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HPRN Projects and Programs

HPRN typically conducts multiple studies, quality improvement programs, and assessments at one time. This website will be regularly updated represent new projects and collaborations.  The list below represents selected HPRN studies. 

Asthma Toolkits

…is a quality improvement program funded by the Colorado Department of Public Health and Environment designed to provide “Asthma Toolkits” for primary care clinicians and their patients to help improve asthma care in rural Eastern Colorado.This project is a result of a partnership between HPRN and National Jewish Health.

Community Asthma Integration and Resources (AIR)

…is a community-based project designed to improve community knowledge, attitudes, and self management of asthma in rural Eastern Colorado.The project uses a community-based participatory model and complements and strengthens the current “Asthma Toolkits” program occurring in eastern Colorado. This program is funded by the Caring for Colorado Foundation.


…is a home blood pressure monitoring project to improve their cardiovascular health bygenerating timely and useful information for providers and patients through home blood pressure monitoring (HBPM) and point-of-care (POC) lipid testing. We are in the evaluation phase of this project, which was funded by Colorado Department of Public Health and Environment.

Improving Asthma Outcomes through ETS Reduction Interventions in Primary Care

…is a combines a card study with practice-specific feedback.This study uses a “5A’s based” change strategy to survey pediatric practices to assess their current use of proven ETS reduction strategies.Practices work through advise, agree and assist cycles to increase their use of proven ETS reduction strategies.Changes made in the practices are examined with feedback to the practices to Arrange for sustainability HPRN partnered with National Jewish Health for this study.

Underinsurance in Primary Care Patients

..used is an anonymous patient survey of patients at time of visit to describe underinsured patients in primary care in Colorado. This study was funded by the Colorado Health Foundation.

Promoting Colon Cancer Testing in Rural Colorado a CDC-funded community participatory project designed to increase screening for colorectal cancer in the High Plains region. The HPRN Community Advisory Council worked with the research team to develop a set of main messages and a multi-component, culturally relevant dissemination strategy.  Over 250 local residents helped to implement this intervention in the northeast counties of Colorado.  Southeast Colorado counties served as the control region. See our telephone questionnaire (PDF file).  Preliminary analysis indicates encouraging results.  Final outcomes will be available soon.

Leaders for Effective Activity Planning (LEAP) demonstration project funded by the Robert Wood Johnson Foundation's grant program Prescription for Health. The project is designed especially for promoting healthy behaviors in primary care patients. This study is also occurring in CaReNet practices.

Applied Strategies for Improving Patient Safety (ASIPS)

... is a collaborative effort between the University of Colorado Department of Family Medicine and numerous organizations to analyze the causes and effects of errors in primary care and reduce the incidence of errors. This study also occurred in CaReNet practices.

Lipid and blood pressure management for patients with type 2 diabetes

…is funded by Bennett Parnes's Robert Wood Johnson Foundation Generalist Physician Faculty Scholar Award to examine how primary care providers manage lipids and blood pressure for patients with type 2 diabetes. This study is also occurring in CaReNet practices.

Mental Health Referrals from Primary Care

...examines how primary care providers manage patients' mental health care needs. This study is also occurring in CaReNet practices.

Care of Acute Myocardial Infarction, Unstable Angina, and Chest Pain in Rural Colorado

…ascertains how rural primary care physicians currently care for patients suffering acute myocardial infarction.  Chart abstraction were completed for patients who presented with chest pain to emergency departments in rural Northeast Colorado hospitals between 1995 and 1999.

Improving Access to Health Care for Hispanic Community Members in Western Yuma County

…was a community assessment to better understand the barriers that exist in Western Yuma County that prevent Hispanic Community Members from accessing health care. Focus groups with Hispanic community members, Yuma hospital and clinic staff, and community agency staff.  assessed participants’ belief about health care, prenatal care, barriers to accessing health care, and ideas about overcoming these barriers. In addition, over 250 Hispanic community members were surveyed regarding their current physical and mental health, knowledge of community resources available, and what they perceive the barriers to be that limit their access to health care. This project also included a chart audit of all patients who gave birth at Yuma hospital to detail trends in mothers’ demographics, prenatal care, and prenatal risk factors.

Use of the ACI-TIPI to Improve Heart Attack Triage and Transport

Ten rural Colorado hospitals have been slated for participation in a study to assess the use of the Acute Cardiac Ischemia - Time Insensitive Predictive Instrument (ACI-TIPI). The ACI-TIPI software was installed on ECG machines in the emergency departments of the hospitals. In addition to the standard ECG reading, the software generates a probability score from 0% to 100% of the likelihood that a person is having a heart attack. Physicians use the score as a tool to aid in diagnoses and treatment decisions. ACI-TIPI report scores will be collected on all patients presenting to the hospital with chest pains or other symptoms suggestive of acute cardiac ischemia. Chart abstraction will also be performed on patients to determine admission rates, transfer rates, and treatment decisions in conjunction with the availability of the ACI-TIPI report.

Improving the Care of Patients with Heart Failure

…examined whether there were major differences in the care of heart failure patients by geographic location (rural vs. urban). This study was done in conjunction with the Colorado Foundation for Medical Care (CFMC).

Assessing and Improving Quality of Care for Dying Patients in Rural Colorado

…assessed the knowledge and attitudes towards palliative care of physicians, nurses, other care providers, staffs at hospitals, nursing homes and clinics, and community members in rural communities.

Impact of double Counting and Transfer Bias on Estimated Rates and Outcomes of Acute Myocardial Infarction

...followed up on inconsistent findings on the changes in the incidence of hospitalizations for people suffering with ischemic heart disease. Preliminary data suggest that a large number of patients with acute myocardial infarction in rural communities are transferred to urban centers for care. Patients transferred to a second hospital may be counted twice for one episode of ischemic heart disease. (The abstract to this paper can be found on-line at Medical Care. To request a copy of the full text, please email: