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Chronic Disease Prevention and Management

An important part of good patient care is to promote healthy behaviors in patients. This includes identifying unhealthy habits and supporting patients as they make changes to improve them. This means attending to behaviors like smoking/tobacco use, alcohol use, diet, and exercise. It also means helping patients with existing chronic conditions to best manage their condition through education, support, and other means. Chronic conditions commonly treated in primary care include diabetes, hypertension, heart disease, COPD, asthma, and CHF.

The Department of Family Medicine has an active program of research focused on facilitating practices developing effective and efficient ways to help their patients maintain a healthy lifestyle.

Examples of current studies that explore this topic.

 Fit Family Challenge

The goal is to implement a pediatric obesity program into primary care.  

Funded by The Colorado Health Foundation. 

PI: Bonnie Jortberg


 Connection to Health

The goal is to compare methods for assisting primary care practices in the implementation of self-management support, including a web-based self-management support system. 

Funded by National Institute for Diabetes, Digestive and Kidney Diseases. 

PI: Perry Dickinson.



The goal of this study is to implement self-management support based upon the 5As framework, with a focus on connection to appropriate practice and community based resources for patients with diabetes and additional mental and behavioral health needs.

Funded by Bristol-Myers Squibb. 

PI: Bethany Kwan.



The goal is use an innovative implementation intervention—Boot Camp Translation—to promote and study the implementation of AHRQ’s Self-Management Support Library/Toolkit across 16 primary care practices in four PBRNs. 

Funded by the Agency for Healthcare Research and Quality.

Colorado PI: Donald Nease.


 Maximizing Care Management Effectiveness in Primary Care

Goal is to understand effective components in care management delivery in primary care.

Funded by Agency for Healthcare Research and Quality.

PI: Jodi Summers Holtrop.


Contact Info:

Jodi Summers Holtrop, PhD, MCHES
Associate Vice Chair for Research
Co-Director, SNOCAP
Phone: (303) 724-5339