaluation Resource Center (ERC), serving nonprofit health organizations throughout Georgia. The principal investigator is Maggie Jones.

May 2012

GHRI recently received word of six new awards.

California Academy for the Public's Health

A one-year, $10,000 grant from The California Endowment. Major Goals: To transform the field of public heath; to train public health leaders throughout California for organizational and systems change that imbeds equity, community, and cross-sector collaboration into practice. The principal investigator is William L. Beery.

Disparities in Chronic Illness Care for Patients with Language Barriers

A four-year, $1.3 million R01 grant from the National Center on Minority Health and Health Disparities. Major Goals: (1) To evaluate how medication adherence and treatment intensification differ by limited English proficiency (LEP) status in patients with diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia (HL); (2) to characterize differences between patients by LEP status in patient, provider, and health system factors associated with medication adherence and treatment intensification, and to investigate the extent to which these factors explain differences identified in Aim 1 between LEP and non-LEP patients; and (3) to identify modifiable patient, provider, and health system factors associated with medication adherence and treatment intensification in LEP populations. The project will be conducted by a diverse group of junior and experienced senior investigators with complementary backgrounds from institutions across the United States including Group Health Research Institute (GHRI), the University of Washington, the University of California, Los Angeles, and the University of Wisconsin-Madison. The principal investigator is Leo S. Morales.

Health Impact Assessment

A two-year, $33,527 grant from the Robert Wood Johnson Foundation. Major Goals: To conduct site visits and produce in-depth case studies of 26 Health Impact Assessments (HIAs) around the United States, thus enhancing the validity of the evaluation among experts in the field of HIA; to present the evaluation’s progress and participate in annual HIA conferences sponsored by The Pew Charitable Trusts and the Robert Wood Johnson Foundation. The principal investigator is Allen Cheadle.

Technical Assistance to Support the Learning and Diffusion Activities at the Center for Medicare & Medicaid Innovation (CMMI)

A three-month, $90,358 grant from CMMI. Major Goals: To design, develop, and present webinars on the Patient-Centered Medical Home Change Concepts and related topics as well as assist with planning the technical assistance structure and offerings that the American Institutes for Research (AIR) will provide to assist CMS and CMMI in their national Advanced Primary Care Practice (APCP) Demonstration. The principal investigator is Edward H. Wagner.

Updating of the Validation of Nonunion and Malunion Codes & Estimating the Incidence of Nonunions

A six-month, $64,778 grant from AMGEN. Major goals: To update/improve our work validating nonunion and malunions of fractures as well as estimating the incidence of nonunions at Group Health Cooperative and Kaiser Permanente Colorado. The principal investigator is Denise M. Boudreau.

VA Contract for Katharine Bradley- Mentoring and Consulting

A four-year, $119,118 grant from Veteran's Administration. Major Goals: To consult with VA quality improvement research related to alcohol misuse, including mentoring UW Department of Health Services PhD students and junior faculty who are conducting research on alcohol misuse in the VA. The principal investigator is Katharine A. Bradley.

April 2012

GHRI recently received word of ten new awards.

Anticholinergic Medication Use and Risk for Cognitive Decline, Neuropathology, and Physical Performance

A two-year, $671,693 grant from the National Institute on Aging. Major goals: The overarching goal of this project is to examine whether use of medications with anticholinergic effects is associated with clinical and neuropathological Alzheimer's disease, rates of cognitive decline, and rates of decline in physical performance measures (e.g., walking speed.) The principal investigator is Eric B. Larson.

Comparison of Antipsychotic Medications

A seven-month, $164,993 grant from Bristol Myers Squibb. Major Goals: Compare the drug Abilify to other antipsychotic medications on the market. The principal investigator is Robert Penfold.

Efforts to Develop the Sentinel Initiative—Drug Use Studies—Comparison to National Projected Databases

A four-month, $1,695 grant from Food and Drug Administration. Major goals: The study design is a retrospective inception cohort. All patients enrolled in drug and medical coverage who have greater than or equal to one prescription for entacapone, a dopamine agonistor MAO-B inhibitor will serve as the base population from which study cohorts will be selected. The GHRI lead investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative—Risk of Acute Myocardial Infarction in Patients with Parkinson's Disease Treated with Entacapone of Dopamine Agonists-MAO-B Inhibitors (Stalevo)

A four-month, $3,112 grant from Food and Drug Administration. Major goals: To be conducted with distributed programs that will execute against the Mini-Sentinel Distributed Dataset. To implement the distributed SAS programs, review results, and help troubleshoot site-specific problems that may arise. The GHRI lead investigator is Denise M. Boudreau.

Exploring the Impact of Pediatric Behavioral-Health Screening on Health Care Use

A two-year, $158,725 grant from National Institutes of Health. Major goals: To explore the relationship between the implementation of behavioral health (BH) screening in pediatric settings and the quantity and quality of BH and non-BH care use. The GHRI lead investigator is Robert Penfold.

Health Impact Assessment Monograph

A ten-month, $3,000 grant from Healthcare Georgia Foundation. Major Goals: To prepare a Health Impact Assessment monograph designed for nonprofit health organizations that includes definition, rationale, standards, implementation steps, and examples to be used by organizations having policy and advocacy responsibilities. The principal investigator is Emily Bourcier.

Linking Primary Care and Resources in the Community to Improve Health—Development of Measures

A two-year, $14,935 grant from the Agency for Healthcare Research and Quality. Major goals: Provide review and input on five tasks and participate as expert panel member; create a Clinical-Community Linkages Measures Atlas; Develop an initial list of candidate measures; create an evaluation roadmap; disseminate the Clinical-Community Linkages Measures Atlas and evaluation roadmap; and create a final report. The principal investigator is Allen Cheadle.

Novel Methods of Measuring Health Disparities

A three-month, $25,266 grant from National Heart, Lung, and Blood Institute. Major Goals: To develop a sample frame for a population-based study of health disparities. The GHRI lead investigator is Leo S. Morales.

The Primary Care Team—Learning from Effective Practices

A three-year, $3,287,255 grant from Robert Wood Johnson. Major Goals: To identify and carefully study high functioning primary care practices with interesting team models and use of staff. What we learn from these sites will be used to construct a technical assistance package/toolkit that can then be tested during phase II of this work in primary care sites involved in practice transformation. The principal investigator is Edward H. Wagner.

Virginia Mason Community-Health Needs Assessment

A three-month, $20,601 grant from Virginia Mason Medical Center. Major Goals: The principal investigator is William L. Beery.

March 2012

GHRI recently received word of two new awards.

Health Impact Assessment Monograph

A ten-month, $3,000 grant from Healthcare Georgia Foundation. Major Goals: To prepare a health impact assessment monograph designed for nonprofit health organizations, which includes definition, rationale, standards, implementation steps, and examples to be used by organizations with policy and advocacy responsibilities. The principal investigator is Emily Bourcier.

Novel Methods of Measuring Health Disparities

A three-month, $25,266 grant from National Heart, Lung, and Blood Institute. Major Goals: To develop a sample frame for a population-based study of health disparities. The GHRI lead investigator is Leo S. Morales.

February 2012

GHRI recently received word of thirteen new awards.

Efforts to Develop the Sentinel Initiative—Acute Myocardial Infarction Surveillance (AMI)

A three-year, $126,333 grant from the Food and Drug Administration (FDA) to implement a protocol developed as part of the FDA Mini-Sentinel initiative for the active surveillance of acute myocardial infarction in users of saxagliptin compared to users of comparator agents, based on prospective data obtained from large, population-based clinical and claims databases. The surveillance project will be conducted across numerous Mini-Sentinel data partners. The GHRI lead investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative--Core Leader Effort

A one-year, $59,189 grant from the FDA to provide administrative and methodological leadership within the Mini-Sentinel as a Methods Core co-lead. The GHRI lead investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative: Detection and Analysis of Adverse Events Related to Regulated Products in Automated Health Care Data (Clinical Data Expansion Workgroup—Add Seven Labs)

A one-year, $54,450 grant from Food and Drug Administration for continuation of the Clinical Data Workgroup; to expand the Mini-Sentinel Common Data Model data dictionary and data model to include the additional labs (up to seven); populate the laboratory results tables with updated lab values; and develop and run data checks for the new labs. The GHRI lead investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative—Establish Capacity for Timely Response to Mini-Sentinel Coordinating Center (MSCC) Activities (Queries, Modular Programs)

A one-year, $95,089 grant from the FDA to establish and maintain the administrative and technical capability to accept and respond to FDA queries related to medication safety. The GHRI lead investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative: Prepare Summary Tables for Distributed Menu-Driven Queries/Test Modular Programs

A one-year, $46,132 grant from the FDA The GHRI lead investigator is Denise M. Boudreau

MSI FLASH 03—Comparative Efficacy of Low-Dose Estradiol and the SNRI Venlafaxine XR for Treatment of Menopausal Symptoms

A nine-month, $301,889 grant from National Institute on Aging. Major Goals: To determine and assess the efficacy of venlafaxine XR and low-dose estrogen therapy relative to placebo in reducing the frequency of hot flashes; to determine if the global perception of improvement in hot flashes is greater on active treatment than on placebo; to evaluate whether the efficacy of either treatment varies by the presence of co-occurring menopausal symptoms measured at baseline (sleep disturbance, depression, anxiety, and sexual dysfunction). The principal investigator is Andrea Z. LaCroix.

