Grants Awarded 2014


December 2014

GHRI recently received word of 23 new awards.

Addressing the Personal Health Information Management Needs of Older Adults

A four-year, $99,663 grant from the Agency for Healthcare Research and Quality. Major goals: to investigate the personal health information management goals, activities, and practices of older adults in a variety of living environments, and to identify design principles for the development of information technology (IT) applications that can better support them. The GHRI lead investigator is Andrea Hartzler.

Advancing Geriatrics Infrastructure and Network Growth

A four-year, $40,618 grant from the National Institute on Aging.  Major goals: Focus is on older adults with multiple chronic conditions. Establish partnership between the HMO Research Network (HMORN) and 13 Older American Independence Centers (OAIC), a.k.a. "Pepper Centers." This is an infrastructure grant. Planned activities include pilot projects, mentorship program, dissemination activities, and methods development. These will all be collaborations between the HMORN and OAICs. The GHRI lead investigator is Eric B. Larson.

Alliance for Reducing Cancer, Northwest (ARC NW)

A five-year, $40,516 grant from the Centers for Disease Control and Prevention. Major goals: To participate in meetings and workgroups (colon cancer and worksite interventions) and some national networking functions. To work with Group Health and the Group Health Research Institute to find collaborative opportunities to improve cancer prevention and control and, in particular, to implement findings from the Community Task Force, related to cancer, as well as to participate in planning for grant writing and grant submission in collaboration with other members. The GHRI lead investigator is Beverly B. Green.

Efforts to Develop the Sentinel Initiative: SUPREME DM Datalink and MS Linkage Project

A two-year, $70,265 grant from the Food and Drug Administration. Major goals: The purpose of this proposal is to conduct an alternative validation study using data from selected Mini-Sentinel Data Partner sites that are also Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) sites and to complete the following specific aims: 1) Demonstrate the feasibility of linking the Mini-Sentinel Distributed Database (MSDD) and the SUPREME-DM DataLink. 2) Determine the sensitivity and positive predictive value (PPV) of diagnosis codes for both T1DM and T2DM that are used to identify patients with diabetes mellitus in the MSDD, compared to the SUPREME-DM DataLink as the gold standard. The GHRI lead investigator is Katherine M. Newton.

Evaluation of the Model Communities Initiative

A two-year, $138,065 grant from the Group Health Foundation (GHF). Major goals: Evaluate GHF's Model Communities initiative. The principal investigator is Clarissa Hsu.

Feasibility Assessment for a Claims-Based Retrospective Case-Control Study of the Association between Opioid Use during Pregnancy and Neural-Tube Defects Using Data from the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP)

A seven-month, $9,504 grant from the Food and Drug Administration. Major goals: To determine whether it is feasible to conduct a case-control study within the Medication Exposure Risk Evaluation program to examine whether use of opioids in early pregnancy is associated with higher risk of birth defects in exposed infants. The GHRI lead investigator is Sascha Dublin.

Healthier Communities Curriculum Development

A nine-month, $46,920 grant from the Robert Wood Johnson Foundation.  Major Goals: CCHE will develop a readiness assessment to assist communities in determining overall readiness to engage in community health improvement efforts and develop and evaluation plan for the Healthier Communities Initiatives’ lighter touch Technical Assistance program. The principal investigator is Maggie Jones.

Healthwise Medical Editor

A one-year, $38,829 grant from Healthwise. 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.

Informatics Conference

A five-month, $19,995 grant from the Group Health Research Institute Development Fund. Major goals: To host a conference on future opportunities and challenges in clinical research informatics at Met Park East. The three goals of the conference would be to educate GHRI investigators and staff about clinical research informatics, to identify research areas where GHRI data and state-of-the-art informatics methods can be leveraged for productive, fundable research, and to identify potential new informatics collaborators. The principal investigator is David Carrell.

Innovations in Primary Care Teamwork

A nine-month, $64,440 grant from Group Health Foundation. Major goals: To identify, refine, and test innovative strategies developed within Group Health to create and sustain high-functioning primary care teams. The principal investigator is Michael L. Parchman.

Low Value Care 3

A one-year, $84,775 grant from Group Health Foundation. Major goals: Building on current Low-Value Care work, we propose engaging two to three Group Health specialty groups to identify tests and procedures (services) that these specialty groups think are the highest priority to address for harm and/or inappropriate care. We would then develop and implement at least two interventions to try to reduce overuse of low-value services and evaluate variability in low-value care and testing strategies at the provider and patient level to decrease overuse. The principal investigator is Diana S. Buist.

Lung Cancer Screening Infrastructure

A one-year, $60,000 grant from the Group Health Research Institute Development Fund. Major goals: To develop infrastructure to examine the implementation of a new guideline for lung cancer screening within the Group Health delivery system. The principal investigator is Diana S. Buist.

Mental Health Research Network: Understanding the Factors that Lead to Disparities in Depression Treatment

A two-year, $801,816 grant from the National Institute of Mental Health. Major goals: There are clear racial/ethnic disparities in depression treatment; however, it is unknown if these are patient-, provider-, or healthcare system driven. We’ll examine factors that lead to disparities using data from five large healthcare systems within the Mental Health Research Network to provide the foundation needed to develop appropriate interventions to address these disparities. The principal investigator is Gregory E. Simon.

Merced County—Cope Evaluation

An eight-month, $50,000 grant from the Mental Health Services Act. Major goals: To 1) assess the effectiveness in the short-term of the Community Outreach Program Engagement and Education (COPE) Program at connecting persons with chronic disease (physical) and mental illness to services and contributing to systems changes; 2) identify the most effective strategies in order to maximize program impact; and 3) lay the foundation for an ongoing, sustainable evaluation approach to tell the story of the longer-term impact of the COPE Program. The GHRI lead investigator is Allen Cheadle.

Neighborcare Diabetes Focus Groups

A four-month, $10,000 grant from Neighborcare Health. Major goals: Conduct focus groups with diabetic patients to gather information that may help them control their disease. The principal investigator is Allen Cheadle.

Pragmatic Trial of Population-Based Programs to Prevent Suicide Attempt

A four-year, $6,370,865 grant from NIH Common Fund. Major goals: To conduct a large, pragmatic trial to examine two population-based programs to prevent suicide attempt. Participants will be randomly assigned to continued usual care or usual care supplemented by one of the two prevention programs: an outreach and care management program (via secure messaging and telephone) including structured assessment linked to specific care pathways, or an online psycho-educational program focused on development of emotion regulation skills and prevention of suicidal behaviors, supported by coaching to promote engagement and adherence. The primary outcome will be suicide attempt (fatal or non-fatal) during 18 months following enrollment—ascertained automatically from computerized records.  The trial will be conducted in three health systems: Group Health Cooperative, Kaiser Permanente Colorado, and HealthPartners. The principal investigator is Gregory E. Simon.

Puget Sound Blood Center Interviews for Hemophilia Study

A two-year, $12,000 grant from Health Resources and Services Administration. Major goals: The Center for Community Health and Evaluation (CCHE) is being engaged as an evaluation partner for the Puget Sound Blood Center’s Hemophilia study. The evaluation activities to be carried out by the CCHE fall into two broad areas: 1) conducting interviewed and 2) analysis, synthesis, and reporting on the data. The GHRI lead investigator is Emily Bourcier.

Retrospective Cohort Study of High-Dose Proton Pump Inhibitor (HD-PPI) Use, labeled PPI Use, or H2 Receptor Antagonist (H2RA) Use on Risk of Hip Fractures and a Nested Case-Control Study of Cytochrome P4502C19 Pharmacogenetics

A three-year, $274,877 grant from the Food and Drug Administration. Major goals: To study the association between use of high-dose proton pump inhibitors and hip fracture, including pharmacogenomics. The GHRI lead investigator is Sascha Dublin.

Shared Decision-Making for Maternity Care

A one-year, $111,829 grant from Group Health Foundation. Major goals: To implement a novel, internet-based suite of patient decision aids related to maternity care to support shared decision-making for pregnant women related to elective induction, vaginal birth after cesarean section (VBAC), fetal macrosomia, and gestational diabetes. The patient decision aids will be offered at one Group Health Women’s Health clinic with a second clinic serving as a control site. Outcomes will be measured using pre- and post-pilot survey assessments of patients and providers regarding shared decision-making related to maternity care. The patient survey will assess patient knowledge, values/preferences, treatment decisions, and satisfaction. The provider survey will assess shared decision-making knowledge, use of shared decision-making skills, and satisfaction with the program. The principal investigator is David E. Arterburn.

Snohomish County Gear up and Go! Validation Pilot

\A three-month, $6,000 grant from Group Health Foundation. Major goals: To validate the use of low-cost wearable accelerometers by having kids wear both accelerometers and pedometers. The principal investigator is Allen Cheadle.

