Background: The Duke Primary Care Research Consortium (PCRC) was established in 1997 as a primary care research network composed of academic and community practices within the Duke University Health System, the Durham Veterans Affairs Medical Center, and surrounding communities. The PCRC serves a total of 185 family practitioners, internists, and pediatricians who collaborate in adult and pediatric studies. The PCRC consists of 23 practices with 29 sites located in eight counties of the Piedmont area of North Carolina. Our mission is to participate in studies that will improve health care delivery and patient outcomes, plus generate findings to support the practice of evidence-based medicine. The Duke PCRC is applying for both categories of developmental funding. Category I, Infrastructure Project: The goal of the Duke PCRC is to build the infrastructure for translation of research into the primary care practices within the Duke Health System. This will entail (1) planning for implementation of evidence-based care, including the measurement of organizational, provider, and patient readiness; (2) exploration of methods for communication among clinicians and the dissemination and implementation of research findings; and (3) the development and testing of handheld devices for collecting physician and patient data. Category II, Pilot Research Project: Duke PCRC plans to implement a practice improvement project assessing the rates of influenza immunization in asthma patients followed within the primary care practices. The American Lung Association Asthma Research Centers recently published a crossover study demonstrating the safety of influenza vaccine for asthmatics. Our goal is to (1) identify the organizational and patient barriers to influenza immunization of asthma patients, (2) randomize patients to dissemination of the research findings, and (3) tailor interventions to improve immunization of asthma patients. The primary outcome is the rate of influenza immunization, measured by the proportion of clinic procedure codes for influenza vaccine and though patient self-report. While the focus is immunization of asthma patients, the toolbox of interventions should be applicable to other high-risk pediatric and adult populations, including minority and underserved populations. This pilot project aims to measure the impact of translation efforts in influenza immunization, with the future goal for expansion into additional preventive health behaviors (other vaccines, screening modalities) and expansion into evidence-based management of chronic illnesses.