Preliminary Studies Using Psychotherapy Referral Data for Use in Patient-Centered Outcomes Research

A one-year, $73,965 grant from Group Health Research Institute Development Fund to describe the availability (location of data tables, frequency of referrals from primary care, frequency of self-referral, selection bias in repeat measurements, missingness) of referrals for psychotherapy in GHC electronic health records in order to assess the suitability of these data for use in models of patient-centered outcomes; to determine the strongest predictors of failure. The principal investigator is Robert Penfold.

Radiation Exposure from CT Imaging and Collaborative Efforts to Reduce Dose

A two-year, $218,532 grant from Group Health Research Institute Development Fund to develop CT radiation dose benchmarks for Group Health radiologists and technologists that take into account patient size; provide feedback to both radiologists and technologists on how their doses compare to these benchmarks; and educate radiologists and technologists on how to lower dose while maintaining image quality. The principal investigator is Diana L. Miglioretti.

Research Infrastructure and Collaboration for Evaluation of Personal Health Engagement Programs

A one-year, $117,305 grant from Group Health Research Institute Development Fund to establish data source and metrics for evaluation of personal health engagement tools being implemented by Group Health Cooperative; to describe initial adoption of personal health engagement program; to clarify user needs for personal health engagement among vulnerable populations. The principal investigator is James D. Ralston.

Studying Colorectal Cancer—Effectiveness of Screening Strategies (SuCCESS)—Project 1/Screening

A five-year, $623,197 grant from National Cancer Institute. Major Goals: This project responds to the PROSPR mandatory comparative effectiveness research project dedicated to comprehensive study of the benefits and harms of the screening process. We will describe colorectal cancer (CRC) screening patterns among Group Health enrollees and compare the effectiveness of different screening and surveillance patterns in terms of reduction in the risk of incident CRC diagnosis, late-stage CRC diagnosis, and CRC mortality. The principal investigator is Carolyn M. Rutter.

System-level Tools for Helping Doctors and Patients Know Cancer Treatment Costs in Real-Time

A seven-month, $49,523 grant from Group Health Research Institute Development Fund to evaluate barriers and supports to making treatment costs transparent to both patients and oncologists in real time through key informant interviews with stakeholders and assessment of infrastructure; to develop simple prototype tools and assess their usability and usefulness to a small sample of oncologist and patients. The principal investigator is Nora Henrikson.

January 2012

GHRI recently received word of six new awards.

Interactive Voice Response (IVR) and Colorectal Cancer Screening

A five-month, $37,882 grant from Group Health Research Institute Development Fund. Major Goals: To compare the effectiveness of IVR to usual care on colorectal cancer screening rates to increase adherence among 13,279 members within the network. To determine the cost-effectiveness of the implementation of IVR compared to usual care. The principal investigator is Karen Wernli.

Pilot Survey to Group Health Quit for Life Smoking Cessation Program Participants

A six-month, $38,412 grant from Group Health Research Institute Development Fund. Major Goals: The principal investigator is Jennifer B. McClure.

Safety and Health Care Epidemiology Prevention Research Development (SHEPheRD) Program

This is a contract task order for future work. No money awarded to date. A six-year grant from CDC. Major Goals: The goal of this contract is to provide CDC with an "as needed" mechanism for studies of health care-associated infections. Individual studies within the contract will be established by issuing task orders for sites participating in the contract. The GHRI lead investigator is Michael L. Jackson.

Support and Evaluation Resource Program for Research Centers of Excellence in Clinical Preventive Support Services

A five-year, $740,438 grant from Agency for Healthcare Research and Quality. Major Goals: To provide technical support in the areas of collaboration, evaluation, and dissemination to three planned Research Centers of Excellence in Clinical Preventive Services funded by the Agency for Healthcare Research and Quality. The GHRI lead investigator is Judith Schaefer.

Type 1 Diabetes Cohort and Registry

A one-year, $100,849 grant from Group Health Research Institute Development Fund. Major Goals: To enumerate and characterize the population of persons with type 1 diabetes at Group Health; and to establish and prospectively populate a research registry of patients with type 1-diabetes based on automated data. The principal investigator is Jessica Chubak.

Understanding Physical Activity (PA) Programs among Medicare Beneficiaries at Group Health

A one-year, $101,032 grant from Group Health Research Institute Development Fund. Major Goals: To describe the characteristics of Medicare beneficiaries at Group Health who utilize PA programs compared to those who do not; to examine referral mechanisms of PA programs; to understand barriers and facilitators to participate in the PA programs among those eligible for this benefit. The principal investigator is Dori E. Rosenberg.