We propose to establish the Northwestern University Center for Advancing Equity in Clinical Preventive Services. The overall goal is to expand and accelerate the development, testing, and dissemination of innovative, practical, effective, generalizable interventions to increase equity of clinical preventive services. Our Steering Committee (SC) will include leaders from academic departments, our practice-based research networks, and our partner networks of community health centers (CHCs). The SC willl create a vision and strategic plan for expanding our research program and allocate funds for pilot projects to implement that plan. Our Core Administration will provide support for research development, research methods and analysis, dissemination, and research training.
We aim to generate multiple new grants over the 3-year funding period, at least one of which will be an implementation and dissemination grant across our large practice networks. Funds are requested for 3 initial projects to address important disparities. Project 1 addresses disparities n colorectal cancer screening. We will conduct a randomized controlled trial to determine whether a multifaceted intervention at a CHC serving a poor, predominantly Latino population can increase rates of repeat fecal occult blood testing (FOBT). Project 2 address disparities in cardiovascular disease prevention. We will conduct a randomized trial at 3 CHCs serving very diverse, underserved populations and compare usual care to a system of population health management that will a) use health IT to identify patients with no known cardiac history but high 10-year risk of cardiac events (Framingham Risk Score) who are not currently prescribed a statin, and b) perform outreach to educate patients about their risks, the benefits of treatment, and facilitate the treatment of eligible and appropriate patients with statin therapy. Project 3 seeks to understand and address the high rate of refusal of pneumococcal vaccine among African-Americans in one of our clinics. This project will interview patients to understand reasons for refusals and develop a multimedia program to show patients in examination rooms to explain the risks and benefits of pneumococcal vaccination. A pilot study will assess feasibility and patient and staff acceptance.
Disparities exist for use of clinical preventive services by race/ethnicity, language, socioeconomic status, gender, age, and sexual orientation, and national organizations have set goals of reducing disparities. This center will combine our expertise in health literacy/health communication, quality improvement methods, and health information technology to develop and test interventions to achieve equity in preventive services.
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