CANDIDATE: I am proposing to study how certain features of the Primary Care Medical Home (PCMH) impact the utilization of recommended preventive health services by Latino Immigrants. I will build upon my broad clinical and health policy background, using expert mentors and local research training opportunities to develop into an independent health services researcher. RESEARCH FOCUS: Latino immigrants, a rapidly growing segment of our population, underutilize routine preventive health care. Some features of the PCMH have been associated with increased utilization in some vulnerable populations, but little objective, multi-facility data exists to address the effects of these changs on Latino immigrants. The Oregon Community Health Information Network (OCHIN) is a multiple-facility linked electronic medical record that contains data capable of filling this knowledge gap. This proposal expands on existing PCMH research, and proposes to use the OCHIN Electronic Health Record (EHR) data to evaluate the association between certain PCMH principles and preventive service use in Latino immigrants. TRAINING GOALS: My training goals include (1) developing his skills in research design, analysis, and interpretation with a focus on the use of large databases to study vulnerable populations and 2) expanding my knowledge and experience in the strategies for and practice of health disparities research. ENVIRONMENT: I will undergo his career development in the Department of Family Medicine at Oregon Health Science University and through the Oregon Clinical and Translational Research Institute, two organizations with significant and longstanding resources for early-career researchers. METHODS: (1) Cross-sectional analysis of Latino immigrants in the OCHIN EHR data and their rates of utilization of lipid screening, cervical cancer screening, and pneumococcal vaccination. (2) Retrospective cohort analysis of the association between certain features of the PCMH and these preventive services in Latino immigrants. OUTCOMES: I will measure the rates of preventive service use in Latino immigrants cared for in OCHIN clinics and compare these to rates of other populations in OCHIN. I will test how select features of the PCMH will affect the rate of utilization of lipid screening, cervical cancer screening, and pneumococcal vaccination in Latino immigrants.

Public Health Relevance

This project will provide valuable information for medical providers and policy makers as they attempt to finance, organize, and provide routine preventive health care for low-income individuals in our communities. Specifically, our community health centers will benefit from this information as they provide preventive health care with limited resources.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Clinical Investigator Award (CIA) (K08)
Project #
1K08HS021522-01A1
Application #
8509207
Study Section
HSR Health Care Research Training SS (HCRT)
Program Officer
Anderson, Kay
Project Start
2013-07-10
Project End
2017-06-30
Budget Start
2013-07-10
Budget End
2014-06-30
Support Year
1
Fiscal Year
2013
Total Cost
Indirect Cost
Name
Oregon Health and Science University
Department
Family Medicine
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Bailey, Steffani R; Hoopes, Megan J; Marino, Miguel et al. (2016) Effect of Gaining Insurance Coverage on Smoking Cessation in Community Health Centers: A Cohort Study. J Gen Intern Med 31:1198-205
Bailey, Steffani R; Marino, Miguel; Hoopes, Megan et al. (2016) Healthcare Utilization After a Children's Health Insurance Program Expansion in Oregon. Matern Child Health J 20:946-54
Heintzman, John; Bailey, Steffani R; DeVoe, Jennifer et al. (2016) In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon. J Racial Ethn Health Disparities :
O'Malley, Jean P; O'Keeffe-Rosetti, Maureen; Lowe, Robert A et al. (2016) Health Care Utilization Rates After Oregon's 2008 Medicaid Expansion: Within-Group and Between-Group Differences Over Time Among New, Returning, and Continuously Insured Enrollees. Med Care 54:984-991
Marino, Miguel; Bailey, Steffani R; Gold, Rachel et al. (2016) Receipt of Preventive Services After Oregon's Randomized Medicaid Experiment. Am J Prev Med 50:161-70
Heintzman, John; Marino, Miguel; Hoopes, Megan et al. (2015) Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data? J Am Med Inform Assoc 22:909-13
Angier, Heather; Hoopes, Megan; Gold, Rachel et al. (2015) An early look at rates of uninsured safety net clinic visits after the Affordable Care Act. Ann Fam Med 13:10-6
Bailey, Steffani R; O'Malley, Jean P; Gold, Rachel et al. (2015) Receipt of diabetes preventive services differs by insurance status at visit. Am J Prev Med 48:229-33
DeVoe, Jennifer E; Marino, Miguel; Gold, Rachel et al. (2015) Community Health Center Use After Oregon's Randomized Medicaid Experiment. Ann Fam Med 13:312-20
Heintzman, John; Bailey, Steffani R; Hoopes, Megan J et al. (2014) Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults. J Am Med Inform Assoc 21:720-4

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