Transcript Participating Centers

FQHC Workgroup
Participating Centers
Emory University
Texas A&M
University of Texas, Houston*
University of Washington*
University of Colorado
University of California, Los Angeles
Washington University in Saint Louis
UNC-Chapel Hill
University of South Carolina
FQHC Workgroup Goal
To partner with FQHCs and state, regional and
national associations representing FQHCs to advance
the dissemination and implementation of cancer
prevention and control programs in community
health centers that provide primary care to
underserved populations.
What We Did
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Studied many models before selecting the Practice Change and
Development Model and the Consolidated Framework for
Implementation Research (CFIR) to guide the group’s work.
Over the years several sub-groups / mini-committees formed:
1) Partnership Subgroup
2) Data Subgroup
3) Cross-Center Survey Subgroup
4) Qualitative Inquiry Subgroup
5) Dissemination Subgroup
What We Did
Partnership Subgroup engaged HRSA/Bureau of
Primary Health Care, National Association of
Community Health Centers (NACHC), National Center
for Farmworker Health, and other state and local
partners to guide and provide feedback for our work.
What We Did
Data Subgroup began hosting guest presentations
focused on the use of “big data” and EMRs to
answer questions on cancer prevention and control
strategies.
Group then conducted cross-site studies using preexisting FQHC data and incorporating GIS
applications to explore cancer data and the impact
of FQHCs at the neighborhood level.
What We Did
Cross-Center Survey Subgroup conducted searches
for and selected measures for constructs of CFIR,
recruited FQHCs across 7 states, and conducted a
survey of FQHCs related to implementation of
evidence-based practices.
What We Did
Qualitative Inquiry Subgroup conducted
interviews and focus groups of leaders and staff
members from FQHCs in 14 states to explore
factors affecting implementation of evidence-based
practices.
What We Did
Dissemination Subgroup developed template for
ways to share cross-center results with national, state
and local partners.
What We Accomplished
Practice adaptive reserve and colorectal cancer screening
best practices at community health center clinics in seven
states. S-P Tu, V Young, LJ Coombs, et al. Cancer. Accepted/
In press.
Decreased cancer mortality-to-incidence ratios with
increased accessibility of federally qualified health centers.
SA Adams, SK Choi, L Khang, et al. Submitted to Journal of
Community Health. Accepted/In press.
What We Accomplished
Reported use of electronic health records to implement evidence-based
approaches to colorectal cancer screening in community health centers.
A Cole, S-P Tu, ME Fernandez, et al. Submitted to Journal of Health Care
for the Poor and Underserved (Under Review)
Is availability of mammography services at federally qualified health
centers associated with breast cancer mortality-to-incidence ratios? An
ecological analysis. SA Adams , SK Choi, JM Eberth, DB Friedman, et al.
Submitted to Journal of Women’s Health (Under Review)
What We Accomplished
Medicaid coverage expansion and cancer disparities. SK Choi, SA Adams,
JM Eberth, et al. In preparation for submission to a special journal issue.
Practice change in federally qualified health centers: Leaders'
experiences in overcoming the challenges of implementing practice
changes in FQHCs. ME Fernandez, N Woolf, M Kegler, et al. In progress.
Developing measures to assess constructs of the consolidated
framework for implementation research. M Kegler, M Carvalho, L Liang,
et al. In progress.
Developing measures to assess constructs from the inner settings of the
consolidated framework for implementation research. MR Fernandez, W
Calo, M Kegler, et al. In progress.
FQHC implementation of electronic health records: A qualitative
analysis. ME Fernandez, N Woolf, L Liang, et al. In progress.
What We Accomplished
NCI P01 Tobacco TIPS: Translation into Practice Systems. (PI of
Project 2: Fernandez; overall PI: Wetter). The aim of Project 2
study is to increase the adoption, implementation, and
maintenance of AAC among health care systems that serve
disadvantaged populations. Submitted May 2014.
NCI-R15 A Geospatial Investigation of Breast Cancer Treatment
(PI: Adams).
Grant Awarded: August 2014. We propose to apply geospatial
methodologies in innovative ways to the problem of breast
cancer disparities among African American women. We plan
to examine breast cancer treatment and mortality patterns
among a racially and geographically (urban vs. rural) diverse
cohort of women residing in South Carolina.
How We Worked Together
• Calls – to establish priorities and work
• By email – to write/edit protocols and
papers
• Involved our partners in decision making
– CRITICAL
• Assigned some roles – leaders,
organizers, etc.
What Worked and What Didn’t
• What Worked Well:
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Co-chairing workgroup and having subgroups; sharing
responsibilities for logistics
Calls/meetings focused on specific
analyses/projects/papers
Checking in on progress
• What Didn’t Work Well:
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Important decisions about project aims, variables, etc. not
being made upfront – can delay IRB, analysis, writing, etc.
On and off participation by key players
Confusion regarding leads on data analysis
Lessons Learned
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Don’t bite off more than you can chew!
Allocate adequate $$ (e.g., incentives) and human
resources right off the bat!
Select call/meeting times that work for all key
players.
Ensure follow up and follow through between
call/meeting dates.
Agree upon specific roles for specific people/sites.
Each site has different IRB timelines – beware and
be prepared!