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Transcript of The Greater Cleveland Cancer Prevention Research Collaborating Center Sue Flocke, PhD Case Western...
The Greater Cleveland Cancer Prevention Research Collaborating Center
Sue Flocke, PhDCase Western Reserve University
October 29, 2014
This presentation was supported by Cooperative Agreement Number 1U48DP001930 from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Prevention Research Center for Healthy Neighborhoods (PRCHN)
• Funded as part of national PRC network in 2009
• Our Focus: Disadvantaged urban neighborhoods– Community nutrition and food access– Tobacco prevention & cessation– Supportive environments for healthy eating and active living– Place-based health surveillance
2
78 out of 202 census tracts in Cleveland
have greater than30% living in poverty and
> 25% without HS diploma.
Specific Aims
1. Conduct a study to improve efficiency and effectiveness of tobacco cessation referrals. Implement and test closed loop E-referral to QuitLine.
2. Establish an evidence activation team and rapid PDSA cycles to inform and impact policy and practice.
3. Contribute to the overall impact and success of the national CPCRN initiatives through cross-center collaboration.
PRCHN-CPCRN Investigators & Partners
MetroHealthSeeholzerKaelber, ISOther IT and clinical staff
10 community clinics
Tobacco Research Working Group
PRC Flocke, PISmith, Proj. Coord.Seeholzer, Co-ITrapl, Co-IKoroukian, Co-I
National Jewish HealthQuit Line provider
Ohio Dept of Health
Network of Community Advisors
Ask Advise Connect (AAC)
Approach very successful in safety-net settings.
Systematic – EHR driven
Engages medical assistant vs. clinician
Facilitates documentation and referral to QuitLine
Vidrine JI, Shete S, Li Y, et al. The ask-advise-connect approach for smokers in a safety net healthcare system: a group-randomized trial. Am J Prev Med. 2013;45(6):737–41.Vidrine JI, Shete S, Cao Y, et al. Ask-Advise-Connect A New Approach to Smoking Treatment Delivery in Health Care Settings. JAMA Intern Med. 2013;173(6):458–64.
Project Phases
Phase Products
Phase 1 Establish & test closed loop e-Referral protocol
• Guide for establishing linkage Epic – NJH• Revised protocol for AAC training• Training manual for referral specialist• Resource document for NE Ohio
Phase 2 Pilot test in 2 sites;Evaluate impact across 10 sites
• Manuscripts on outcomes - Implementation AAC - Quit Line data – appropriate referrals,
enrollment - Patient report data – helpful, respectful
Phase 3 Develop tools and strategy for dissemination (statewide)
• Learning Collaborative materials
Proposed Cross-Center Projects
• Implement and test AAC and eReferral across multiple settings.– Randomize and test additional features– Best partners are those with Epic and strong working
relationships with primary care networks
• Other areas of interest– Capacity building & use of existing data– Integrating farmers’ markets with FQHC systems – opportunity
with the new Food Insecurity Nutrition Program grants from USDA and food assistance incentive programs.
– Collaboration across HPV initiatives – systems level and population-based interventions.