Support for Timely and Efficient Transition to Using ICD-10 Codes in the Vaccine Safety Datalink (VSD) to Optimize Vaccine Safety Surveillance and Research Studies

A two-year, $125,339 grant from the Centers for Disease Control and Prevention.  Major goals: This is a Request for Task Order Proposal for the existing VSD sites to prepare for the transition to ICD-10 in 2015. Work includes updating programs and data dictionaries to use ICD_10 codes, as well as validating selected ICD-10 diagnoses through historical comparisons with ICD-9. The principal investigator is Lisa A. Jackson.

Task Order 001 Asthma Evidence to Action Network

A three-year, $525,519 grant from the Patient-Centered Outcomes Research Institute. Major goals: Abt Associates, the MacColl Center for Health Care Innovation, and gravitytank are collaborating on a PCORI-funded “Evidence to Action Network” (E2AN). The Asthma E2AN includes fourteen awardee teams and will enable cross-learning; bring to light shared questions and methods; and support the application of multiple perspectives and disciplines to address common challenges. It will also support the dissemination of new findings in ways that are tailored to end users. Network participants will experiment with innovative technologies and techniques to accomplish the collective goals of accelerating the pace of research, speeding the implementation of findings, influencing research and other funders, and, ultimately, improving patient care for asthma. The GHRI lead investigator is Judith Schaefer.

The Direct and Indirect Cost of Alzheimer's Disease

A one-year, $49,034 grant from the Centers for Disease Control and Prevention. Major goals: Estimate and compare the direct costs of dementia and Alzheimer’s disease in a Medicare Advantage and fee-for-service population. The GHRI lead investigator is Paul A. Fishman

November 2014

GHRI recently received word of 16 new awards.

Alliance for Reducing Cancer, Northwest (ARC NW)

A five-year, $40,516 grant from the Centers for Disease Control and Prevention.  Major Goals: To participate in meetings and workgroups (colon cancer and worksite interventions) and some national networking functions.  To work with Group Health and Group Health Research Institute to find collaborative opportunities to improve cancer prevention and control and, in particular, to implement findings from the Community Task Force related to cancer; to participate in planning for grant writing and grant submission in collaboration with other members. The GHRI lead investigator is Beverly B. Green

Efforts to Develop the Sentinel Initiative—SUPREME Diabetes Mellitus (DM) DataLink and MS Linkage Project

A two-year, $70,265 grant from the Food and Drug Administration.  Major goals: The purpose of this proposal is to conduct an alternative validation study using data from selected Mini-Sentinel Data Partner sites that are also SUPREME-DM sites and to complete the following specific aims: Specific Aim 1) Demonstrate the feasibility of linking the Mini-Sentinel Distributed Database (MSDD) and the SUPREME-DM DataLink. Specific Aim 2) Determine the sensitivity and positive predictive value of diagnosis codes for both Type 1 DM and Type 2 DM, which are used to identify patients with DM in the MSDD, compared to the SUPREME-DM DataLink as the gold standard. The GHRI lead investigator is Katherine M. Newton.   

Evaluation of the Model Communities Initiative

A two-year, $138,065 grant from the Group Health Foundation.  Major goals: Evaluate the Group Health Foundation’s Model Communities initiative. The principal investigator is Clarissa Hsu.

Feasibility Assessment for a Claims-Based Retrospective Case-Control Study of the Association Between Opioid Use During Pregnancy and Neural Tube Defects Using Data from the Medication Exposure in Pregnancy Risk-Evaluation Program (MEPREP)

A seven-month, $9,504 grant from the Food and Drug Administration. Major goals: To determine whether it is feasible to conduct a case-control study within the MEPREP to examine whether use of opioids in early pregnancy is associated with higher risk of birth defects in exposed infants. The GHRI lead investigator is Sascha Dublin

Healthier Communities Curriculum Development

A nine-month, $46,920 grant from the Robert Wood Johnson Foundation.  Major goals: GHRI’s Center for Community Health & Evaluation will develop a readiness assessment to assist communities in determining overall readiness to engage in community health improvement efforts and develop an evaluation plan for the Healthier Communities Initiatives’ lighter touch technical assistance program. The principal investigator is Maggie Jones

Healthwise Medical Editor

A one-year, $38,829 grant from Healthwise.  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

Informatics Conference

A five-month, $19,995 grant from the Group Health Research Institute Development Fund. Major Goals: To host a conference at Met Park East on future opportunities and challenges in clinical research informatics. The three goals of the conference are to educate GHRI investigators and staff about clinical research informatics; to identify research areas where GHRI data and state-of-the-art informatics methods can be leveraged for productive, fundable research; and to identify potential new informatics collaborators. The principal investigator is David Carrell.

Innovations in Primary Care Teamwork

A nine-month, $64,440 grant from the Group Health Foundation. Major goals: To identify, refine, and test innovative strategies developed within Group Health to create and sustain high-functioning primary care teams. The principal investigator is Michael L. Parchman

Lung Cancer Screening Infrastructure

A one-year, $60,000 grant from the Group Health Research Institute Development Fund. Major goals: To develop infrastructure to examine the implementation of a new guideline for lung cancer screening within the Group Health delivery system. The principal investigator is Diana S. Buist

Pragmatic Trial of Population-Based Programs to Prevent Suicide Attempt

A four-year, $6,370,865 grant from the NIH Common Fund.  Major goals: To conduct a large, pragmatic trial to examine two population-based programs to prevent suicide attempt. Participants will be randomly assigned to continued usual care or usual care supplemented by one of two prevention programs: an outreach and care management program (via secure messaging and telephone) including structured assessment linked to specific care pathways, or an online psycho-educational program focused on development of emotion regulation skills and prevention of suicidal behaviors, supported by coaching to promote engagement and adherence. The primary outcome will be suicide attempt (fatal or non-fatal) during 18 months following enrollment—ascertained automatically from computerized records.  The trial will be conducted in three health systems: Group Health Cooperative, Kaiser Permanente Colorado, and HealthPartners. The principal investigator is Gregory E. Simon

Puget Sound Blood Center Interviews for Hemophilia Study

A two-year, $12,000 grant from Health Resources and Services Administration. Major goals: CCHE is being engaged as an evaluation partner for the Puget Sound Blood Center's (PSBC) Hemophilia study. Activities fall into two broad areas: 1) conducting interviews and 2) analysis, synthesis, and reporting on the data. The GHRI lead investigator is Emily Bourcier

Retrospective Cohort Study of High-Dose Proton Pump Inhibitor (HD-PPI) Use, labeled PPI Use, or H2 Receptor Antagonist (H2RA) Use on Risk of Hip Fractures and a Nested Case-control Study of Cytochrome P4502C19 Pharmacogenetics

A three-year, $274,877 grant from the Food and Drug Administration. Major goals: To study the association between use of high-dose proton pump inhibitors and hip fracture, including pharmacogenomics. The GHRI lead investigator is Sascha Dublin

Shared Decision-Making for Maternity Care

A one-year, $111,829 grant from the Group Health Foundation.  Major goals: To implement a novel, internet-based suite of patient decision aids related to maternity care to support shared decision-making for pregnant women related to elective induction, vaginal birth after cesarean section, fetal macrosomia, and gestational diabetes. The patient decision aids will be offered at one Group Health Women’s Health clinic with a second clinic serving as a control site. Outcomes will be measured using pre- and post-pilot survey assessments of patients and providers regarding shared decision-making related to maternity care. The patient survey will assess patient knowledge, values/preferences, treatment decisions, and satisfaction. The provider survey will assess shared decision-making knowledge, use of shared decision-making skills, and satisfaction with the program. The principal investigator is David E. Arterburn.

Snohomish County Gear Up and Go! Validation Pilot

A three-month, $6,000 grant from the Group Health Foundation. Major goals: To validate the use of low-cost wearable accelerometers by having kids wear both accelerometers and pedometers. The principal investigator is Allen Cheadle

Support for Timely and Efficient Transition to Using ICD-10 Codes in Vaccine Safety DataLink (VSD) to Optimize Vaccine Safety Surveillance and Research Studies

A two-year, $125,339 grant from the Centers for Disease Control and Prevention. Major goals: This is a Request for Task Order Proposals for the existing VSD sites to prepare for the transition to ICD-10 in 2015. Work includes updating programs and data dictionaries to use ICD-10 codes, as well as validating selected ICD-10 diagnoses through historical comparisons with ICD-9. The principal investigator is Lisa A. Jackson

The Direct and Indirect Cost of Alzheimer's Disease (AD)

A one-year, $49,034 grant from the Centers for Disease Control and Prevention.  Major goals: Estimate and compare the direct costs of dementia and AD in a Medicare Advantage and fee-for-service population. The GHRI lead investigator is Paul A. Fishman.   

October 2014

GHRI recently received word of 22 new awards.

A Novel Patient-Centered Decision Aid to Inform Alcohol Treatment Choices

A two-year, $439,966 grant from the National Institute of Alcohol Abuse and Alcoholism. Major goals: To develop a patient decision aid for shared decision-making with patients with alcohol use disorders according to international standards. The principal investigator is Katharine A. Bradley.  

