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Current Projects and Grants

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Online Problem-Solving Skills Training for Mothers of Childhood Cancer Patients

This is a randomized controlled trial of the effect of maternal problem-solving skills training delivered face-to-face vs. delivered online on problem-solving skill and negative affectivity. 

Principal Statistician: Diane Fairclough, DrPH
Funding Agency: NIH/NCI
Contact Information: 303-724-1168




A Cardiovascular Risk Reduction Learning Community in DARTNet
This project proposes to improve the control of high blood pressure and elevated cholesterol, two of the major reversible risk factors through innovative electronic audit and feedback to primary care providers of more than 320,000 patients in the Distributed Ambulatory Research in Therapeutics Network (DARTNet).  Our approach includes: 1) Define our conceptual mode; 2) Describe DARTNet; 3) Form a Cardiovascular Risk Reduction Learning Community consisting of DARTNet care providers and patients plus the investigators of the present proposal; 4) Collect data and develop multivariate models of blood pressure and cholesterol control; 5) Develop and implement recurring electronic feedback and changes in blood pressure and cholesterol control following feedback, and; 7) if the results in 6) appear promising, plan an RCT with new DARTNet participants to test the hypothesis that innovative audit and feedback improves blood pressure and cholesterol control and reduces major adverse cardiovascular events.
Principal InvestigatorKarl Hammermeister, MD
Funding Agency: NHLBI
Contact Information: 303-724-0164


Chronic Diseases (Hypertension, Respiratory):


Association between Providers’ Ethnic/Racial Biases and Hypertension Control
The major goals of this project are to measure healthcare providers’ implicit and explicit biases toward African Americans and Latinos, and examine the degree to which those biases are associated with ethnic/racial disparities in hypertensive patients’ perceptions, disease management and health outcomes.
Principal Statistician: Diane Fairclough, DrPH
Funding Agency: NIH/NHLBI
Contact Information: 303-724-1168 


Diagnosis and Treatment of Critical Illness Polyneuromyopathy in Patients with Acute Respiratory Failure.
This is a clinical trial that will determine a new diagnostic test and therapeutic option for acute respiratory failure patients that have developed critical illness polyneuromyopathy.
Principal Investigator: Diane Fairclough, DrPH
Funding Agency: NIH
Contact Information: 303-724-1168  


Creation and Demonstration of a Palliative Care Research Cooperative Group
Many important clinical questions remain unanswered in palliative care, due to the lack of research infrastructure in this field.  We will: (1) establish a national cooperative group to support high-quality, multi-site, collaborative research addressing clinically relevant topics in palliative care, and; (2) test the collaborative through a clinical trial addressing the question of whether or not to discontinue statins as patients near death.

Principal Statistician: Diane Fairclough, DrPH
Funding Agency: NIH/NINR
Contact Information: 303-724-1168


Improving Symptoms and Quality of Life in Advanced Chronic Heart Failure

The major goal of this project is to conduct a randomized clinical trial to evaluate a palliative symptom management and psychosocial care intervention to reduce symptom severity and depression.

Principal Statistician: Diane Fairclough, DrPH
Funding Agency: NIH/NINR
Contact Information: 303-724-1168



Family Medicine: (By Investigator)

Principal Investigator: Shandra Brown Levy, PhD

Dr. Brown-Levey's project aims to examine the value-added of including psychological services in health care settings, specifically Primary Care. The focus of the evaluation is to examine utilization of health care services and costs in settings with and without psychologists comparing multiple sites within the University of Colorado health care system over a minimum of a 2 year period of time.

Principal Investigator: Perry Dickinson, MD

1. The Life Quality Initiative is a collaborative program to integrate palliative care principles and approaches into healthcare sectors serving people with serious, chronic, or advanced illness. The Life Quality Initiative will offer provider training and application of practices that are proven to alleviate personal and systemic burdens of complex issues. This funding will provide evaluation of this program by using a mixed-methods approach which will answer questions about the implementation and outcomes in primary care settings.
2. Project 2 will implement a cooperative program to build primary care practice capacity for quality improvement, change management, and implementation of PCOR findings in primary care practices in Colorado and New Mexico, with an initial focus on cardiovascular care. It also will conduct a cluster randomized trial with an external matched cohort control group to examine the Reach, Effectiveness, Adoption, Implementation, and Maintenance of two approaches to practice transformation to implement PCOR interventions for reducing cardiovascular risks in primary care practices, comparing the impact of 1) a standard practice transformation support intervention (including practice facilitation, practice assessment with feedback, HIT assistance, academic detailing, and collaborative learning sessions) to 2) an approach that adds patient engagement activities as part of the practice transformation support. 
3. The Colorado SIM project will assist 400 practices in transforming to advanced models of primary care including behavioral health integration. 
4. Dr. Dickinson's fourth project provides support for practice and curriculum transformation for Rose Hospital and Swedish Hospital Family Medicine residency programs to become patient-centered medical homes.
5. Dr. Dickinson's last project provides support for practice and curriculum transformation for eight Colorado Family Medicine residency programs to become patient-centered medical homes.

Principal Investigator: Douglas Fernald, BA, MA

Dr. Fernald's project will advance AHRQ’s goals of promoting the use of evidence-based health assessments and self-management support strategies in primary care by providing free, readily-available, Board-endorsed MOC Part IV educational Modules. It directly addresses access barriers to MOC among PCPs.