A Pragmatic Randomized Trial of Calcitriol in Patients with Chronic Kidney Disease

A ten-month, $562,787 grant from the National Heart, Lung, and Blood Institute. Major Goals: To evaluate the long-term safety and efficacy of calcitriol in the prevention of cardiac events in patients with chronic kidney disease. The principal investigator is Delia Scholes.

CAHN Rural Health Network Development Project

A three-year, $99,501 grant from the Health Resources and Services Administration. Major goals: Evaluate a rural health-improvement project designed to promote system integration among hospitals, clinics, and other health-related organizations in four Washington counties. The GHRI lead investigator is Allen Cheadle.   

Development and Usability of Quality of Life Tracker to Measure and Display Quality of Life Outcomes for Prostate Cancer Care

A one-year, $20,448 grant from the University of Washington. Major goals: To develop the Quality of Life Tracker design concept into a high-fidelity functional prototype that is interactive and tested by patients and clinicians (i.e., target users). The GHRI lead investigator is Andrea Hartzler. 

Development Fund: Clonal Diagnostics for Antibicrobial Resistance of Uropathogenic E. coli

A seven-month, $64,932 grant from the Group Health Research Institute Development Fund.  Major goals: To develop materials and procedures to conduct E. coli clonal testing using a newly developed point-of-care test in patients presenting with symptoms of E. coli infection (Urinary Tract Infection). The principal investigator is Delia Scholes. 

Efforts to Develop the Sentinel Initiative—Core Leader

A one-year, $102,724 grant from the Food and Drug Administration. Major goals: Will oversee the activities of the Data Core, provide support to Mini-Sentinel Data Partners and ensure that Year 6 tasks are met. The GHRI lead investigator is Denise M. Boudreau. 

Efforts to Develop the Sentinel Initiative—Establish Capacity for Timely Response to Mini-Sentinel Operations Center Queries and Participation in Data Partner Activities

A one-year, $125,485 grant from the Food and Drug Administration. Major goals: In year 6, data partners will establish capacity to be active in all data core activities and are responsible for establishing and maintaining the administrative and technical capability to respond to Mini-Sentinel Operations Center requests. The GHRI lead investigator is Denise M. Boudreau. 

Efforts to Develop the Sentinel Initiative—IV Iron and Anaphylactoid Reactions

A three-month, $7,823 grant from the Food and Drug Administration.  Major goals: The objective of the Mini-Sentinel Parenteral Iron Products and Anaphylactoid Reactions project is to perform a one-time assessment of the association between parenteral iron products and anaphylactoid/anaphylactic reactions. The exposure and outcome will be confirmed by chart abstraction. The GHRI lead investigator is Denise M. Boudreau. 

Efforts to Develop the Sentinel Initiative—Mini-Sentinel Year 6 Infrastructure

A one-year, grant from the Food and Drug Administration. Major goals: To continue to partner with the Food and Drug Administration to support the Sentinel Initiative, which includes scientific expertise, data sources, distributed network capabilities, and management experience to develop and evaluate methods for active surveillance of the safety of marketed medical products. The GHRI lead investigator is Denise M. Boudreau. 

Efforts to Develop the Sentinel Initiative: Prepare Summary Tables to Support the Mini-Sentinel Distributed Query Tool and Test Modular Programs and Query Tool Revisions

A one-year, $51,397 grant from the Food and Drug Administration. Major goals: In Year 6, data partners will establish capacity to be active in all data core activities and are responsible for establishing and maintaining the administrative and technical capability to respond to Mini-Sentinel Operations Center requests. Capacity requirements include having more than one staff member capable of responding to the modular program, query tool, PROMPT module, or ad-hoc queries at any given time. The GHRI lead investigator is Denise M. Boudreau. 

Efforts to Develop the Sentinel Initiative: Update the Mini-Sentinel Distributed Data Quarterly

A one-year, $117,818 grant from the Food and Drug Administration. Major goals: In Year 6, the Mini-Sentinel Distributed Database (MSDD) will continue to be updated on a regular basis. The Mini-Sentinel Operations Center staff will work closely with all data partners to update their MSDD (i.e., the core administrative and claims data, as well as laboratory results and vital signs data elements, if applicable). The GHRI lead investigator is Denise M. Boudreau. 

Evaluating Granulocyte Colony Stimulating Factor (G-CSF) Use in Cancer Patients

A ten-month, $19,440 grant from the National Cancer Institute.  Major goals: Using the Virtual Data Warehouse, to develop a model to predict neutropenia risk in patients with cancer. The GHRI lead investigator is Diana S. Buist.

U.S. Study of Uterine Fibroids—Case-Finding, Incidence, and Patterns of Care in a Population-Based Cohort

A two-year, $279,526 grant from Bayer Pharmaceutical Co.  Major goals: To characterize women experiencing uterine fibroids relative to those who are not and to evaluate the association between covariates and uterine fibroid occurrence. The principal investigator is Delia Scholes. 

Interventions and Innovation to Improve Hypertension Control (iH20)

A six-month, $28,559 grant from the Group Health Research Institute Development Fund. Major goals: 1) To evaluate the planned kiosk pilot being implemented at three Group Health clinics. This pilot includes a plan for integration of blood press data into the electronic health record and a work flow for managing hypertensive patients with uncontrolled blood pressure. Group Health is doing the pilot on their own, so it is exempt from research. We will assist in evaluating the pilot and will also inform Aim 2. 2) To prepare for a Patient-Centered Outcomes Research Institute Funding Announcement to conduct a large three-arm pragmatic randomized cluster trial to improve hypertension control in safety net and rural clinics. This work will include recruiting and describing clinics, focus groups, survey, and collection of ethnographic data with patients and stakeholders. The principal investigator is Beverly B. Green. 

Investigating Sedentary Time in Aging—New Directions Using Technology (iSTAND)

A four-year, $583,452 grant from the National Heart, Lung, and Blood Institute.  Major goals: To leverage technology advancements to measure sedentary time and examine relationships with health risk factors. The project will also develop a technology-based program to reduce sedentary time and support healthy aging in the growing population of older adults with chronic health conditions. The principal investigator is Dori E. Rosenberg. 

Respiratory Syncytial Virus (RSV) E-201—A Phase II Randomized, Observer-Blind, Placebo-Controlled Study to Evaluate the Immunogenicity and Safety of (RSV) F Vaccine in Healthy Elderly Subjects

A five-year, $1,017,000 contract from Novavax, Inc. Major goals: To evaluate the immunogenicity and safety of (RSV) F vaccine in healthy elderly subjects. The principal investigator is Lisa A. Jackson. 

Surveillance of Opioid Misuse and Abuse from Electronic Health Records Using Natural Language Processing (Extension)

A one-year, $249,864 grant from Pfizer.  Major goals: We will apply natural language processing (NLP) methods developed in the completed project to all Group Health Cooperative enrollees using opioids from 2006 through June 2014, including patients using opioids for acute pain, post-procedure pain, cancer pain, and pain in end-stage disease. We will use machine learning techniques to improve the accuracy of the NLP algorithms. We will employ refined methods for computer-assisted manual review of clinical notes identified as positive by NLP. We will apply the NLP algorithms and computer-assisted manual reviews to a random sample of enrollees not receiving opioids. We will develop estimates of costs of care for opioid users with and without opioid overuse, misuse, and abuse. The principal investigator is David Carrell.

Sustained Implementation of Patient-Centered Care for Alcohol Misuse

A four-year, $1,880,019 grant from the Agency for Healthcare Research and Quality. Major goals: This project will implement sustained evidence-based alcohol-related care in a large regional network of 25 primary care practices (Group Health).  We will use three strategies to improve the quality of alcohol screening and brief alcohol interventions: 1) enabling with proven methods for obtaining buy-in and improving attitudes, skills, knowledge, and self-efficacy; 2) supporting with an electronic health record; and 3) monitoring and providing feedback on performance by primary care leaders. The principal investigator is Katharine A. Bradley. 

Thrive Home-Visiting Evaluation Supplement

A nine-month, $42,000 grant from Thrive by Five Washington. Major goals: To add an additional four sites to our evaluation of home-visiting programs in Washington state. The principal investigator is Allen Cheadle.

Transition to Long-Term Opioid Use Among Older Adults with Chronic Pain

A seven-month, $19,161 grant from the National Institute on Aging. Major goals: This supplemental award will support a mail survey pilot test among 600 Group Health enrollees pilot evaluating psychometric properties of the National Pain Strategy pain assessment (a brief 21 item questionnaire) with the breakdown of participants being a random sample of Group Health enrollees (n=300) and a sample of persons with high use of services for chronic pain (n=300). The principal investigator is Michael R. Von Korff. 

Vaccine & Treatment Evaluation Unit 13-0034—H7N9 Influenza Vaccine in Older Adults Study

A four-year, $901,944 grant from the National Institute of Allergy and Infectious Diseases. Major goals: To assist with conducting a phase II randomized, partially blinded, controlled trial in healthy adults aged 65 years and older to assess the safety, reactogenicity, and immunogenicity of an MF59-adjuvanted, monovalent inactivated influenza A/H7N9 virus vaccine administered intramuscularly at different intervals and dosages. The principal investigator is Lisa A. Jackson.  

September 2014

GHRI recently received word of 19 new awards.

Acceptance and Commitment Therapy for Smoking Cessation—Administrative Supplement

A one-year, $20,977 grant from the National Cancer Institute. Major goals: To examine the cost-effectiveness of group-based acceptance and commitment therapy compared to standard cognitive behavioral therapy delivered in the PATH smoking cessation trial. The GHRI lead investigator is Jennifer B. McClure.

Addressing Specialist Demand through a High-Referral Intervention

A four-month, $20,000 grant from the Group Health Foundation. Major goals: To lessen the referral rates for high-referring physicians by developing a coaching program and feedback mechanism for high-referring physicians, many of whom have consistent high referral patterns across specialty areas. The principal investigator is Robert J. Reid

AHRQ Primary Care Synthesis

A one-year, $119,964 grant from the Agency for Healthcare Research and Quality. Major goals: To synthesize the valuable insights and learnings from three AHRQ initiatives (IMPaCT, Transforming Primary Care Practice, and Estimating Costs of Supporting Primary Care Practice Transformation) and to create products to disseminate the findings to key target audiences in formats designed to facilitate their implementation. The GHRI lead investigator is Judith Schaefer

Dating Violence Survey

A five-month, $8,000 grant from the Group Health Foundation. Major goals: To conduct an online survey of Seattle school-based health center staff to learn about their perception of the prevalence of dating violence among the students at the middle and high schools where they work; to learn about resources at the school and any teacher/staff training to intervene. The principal investigator is Allen Cheadle

Early-Life Antibiotic Exposure and Adiposity in Childhood

A seven-month, $10,743 grant from the Hearst Foundation. Major Goals: The purpose of this study is to assess the impact of antibiotics exposure in children aged 0-3 years on the development of obesity in later childhood. The GHRI lead investigator is Paula Lozano

Hallways to Health Evaluation

A two-month, $4,000 grant from the Group Health Foundation. Major goals: To assess the impact of the Hallways to Health program in two Seattle middle schools—Washington and Aki Kurose. The principal investigator is Allen Cheadle

Kaiser Permanente Walking and Physical Activity Impact and Value Demonstration Report

A four-month, $17,400 grant from the Kaiser Foundation Health Plan. Major goals: To chronicle and “lift up” Kaiser Permanente's (KP's) investments in promoting walking and physical activity. The main product of this work would be a brief, compelling report (accompanied by a slide deck, infographics, key messages, etc.) to be presented to KP’s Board of Directors in early December 2014. The GHRI lead investigator is Emily Bourcier

Major Taylor Program Evaluation

A seven-month, $15,000 grant from the Group Health Research Institute. Major goals: To assess and demonstrate the value of the Major Taylor bicycling program to various stakeholders to help increase future student/school participation and improve funding/support. The program’s goal is to empower underserved youth by promoting positive physical, emotional and social development through cycling. The principal investigator is David E. Arterburn

Mental Health Research Network (MHRN) II

MHRN II received the following five-year grants from the National Institute of Mental Health. The major goal of these grants is to provide targeted expansion of the Mental Health Network to 1) develop capacity to perform trials involving pharmacotherapy; 2) develop procedures for deploying large-scale mental health IT interventions; and 3) conduct a signature project of a large population impact on an area of high priority to the field. The principal investigator is Gregory E. Simon

  • Automated Virtual Follow-Up to Reduce Premature Treatment Discontinuation: A five-year, $531,622 grant
  • Maximizing Bio-specimen Collection from Children with Mental Health Conditions: A five-year, $496,122 grant
  • Next Generation Clinical Assessment Using Mobile Devices: A five-year, $515,356 grant
  • Reducing Cardiovascular Risk in Adults with Serious Mental Illness Using Electronic Medical Record-Based Clinical Decision Support: A five-year, $3,011,866 grant 

New Models of Primary Care Workforce and Financing

A two-year, $429,091 grant from the Agency for Healthcare Research and Quality. Major goals: The purpose of this research project is to generate information that can be used by the health care system to make decisions about how to configure and pay for the workforce needed to deliver fully-comprehensive, high-quality primary care across the population. This project will culminate in a final research report that outlines the development of the new models of primary care workforce configurations, including estimates of panel sizes and estimates of the per-person cost of providing fully-comprehensive, high-quality primary care via these new models. The GHRI lead investigator is Judith Schaefer

Partnership for Innovation Final Review Process Assessment

A two-month, $6,000 grant from the Group Health Foundation. Major goals: To conduct a review of the Partnership for Innovation (PFI) final review process and (1) make recommendations for how data collection from key stakeholders can be improved and streamlined and (2) lay out a process and required resources for GHRI’s Center for Community Health & Evaluation to take on the work of preparing the final summary project report and recommendations. The principal investigator is Emily Bourcier

Pilot Study to Evaluate Extracting National Ambulatory Medical Care Survey (NAMCS) Data from Electronic Health Record (EHR) Systems

A nine-month, $77,144 grant from Centers for Disease Control and Prevention. Major Goals: Pilot study to examine completeness and comparability of NAMCS patient record form data captured using three different modes of data collection. The principal investigator is Robert J. Reid.

Planning Grant for Implementation of a Rural, Telemonitoring, Aging-in-Place Intervention

A five-month, $30,000 grant from the Empire Health Foundation. Major goals: The GHRI Center for Community Health and Evaluation (CCHE) will help the Critical Access Hospital Network during the planning stage for a rural, telemonitoring aging-in-place transition. CCHE will identify eligibility criteria of residents/seniors to maximize impact of demonstration and identify performance metrics to measure impact. The GHRI lead investigator is Allen Cheadle.

Primary Care Teams: Learning from Effective Ambulatory Practices Phase 2

A three-year, $2,099,999 grant from the Robert Wood Johnson Foundation. Major Goals: To help primary care practices involved in Patient Centered Medical Home (PCMH) transformation efforts develop effective, high-functioning teams. Specific objectives include: a) To further develop and refine the Web-based Team Guide developed in Phase 1; b) To recruit primary care learning communities interested in integrating the guide into their curriculum and participating in training related to its use; c) To conduct a mixed methods evaluation of the acceptability, use, and impact of the program on teamwork and performance of key functions among the participating practices; d) To develop and implement a national dissemination strategy for the LEAP Team Guide; e. To sustain the 31 sites involved in LEAP Phase 1 as “exemplar practices” in their ongoing learning community. The principal investigator is Edward H. Wagner

Sierra Health Foundation—Clinic Capacity

A two-year, $99,980 grant from the Sierra Health Foundation. Major goals: To evaluate the Sierra Health Foundation's Clinic Capacity Building Program, assessing the extent and nature of changes in clinic capacity over the course of the program, as well as the influence the capacity-building grants had on those changes and the perceptions of the clinics by various stakeholders. The principal investigator is Maggie Jones

Understanding and Honoring Priorities in Patients with Multiple Chronic Conditions

A three-year, $1,497,980 grant from the Agency for Healthcare Research and Quality. Objective: To describe the core design elements of a shared and interactive priority plan for patients living with multiple chronic health conditions. We will accomplish this through two aims: 1) Establish patient needs, preferences and capabilities for an interactive priority plan; 2) Evaluate the participatory design approach. The principal investigator is James D. Ralston.

August 2014

GHRI recently received word of seven new awards.

Alcohol and Drug Use Disorders—Three Visits in 30 Days

A one-year, $60,264 grant from the Group Health Foundation. Major goals: The proposed partnership between Behavioral Health Service, Primary Care, and Group Health Research Institute will pilot test an innovation designed to decrease costs while improving the quality of patient-centered care among patients with alcohol or drug use disorders (AOD). Specifically, the project will develop an innovative population-based system to: 1) identify patients daily who have had a new AOD diagnosis in the prior 24 hours; 2) to proactively follow-up to engage them in AOD care with three visits in 30 days, and 3) to support patients in carrying out their goals for AOD care. The GHRI lead investigator is Katharine A. Bradley

Driving Technology-Enhanced Immunization Outreach in the Los Angeles Safety-Net

A three-year, $75,000 grant from Pfizer. Major goals: To evaluate the impact of a program by the Los Angeles County Department of Health Services to increase the pneumococcal immunization rate for the underserved through a three-pronged approach that includes electronic identification of at-risk adults, automated multi-modal outreach, and automated scheduling. Utilization of standardized protocols will result in non-provider staff safely, efficiently, and effectively ordering and administering pneumococcal vaccines. The GHRI lead investigator is Allen Cheadle.

Expanding Access through Team Care Evaluation

A two-year, $80,000 grant from the Blue Shield of California Foundation. Major goals: This is an evaluation of the Expanding Access to Care through Team Care program. The evaluation will determine: 1) impact of care team improvements on patients’ ability to access care; 2) effectiveness of the program as an incubator for new models and approaches; 3) how the program is successfully implemented in safety net organizations; 4) whether grantees should be pursuing different or additional activities to further improve access to care; and it will 5) evaluate the impact and success of individual grants through the RFA. The GHRI lead investigator is Maggie Jones.

Physical Activity in Prostate Cancer

A one-year, $75,000 grant from the National Cancer Institute. Major goals: Men taking androgen deprivation therapy (ADT) for prostate cancer are older, face a high burden of chronic conditions, and are at-risk for treatment effects such as depression and muscle atrophy. Physical activity and sedentary behavior improvements could help control or treat these concerns. However, levels of activity in men taking ADT are unknown. Our study will explore the feasibility of using technology to measure activity in men taking ADT and help us explore future intervention possibilities. The GHRI lead investigator is Dori E. Rosenberg.

Prevalence and Predictors of Hepatocellular Carcinoma Surveillance in the Cancer Research Network

A six-month, $12,103 grant from the University of Texas Southwestern Medical Center. Major goals: To determine prevalence and predictors of hepatocellular carcinoma surveillance among cirrhotic patients in integrated health care systems. The GHRI lead investigator is Jessica Chubak.

Studying Colorectal Cancer Effectiveness of Screening Strategies (SuCCESS) Cervical Cancer Unit

A two-year, $1,298,289 grant from the National Cancer Institute. Major Goals: To 1) collect and document high quality, multilevel, comprehensive cervical cancer screening process data from 2010–2015 on both screened and unscreened females enrolled in Group Health; 2) securely transmit standardized data elements on the cervical cancer screening process to the PROSPR Statistical Coordinating Center (PSCC) at least annually; and 3) participate in collaborative projects within the PROSPR network, using pooled data. The principal investigator is Carolyn M. Rutter.

Utilization and Outcomes of Skin Biopsies for Cutaneous Malignancies

A one-year, $75,000 grant from the National Cancer Institute. Major Goals: Determine patterns of skin biopsy utilization over time for suspected skin cancer by patient and provider characteristics, as well as characterize indications for biopsy and histopathologic outcomes associated with these skin biopsies. The GHRI lead investigator is Denise M. Boudreau.

July 2014

GHRI recently received word of six new awards.

Efforts to Develop the Sentinel Initiative: Adverse Metabolic Effects of Second Generation Antipsychotics in Youth Sub-Project 3: Examining Longitudinal Change in Body Mass Index for Youth Initiating Treatment with Second-Generation Antipsychotic Medications

A one-year, $146,578 grant from the Food and Drug Administration. Major goals: Model risk of weight gain in children using antipsychotic medication. The GHRI lead investigator is Robert Penfold

Group Health Community Benefit Remote Area Medical (RAM)/Healthfest Evaluation

A six-month, $17,400 grant from Group Health Cooperative. Major Goals: In collaboration with the Clinic Host Community, of which Group Health is a part, design and implement an evaluation of the RAM/Healthfest community events, capture program outputs, as well as participant outcomes related to the satisfaction with and utility of the execution and value of the events from diverse audiences (clinic patient, health fair visitor, health fair exhibitor, host community), and provide information to Group Health to inform future community benefit/community engagement strategies. The principal investigator is Allen Cheadle.

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

A two-month, $14,027 grant from the 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.

Oral Health 4 Life—Promoting Oral Health Among Tobacco Quitline Callers

A four-year, $2,279,047 grant from the National Institute of Dental and Craniofacial Research. Major Goals: Test the effectiveness of a multi-modal behavioral intervention (the Oral Health 4 Life program) targeted to smokers who are ready to quit smoking and seeking services through tobacco quitlines. The principal investigator is Jennifer B. McClure.

Prescribers, Pharmacists, and the Opioid Dilemma—a Multi-Site Qualitative Study

A three-year, $217,435 grant from the National Institute on Drug Abuse. Major goals: The purpose of this study is to understand primary care provider and pharmacist perspectives on use of chronic opioid medications for chronic non-cancer pain. The GHRI lead investigator is Katharine A. Bradley.

Southern California Thriving Schools Evaluation

A two-year, $157,658 grant from the Kaiser Foundation Hospitals Inc., Southern California Region. Major goals: 1) Support the development of high quality proposals and strategies submitted by school district applicants. 2) Provide consistent and standard support to selected school district and school sites around evaluation planning and implementation. 3) Coordinate data collection and conduct analysis to inform process and outcome improvements across strategies and sites to demonstrate overall impact of the investment. 4) Communicate evaluation findings to support ongoing learning and planning. The principal investigator is Allen Cheadle.

June 2014

GHRI recently received word of two new awards.

Mental Health Research Network II

 A five-year, $9,998,565 grant from the National Institute of Mental Health. Major goals: To provide targeted expansion of the Mental Health Research Network by developing capacity to perform trials involving pharmacotherapy, developing procedures for deploying large-scale mental health IT interventions, and conducting a signature project of a large population impact on an area of high priority to the field. The principal investigator is Gregory E. Simon.

Systematic Review of Thyroid Cancer Screening

A three-year, $376,571 grant from the Agency for Healthcare Research and Quality. Major goals: to provide technical support for the U.S. Preventive Services Task Force by conducting systematic evidence reviews and decisions analysis that the Task Force will use to make new or update existing recommendations. The GHRI lead investigator is David C. Grossman.

May 2014

GHRI recently received word of seven new awards.

Group Health Foundation HPV Initiative—Year 1

A nine-month, $97,637 grant from Group Health Foundation. Major Goals: 1) Determine experience and attitudes with HPV testing among parents both inside and outside of Group Health (survey). 2) Determine communication styles of providers about HPV (focus group). The principal investigator is Nora Henrikson.

Kaiser Permanente & Strategic Partners Patient Outcomes Research to Advance Learning (PORTAL) Network

A two-year, $138,172 grant from Patient-Centered Outcomes Research Institute. Major Goals: The PORTAL network proposes to create cohorts of: 1) patients with a diagnosis of colorectal cancer; 2) adolescents and adults with severe congenital heart disease (CHD); and 3) adults who are overweight or obese, including those who have prediabetes or diabetes. The cohort development activity will demonstrate that the PORTAL network is able to meet the 10 criteria for a clinical data research network (CDRN) specified in the PCORI funding announcement. Further, PORTAL will offer a scientifically sound set of cohorts on which to conduct comparative effectiveness research and a foundation on which to build future cohorts. The GHRI lead investigator is David E. Arterburn.

Modeling the Impact of Neisseria Meningitideses Serogroup A (MenA) Vaccine on Meningococcal Disease Rates and Mortality in Africa

A nine-month, $46,023 grant from Centers for Disease Control Foundation. Major Goals: We previously developed a simulation model for meningococcal disease in the African Meningitis belt. In this project, we will apply the model to three African countries and predict the impact of meningococcal vaccination on the epidemiology of meningococcal disease. The principal investigator is Michael L. Jackson.

Neighborhood Health Link: Promoting Access to Healthy Community Resources

A one-year, $15,000 grant from Department of Health and Human Services. Major Goals: To link primary care patients to health promoting community resources through use of a customized web database: Neighborhood Health Link (NHL). The principal investigator is Emily Bourcier.

Performance of Screening Ultrasound by Breast Cancer Risk and Density

A nine-month, $191,777 grant from American Cancer Society. Major Goals: To evaluate and compare the performance of breast cancer screening with mammography plus screening ultrasound to screening mammography alone in the community setting among women with and without a history of breast cancer. The principal investigator is Diana L. Miglioretti.

Pharmaconeuropathology of Brain Aging and Dementia

A three-year, $129,536 grant from National Institute on Aging. Major Goals: To test the hypothesis that some commonly used pharmaceuticals are associated with suppressed pathological features of neurodegeneration in cognitively normal individuals, those with prodromal dementia and those with incident dementia. The GHRI lead investigator is Eric B. Larson.

Psychotropic Medication Use among U.S. Children and Youth: National Trends, Disparities and Related Expenditures

A one-year, $24,928 grant from Health Resources and Services Administration. Major Goals: Will contribute expertise in time series analysis and geographic disparities in health care utilization by leading the sub-group analyses in Specific Aim 3—particularly with regard to insurance status (e.g., Medicaid versus private insurance) and geography (rural versus urban, region of the US). The GHRI lead investigator is Robert Penfold.

April 2014

GHRI recently received word of seven new awards.

Efforts to Develop the Sentinel Initiative—MSOC TO7 Work Plan Support

A ten-month, $18,460 grant from the Food and Drug Administration. Major goals: This task order seeks to use the tools, resources, and data environments of the Mini-Sentinel pilot to examine potential associations of exposures to a drug with specified adverse outcomes under several sets of conditions. The GHRI lead investigator is Denise M. Boudreau.

Evaluation of Snohomish County Health Leadership Coalition

A nine-month, $24,160 grant from YMCA. Major goals: 1) Demonstrate the impact of specific coalition initiatives for key audiences: program patterns, other coalition stakeholders, as well as current and potential funders; 2) Provide information useful for program development, improvement, and expansion; 3) Demonstrate the overall long-term impact of the coalition through tracking of key county-level health and economic outcomes; and 4) Leverage support from research and foundation funding sources by developing projects that test the coalition as a model for improving community health. The principal investigator is Allen Cheadle.

Evidence-Based Practice Centers (EPCs) IV: Screening for Colorectal Cancer

A three-month, $27,163 grant from the Agency for Healthcare Research and Quality. Major goals: The Evidence-Based Practice Centers (EPCs) program synthesizes existing scientific literature about important health care topics and promotes evidence-based practice and decision-making. These reviews use systematic review research methodology to systematically and critically appraise existing research and synthesize knowledge on a particular topic. The ultimate goal of EPC work is to present the state of the science on a given topic in a manner that can be directly applied to decisions made by users of health care information. Recently, work of the EPCs has expanded under the Effective Health Care Program to advance the translation and synthesis of knowledge with an array of stakeholders broader than previously established through its partner organizations. The GHRI lead investigator is Carolyn M. Rutter.

Impact of Bariatric Surgery on Cancer Incidence in Severely Obese Adults

A three-year, $218,290 grant from National Cancer Institute. Major goals: We will estimate the incidence of cancer among severely obese (BMI =35) patients who underwent bariatric surgery of any type from 2005-2012 compared to severely obese patients who did not undergo bariatric surgery during the same time period. The major goals of this project are to: 1) Estimate the impact of bariatric surgery versus non-surgical treatment on the incidence of cancer (all types) in severely obese patients. Secondary analyses will explore whether bariatric surgery reduces the incidence of cancer (all types and specific types) in severely obese women; 2) Determine which patient characteristics are most important in predicting bariatric surgery’s salutary effect on cancer incidence in severely obese patients and 3) Explore whether the reduction in risk of cancer after surgery is mediated by weight loss. The GHRI lead investigator is David E. Arterburn.

National Committee for Quality Assurance (NCQA) Phase II Depression Quality Measure Assessment

A two-month, $30,000 grant from the Agency for Healthcare Research and Quality. Major goals: To assist in the testing of quality improvement measures for depression among adolescents. Our role would be to test the feasibility of NCQA-developed measures through chart review and administrative data evaluation. The principal investigator is Robert Penfold.

Public Health Institute/Robert Wood Johnson Foundation Public Health Leadership Training Evaluation

A two-year, $183,500 grant from the Robert Wood Johnson Foundation. Major goals: Plan and conduct an expanded evaluation of the CDC-funded National Leadership Academy for the Public’s Health. The GHRI lead investigator is Maggie Jones.

Pilot National Institute for Drug Abuse (NIDA) Proposals

A ten-month, $19,924 grant from the Group Health Research Institute Development Fund. Major Goals: These pilot analyses will evaluate drug use and drug use disorders in Group Health and associated health behaviors and comorbidities in preparation for NIDA grants. The principal investigator is Katharine A. Bradley.

March 2014

GHRI recently received word of seven new awards.

ACT Plus Pilot Study

A one-year, $58,243 grant from the UW–Dean’s Funds. Major Goals: To evaluate research volunteers from the ACT study according to National Alzheimer’s Coordinating Center (NACC) protocol; upload data to the Alzheimer’s Disease Research Center Clinical Core for review and revision as needed by the ACT study; then upload data to the NACC database. The GHRI lead investigator is Eric B. Larson.

Development of Guidance and Tools for Evaluation of Influenza Vaccine Effectiveness in the Field

A four-month, $15,120 grant from the World Health Organization (WHO). Major Goals: WHO is developing guidelines for conducting observational influenza vaccine effectiveness studies in developing countries. This grant supports a consultant for outlining the content of the guidelines and identifying relevant subject matter experts. The principal investigator is Michael L. Jackson.

Efforts to Develop the Sentinel Initiative: Improvements to Prospective Routine Observational Monitoring Programs Tools (PROMPT) 3 & 4: Modular Code and Documentation

A one-year, $742,482 grant from the Food and Drug Administration. Major Goals: To improve the ability to routinely and efficiently implement sequential design and analysis approaches by further testing and enhancing the Prospective Routine Observational Monitoring Program Tools (PROMPT) modular programming code in the Mini-Sentinel Distributed Database and augmenting existing user documentation and reporting tools. The GHRI lead investigator is Jennifer C. Nelson.

Improving the Care of Persons with Complex Health Needs: Realigning the Patient, Primary Care, and Specialty Care Relationship toward Patient-Centered Care

A two-year, $28,996 grant from the John A. Hartford Foundation. Major Goals: During the initial 18-month planning phase, this project will engage patients, caregivers, and other key stakeholders to: 1) articulate modifiable problems that influence quality, health outcomes, and health costs for complex older adults receiving health care through multiple primary and specialty providers; and 2) address these modifiable problems by integrating innovations from many fields into a feasible, sustainable model of care that realigns primary care/specialty care into a patient-centered approach to the care of complex elders. The project will also develop an evaluation plan to determine whether the model successfully realigns primary care/specialty care as intended and if the realignment improves care and outcomes and decreases costs. The GHRI lead investigator is Michael L. Parchman.

Modeling Effective Health Policies for Colorectal Cancer—Supplement

A one-year, $84,852 grant from National Cancer Institute. Major Goals: New modes of colorectal cancer prevention, screening, and treatment offer the potential to reduce the burden of disease. However, the ability to prioritize dissemination can be hampered by difficulties in synthesizing different sources of information (expert opinion, epidemiologic studies, randomized trials). This project will use microsimulation models to identify effective policies to reduce the burden of colorectal cancer and facilitate implementation of these policies by improving dissemination of insights from the simulation models. The principal investigator is Carolyn M. Rutter.

National Leadership Academy for the Public’s Health

A one-year, $15,000 grant from the Centers for Disease Control and Prevention (CDC). Major Goals: The Public Health Institute in Oakland, CA received a CDC Community Transformation Grant (http://www.healthcare.gov/news/factsheets/
2011/09/community09272011a.html
) to develop and operate a National Applied Public Health Leadership Training Program. The Public Health Institute contracted with GHRI’s Center for Community Health and Evaluation to join the Program’s leadership team and design and implement an evaluation of the Program’s efforts. The evaluation will 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 Maggie Jones.

Pilot Study of Antipsychotics in Youth

A three-month, $26,461 grant from the Group Health Research Institute Directors Project Resource Fund. Major Goals: Pilot study to examine the feasibility of a pragmatic trial about the use of antipsychotic medication in children and adolescents. The principal investigator is Gregory E. Simon.

February 2014

GHRI recently received word of twenty-five new awards.

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

A four-year, $546,122 grant from the National Institutes of Health. Major goals: The overall goal of our Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE) is to perform a large, pragmatic, randomized, controlled trial to determine the effectiveness of a simple, inexpensive, and easy-to-deploy intervention of inserting epidemiological benchmarks into lumbar-spine imaging reports at reducing subsequent tests and treatment. The GHRI lead investigator is Daniel C. Cherkin.

Advance Care Planning (ACP) in Medical Home 2.0, Level 3 Patients

A one-year, $71,211 grant from the Group Health Research Institute Development Fund. Major goals: To support the design and evaluation of ACP in the Medical Home Tier 3 Patients as Part of the Medical Home 2.0 Redesign. The principal investigator is Elizabeth Loggers.

CDC Stakeholders—Environmental Scan

A one-year, $13,868 grant from the Centers for Disease Control and Prevention. Major goals: GHRI will conduct iterative reviews of the academic and grey literature in response to initial and subsequent drafts of the Crosby-generated environmental scan. These reviews will both identify supporting literature for the environmental scan, as well as identify supplementary material that will expand or add to the environmental scan. The GHRI lead investigator is Clarissa Hsu.

Chronic Traumatic Encephalopathy and Delayed Effects of Traumatic Brain Injury

A four-year, $1,372,435 grant from the National Institute of Neurological Disorders and Stroke. Major Goals: To support a multi-center team to increase our understanding of chronic traumatic encephalopathy (CTE) and other late effects of physical trauma to the brain. We will leverage extensive resources from an ongoing prospective cohort study of brain aging to address the many areas of uncertainty and dramatically increase knowledge of CTE and the late effects of traumatic brain injury. The GHRI lead investigator is Eric B. Larson.

Comparative Effectiveness of Clinical Enhancements, Coordination, and Community Health Workers for Asthma Care in Minority Populations

A three-year, $76,914 grant from the Patient-Centered Outcomes Research Institute. Major Goals: To improve patient-centered asthma outcomes through two multi-component guideline implementation interventions that address integration of care processes compared to a lower intensity health plan intervention. The clinic intervention consists of decision support, audit and feedback, provider/staff education, team-based care, office spirometry, and allergy testing. The clinic’s electronic health record provides a platform for sharing a common asthma management plan and enhancing communication among team members. In the home visit intervention, community health workers provide in-home, tailored self-management support. G2P will use a 4-cell factorial design to assess the comparative effectiveness of these two interventions. The GHRI lead investigator is Paula Lozano.

Comparative Modeling: Informing Breast Cancer Control Practice & Policy—Administrative Supplement

A one-year, $29,468 grant from the National Cancer Institute. Major Goals: Group Health may be involved in this administrative supplement for scientific input, and also for Breast Cancer Surveillance Consortium data that may be requested for these runs. The GHRI lead investigator is Diana L. Miglioretti.

Development of Natural Language Processing Algorithms or Other Mechanisms to Capture Molecular Markers from Tumors—Cancer Research Network 4

A one-year, $64,706 grant from the National Cancer Institute. Major Goals: The GHRI lead investigator is David Carrell.

Ecology of Home-based Care for Complex Patients

A one-year, $50,000 grant from the Group Health Foundation Geriatric Research Fund. Major goals: Describe current landscape of home-based care at Group Health, including medical house calls, skilled home care, palliative home care, and home hospice in terms of patients served, resources used, trajectories of care, referral patterns, and geographic and provider variation. Explore critical points in care pathways and options for interventions. The principal investigator is Tracy Mroz.

Efforts to Develop the Sentinel Initiative: A Protocol-Based Assessment of Selected Medications and Death

A one-year, $489,267 grant from the Food and Drug Administration. Major goals: Identify a workgroup whose tasks include, but are not limited to, developing and implementing two separate protocols to assess the associations of anti-arrhythmics and antidepressants with sudden cardiac death; assessing National Death Index Plus (NDI+) linkage feasibility and establishing a process for linking the Mini-Sentinel Distributed Database to the NDI+ for selected patients in all 18 data partners in collaboration with the Mini-Sentinel Operations Center; and preparing a final report to summarize the findings. The GHRI lead investigator is Denise M. Boudreau.

Efforts to Develop the Sentinel Initiative: Analytical Methods to Assess the Robustness of Drug Safety Monitoring

A one-year, $30,077 grant from the Food and Drug Administration (FDA). Major goals: This workgroup activity involves identifying and implementing sensitivity analyses in regard to residual confounding, exposure, outcome, and covariate misclassification, and other biases in collaboration with the Mini-Sentinel Operations Center and FDA. The workgroup will utilize Mini-Sentinel data resources to implement these sensitivity analyses in conjunction with the Prospective Routine Observational Monitoring Program Tools (PROMPT) modules for expedited drug safety monitoring in the Mini-Sentinel Distributed Database. The workgroup will also produce a user manual for the software programs developed during this activity, and will submit a report to the FDA on workgroup findings. The GHRI lead investigator is Sascha Dublin.

Evaluation of a Health Plan Initiative to Mitigate Chronic Opioid Therapy Risks

A three-year, $1,790,083 grant from the Patient-Centered Outcomes Research Institute. Major goals: This research will evaluate Group Health’s chronic opioid therapy risk mitigation initiative to determine whether it reduced risks of prescription opioid use disorder and affected pain outcomes of chronic pain patients using opioids long-term. We will also assess effects of the risk mitigation initiative on major adverse health events including hip/pelvis fractures, motor vehicle accidents, bowel obstruction resulting in hospitalization, and opioid overdose. The principal investigator is Michael R. Von Korff.

Expansion of Patient Access to Information—Open Notes Project Evaluation

A one-year, $24,881 grant from the Group Health Foundation. Major goals: The evaluation of the Open Notes implementation project will include: 1) Patient perceptions of behaviors, benefits, and negative consequences; 2) Provider perceptions of behaviors, benefits, and negative consequences; and 3) Patient healthcare utilization. The principal investigator is James D. Ralston.

GHRI Relationship-Building Content Strategy and Development

A one-year, $159,099 grant from the GHRI Development Fund. Major goals: The objective of this effort is to influence health and health behavior among Group Health members and the public through marketing/dissemination of GHRI-generated knowledge via information technology. Funds would be used to develop a new GHRI content strategy for disseminating GHRI knowledge through a variety of channels such as web-based e-letters, e-mail alerts, and social media. This would include 1) contracting with a content strategy vendor who would work with us through the development of a content management system (CMS); 2) licensing, customizing, and implementing the CMS, including training the GHRI Communications Unit to use it; 3) hiring a web content producer as a limited duration employee to work with the vendor to get the system implemented and operational. The principal investigator is Joan DeClaire.

National Leadership Academy for the Public’s Health 

A one-year, $15,000 grant from the Centers for Disease Control and Prevention (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, CA, 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 Maggie Jones.

Patient-Centered Medical Home (PCMH) 2.0 Model Evaluation

A one-year, $93,242 grant from Group Health Research Institute Development Fund. Major Goals: To extend formative evaluation of Group Health’s PCMH 2.0 redesign, including care staffing and activities specific to patients high risk for unmet health care needs. The principal investigator is James D. Ralston.

Perceptions of Alcohol Use and Sobriety Among Alaska Native People

A five-year, $257,078 grant from the Native American Research Center for Health. Major Goals: Using community-based participatory research methods, this translational research project will: 1) explore underlying explanatory models of alcohol use, misuse, and sobriety among Alaska Native people and other key stakeholders within a Tribal health system; 2) assess the acceptability and perceived utility of different prevention and treatment strategies to reduce alcohol misuse and encourage sobriety, including pharmacotherapy and pharmacogenetics. The GHRI lead investigator is Evette J. Ludman.

Reducing Low-Value Care—Year 2

A one-year, $80,000 grant from the Group Health Foundation. Major goals: To engage providers to reduce overuse of low-value services and evaluate variability in low-value care and testing strategies at the provider and patient level to decrease overuse. The principal investigator is Diana S. Buist.

Statistical Methods for Estimation of Benefits and Harms of Repeat Cancer Screening

A two-year, $160,000 grant from the National Cancer Institute. Major goals: To develop new statistical methods to estimate the expected number of false-positive test results and cumulative probabilities of experiencing a screen-detected cancer, false-negative test result, or false-positive test result over the course of a cancer screening regimen. We will then use these methods to compare risk-based breast cancer screening strategies. The principal investigator is Rebecca Hubbard.

Strategies and Opportunities to Stop Colon Cancer in Priority Populations

A four-year, $544,395 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 (Oregon Community Health Information Network) community-based collaborative network of over 200 FQHCs. The GHRI lead investigator is Beverly B. Green.

Systematic Evidence Reviews to Support the U.S. Preventative Services Task Force (USPSTF)—Skin Cancer

A three-year, $361,410 grant from the Agency for Healthcare Research and Quality. Major Goals: The purpose of this Task Order is to provide technical support for the U.S. Preventive Services Task Force by conducting systematic evidence reviews and decisions analysis that the task force will use to make new or update existing recommendations. The GHRI lead investigator is David C. Grossman.

Take Active Breaks from Sitting—Pilot 2

A one-year, $39,997 grant from the Group Health Research Institute Development Fund. Major goals: Continue to adapt and test the effectiveness of a sedentary-time reduction program in an iterative sample of obese older adults. In doing so, we will continue to obtain data on which measurement techniques best capture changes in sedentary time (self-report, Actigraph, or activPAL accelerometers). The principal investigator is Dori E. Rosenberg.

Validating a Childhood Vaccine Registry—Phase 3

A four-month, $29,893 grant from the Group Health Foundation. Major goals: To determine how vaccine hesitancy changes over time from birth to 2 years in mothers and to identify any risk factors associated with increasing hesitancy using data collected at three time points: birth, 6 months, and 18-24 months. The principal investigator is David C. Grossman.

Validating a Childhood Vaccine Registry—Phase 3 (Group Health Membership Survey)

A one-year, $100,851 grant from the Group Health Research Institute Development Fund. Major Goals: We propose a membership-wide survey to a representative sample of Group Health members. If successful, this initiative could become a GHRI resource and source of preliminary data for all faculty. The principal investigator is Nora Henrikson.

WISH II Survey

A six-month, $3,821 grant from the Group Health Research Institute Directors Project Resource Fund. Major Goals: Supplemental survey work to support parent project to conduct two small case-control studies of the association between certain genetic variants and the risk of bleeding and clotting from warfarin therapy. It will involve identifying case with bleeds and clots who started warfarin therapy within a defined time period, matching controls and contacting subjects via mailings and collecting cheek swabs to obtain genetic information. The principal investigator is Denise M. Boudreau.

January 2014

GHRI recently received word of ten new awards.

A Methods Mini-Symposium: Confronting Methodological Challenges of Using Electronic Health Record Data for Comparative Safety and Effectiveness Research

A one-year, $20,000 grant from the Group Health Research Institute Development Fund. Major goals: To organize a two-day methods mini-symposium convening stakeholders from GHRI, local, and national academic institutions, and funding agencies to a) discuss key methodological challenges of conducting comparative drug safety and effectiveness research using large observational health care databases; b) share creative ideas to address these challenges; and c) enhance further use of cutting-edge methods within research programs at GHRI through a series of focused sessions with nationally recognized methodological experts. The principal investigator is Andrea J. Cook.

Assessment of Patient and Family Centeredness and Engagement in Primary Care—Survey Development and Testing

A two-year, $300,506 grant from the Gordon and Betty Moore Foundation. Major goals: To identify key constructs and the underlying dimensions of patient- and family-centered care to be included in surveys of providers, clinical staff, patients and family members. The survey is aimed at quantifying the degree of patient- and family-centeredness (including knowledge, awareness and barriers) as well as the extent of patient/family engagement in primary care practice redesign. Work includes literature reviews, focus groups with patients, families, patient and family advisors, physicians and clinical staff, and meeting with an expert panel. The GHRI lead investigator is Robert J. Reid.

Efforts to Develop the Sentinel Initiative—OMOP-IMED

A two-year, $43,173 grant from the Food and Drug Administration. Major goals: The primary aim of this activity is to better understand the impact of OMOP’s findings on evaluations that are being conducted within the Mini-Sentinel Distributed Database environment. This project will develop and conduct an evaluation to examine OMOP findings related to ACE inhibitors and angioedema and its relevance to Mini-Sentinel activities. The GHRI lead investigator is Jennifer C. Nelson.

Efforts to Develop the Sentinel Initiative: Protocol-Based Assessment of Thromboembolic Events After Immunoglobulin Administration—Chart Validation

A two-month, $1,713 grant from the Food and Drug Administration. Major goals: To conduct full-text medical record review to confirm and validate the algorithms for thromboembolic event diagnoses and intravenous immunoglobulin exposure recorded in the administrative and claims databases within Mini-Sentinel as part of a one-time, retrospective, protocol-based assessment. The GHRI lead investigator is Denise M. Boudreau.) 

Evaluating Education and Training on Multiple Chronic Conditions (MCC) for Health Care Workforce Services

A three-year, $56,659 grant from Department of Health and Human Services. Major Goals: To (1) assess the health care field to identify and evaluate education and training materials for key health care workforce professions on improving the care of persons with MCC; (2) use the evaluation findings to develop an MCC training and education framework that can be used within specific health care professions and across health care professions to reflect a cross-disciplinary approach that includes health professionals learning about, from, and with each other to enable effective collaboration and improved MCC patient health outcomes; and (3) use the evaluation findings and the framework for collaborating with relevant stakeholders to develop a model MCC curricula and competencies. GHRI’s MacColl Center will provide input on all aspects of the project and will lead the framework development. The GHRI lead investigator is Judith Schaefer.

Home Blood Pressure Telemonitoring and Case Management to Control Hypertension

A three-year, $30,137 grant from the National Heart, Lung, and Blood Institute. Major goals: Competitive continuation of a telemonitoring grant to improve hypertension control in a primary care setting and team models of care. The GHRI lead investigator is Beverly B. Green.

Identifying the Cost of Virtual Encounters

A one-year, $46,719 grant from the Group Health Research Institute Development Fund. Virtual encounters including secured messaging, telephone calls, and virtual consultations between and among providers are a growing share of total health care use at Group Health and across US health care. At present, there is little empirical evidence to support measurement of the financial impact of these encounters and thus we risk misallocating health care resources based on a limited understanding of the costs of this new form of health care use. We propose to develop a method for costing virtual encounters and apply this to previously developed work on standardized costs as applied to health care use. The principal investigator is Paul A. Fishman.

Maintenance and Operation of Medication Exposure in Pregnancy Risk Evaluation (MEPREP)

A one-year, $8,512 grant from the Food and Drug Administration. Major goals: To maintain the data, linkages, and organizational structure developed in the MEPREP pilot. The GHRI lead investigator is Sascha Dublin.

Molecular Clonality of Uropathogenic E. Coli

A five-year, $628,015 grant from the National Institute of Allergy and Infectious Diseases. Major goal: To identify urovirulence-associated Escherichia coli traits using a population genomics approach, combined with experimental models relevant to the pathogenesis of urinary tract infections (UTI). Comparative clonal analysis will be done by genotyping approximately 2,500 freshly-isolated strains obtained from patients with acute and recurrent cystitis, all from the same geographic area (Seattle). Specific Aim 1: Characterize the population diversity of uropathogenic E. coli (UPEC) clones. Specific Aim 2: Identify genetic loci under positive selection in UPEC. Specific Aim 3: Determine the impact of genetic variations on E. coli urovirulence. The GHRI lead investigator is Delia Scholes.

Patient Self-Swabbing at Home for Influenza Testing

A one-year, $56,118 grant from the Group Health Research Institute Development Fund. Major goals: We propose to pilot test the use of patient self-swabbing to test for respiratory virus infections. The goal is to determine whether we can FedEx swab kits to patients and have them successfully collect nasal swabs on themselves and then ship the specimen kits to the study laboratory for testing. The principal investigator is Michael L. Jackson.

Pharmacogenomics in Rural and Underserved Populations II

A one-year, $12,160 grant from National Institutes of Health. Major goals: To conduct two small case-control studies of the association between certain genetic variants and the risk of bleeding and clotting from warfarin therapy. It will involve identifying case with bleeds and clots who started warfarin therapy within a defined time period, matching controls and contacting subjects via mailings and collecting cheek swabs to obtain genetic information. The GHRI lead investigator is Denise M. Boudreau.

Positioning the PORPOISE Study for R01 Funding

A one-year, $30,434 grant from the Group Health Research Institute Development Fund. Major goals: 1) To understand how animal-assisted activities (AAA) affect young people with cancer and how to most effectively deliver AAA interventions; 2) To conduct a pilot AAA intervention for young people with cancer. The principal investigator is Jessica Chubak.

Preparing Clinicians and Patients for Shared Decision-Making about Alcohol Use Disorders—Development of an Entertaining Video that Addresses Misconceptions and Stigma

A one-year, $98,813 grant from the Group Health Research Institute Development Fund. Major Goals: To use formative evaluation to develop, evaluation and refine a 5-10 minute video that overcomes patient and provider misconceptions about unhealthy alcohol use and its medical management. The principal investigator is Katharine A. Bradley.

Samueli Military Medicine Project—USAMRAA

A one-year, $29,745 grant from Department of Defense. Major goals: To provide senior scientific expertise in complementary and alternative medicine therapies to the Samueli Institute for their program on military medicine. The principal investigator is Karen J. Sherman.

Samueli Military Medicine Project—Samueli

A one-year, $29,746 grant from the Samueli Institute. Major Goals: To provide senior scientific expertise in complementary and alternative medicine therapies to the Samueli Institute for their program on military medicine. The principal investigator is Karen J. Sherman.

Social & Scientific Systems, Inc.—Group Health Providers Survey

A four-month, $4,637 grant from the Urban Institute. Major goals: 1) Obtain and maintain relevant regulatory approvals and agreements, such as IRB approval. 2) Identify and compile a list of Group Health providers to receive Social & Scientific Systems’ survey. 3) Draft an e-mail in collaboration with Group Health leadership to Group Health providers informing them about Social & Scientific Systems’ survey and asking them to complete it. 4) E-mail Social & Scientific Systems’ survey link to Group Health providers. The principal investigator is Robert J. Reid.

Structural and Biological Changes in Traumatic Brain Injury-Related Neurodegeneration

A two-year, $93,811 grant from the Allen Institute for Brain Science. Major goals: To support a multi-center team to increase our understanding of chronic traumatic encephalopathy (CTE) and other late effects of physical trauma to the brain. We will leverage extensive resources from an ongoing prospective cohort study of brain aging to address the many areas of uncertainty and dramatically increase knowledge of CTE and the late effects of TBI. The GHRI lead investigator is Eric B. Larson.

UW Staff Assignment CDC-HAN Health, Aging, and Technology Workgroup

A one-year, $7,648 grant from the Centers for Disease Control and Prevention. Major goals: To co-lead monthly conference calls on Healthy Aging and Technology, to develop new research priorities on aging and technology, and to participate in relevant manuscript writing. The GHRI lead investigator is Dori E. Rosenberg.

Vaccine Safety Datalink White Paper—Studying the Safety of the Vaccination Schedule

A one-year, $25,107 grant from the Centers for Disease Control and Prevention. Major goals: We will work with Kaiser Permanente Colorado to write a white paper on approaches for studying the safety of the childhood immunization schedule. The GHRI lead investigator is Michael L. Jackson.