Principal Investigator: Russell Glasgow, MS, PhD​

1.The project will develop a conceptual model of adaptations relevant to primary care delivery and validate the model for primary care practices that implemented the target interventions.
2. Supports infrastructure to facilitate cancer research in integrated health care delivery settings, including an Informatics Core to enhance data resources; promotion of research in strategic scientific areas; a Career Development and Training Program; and a Developmental and Pilot Projects program.

Principal InvestigatorJodi Holtrop, PhD

Research has shown that care management services can improve chronic disease patient outcomes, however, in real-world implementation, results are mixed. Although practice-based care management seems promising, research is needed to inform how to effectively implement it and to maximize the benefit in practices that are struggling. This study will add to the field by providing practical and translatable information about what makes care management work and how practice facilitation may maximize the benefit of this new service in community-based primary care. 

Principal Investigator: Katherine James, PhD MSPH, MSCE

We propose to conduct a cohort study investigating the association between cumulative cadmium exposure and cardiovascular disease in the San Luis Valley Diabetes Study cohort using longitudinal physiologic and behavioral data, including historically collected urine samples to estimate cadmium exposure. The proposed study will address gaps in understanding of the etiology of cadmium and cardiovascular disease, can help elucidate the pathobiology of cardiovascular disease, and can aid in preventive efforts to limit cadmium exposure since primary exposure sources are well recognized.

Principal Investigator: Michael Kahn, MD, PhD

We propose to conduct a cohort study investigating the association between cumulative cadmium exposure and cardiovascular disease in the San Luis Valley Diabetes Study cohort using longitudinal physiologic and behavioral data, including historically collected urine samples to estimate cadmium exposure. The proposed study will address gaps in understanding of the etiology of cadmium and cardiovascular disease, can help elucidate the pathobiology of cardiovascular disease, and can aid in preventive efforts to limit cadmium exposure since primary exposure sources are well recognized.​

Principal Investigator: Bethany Kwan, PhD, MSPH

1. This multi-component evaluation of the CMMI-funded HealthiER emergency department-based care management program is designed to Identify and describe the key factors that contribute to or restrict the success of the HealthiER program, describe the quality case and business case for sustaining the program to key stakeholders, and provide data to support adoption of successful aspects of the program by other health care systems.​
2. This project focuses on linking high-risk diabetes patients to community resources. It involves working with community health centers to identify diabetes patients who are either depressed or have distress around their diabetes and connecting these patents to community resources using ‘three way linkages’ to ensure that all parties have feedback on patient progress and use of resources.
3. This is a mixed-methods evaluation of the reach, implementation and effectiveness of an integrated behavioral health care model in primary care.

Principal Investigator: Linda Zittleman, MSPH​

Christin Sutter, DFM Practice Facilitator for northeaster CO will work with HealthTeamWorks on program implementation-QIC Directed and HPRN practices, assist with ongoing program delivery and participate in ongoing training and development

Health Services:


Demonstration of Health Literacy Universal Precautions Toolkit TO#10
The goals of this project are: 1) To implement the HL Toolkit in diverse practice settings across the US to understand whether it can successfully guide healthcare redesign; 2) to demonstrate that implementing the HL Toolkit can change practice behaviors related to health literacy in measurable ways; and 3) to further the field of health literacy measurement by constructing and validating health literacy quality improvement measures.  Taking the first version of the HL Toolkit at its starting point, this project will take the next step by recruiting primary care practices to implement it in the ways recommended by its authors. Building on the work of SNOCAP USA, the AAFP NRN, and their collaborators in health literacy, patient safety, and distance facilitation of practices, the Project Team (PT) will develop protocols for training and facilitating practices to accomplish this project.
Principal InvestigatorDavid West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


Effect of Racial and Ethnic Discrimination/Bias on Health Care Delivery
Compared with non-Latino whites, members of racial and ethnic minorities in the US have a higher prevalence of conditions that predispose them to cardiovascular disease and have a higher incidence, and poorer outcomes after developing cardiovascular disease; it is accepted that bias is a contributing factor.  The research proposes to reduce the impact of bias on clinical encounters.  The purpose of the study is to improve the measurement of racial/ethnic discrimination in health care systems through improved instrumentation, data collection, and statistical/analytical techniques, enhance the understanding of the influence of racial/ethnic discrimination in health care delivery and its association with disparities in disease  incidence, treatment, and outcomes among disadvantaged racial/ethnic minority groups, and to reduce the prevalence of racial/ethnic health disparities through the development of interventions to reduce the influence of discrimination on health care delivery systems in the US.
Principal Investigator Perry Dickinson, MD​
Funding Agency: DHHA/NIH
Contact Information: 303-724-9754






Expanding  a Distributed Research Network and Cooperative (DARTNET) AHRQ CODEcIDE-TO# 4
This ongoing Task Order focuses on expanding DARTNet to conduct a comparative effectiveness study on major depression.  The specific aims of this proposal are: Aim 1: Expand the Distributed Ambulatory Research in Therapeutics Network by including more primary care practices with a focus on adding general pediatric practices, as well as expanding the breadth and number of non-primary care specialists in the network; Aim 2: Evaluate alternative data extraction and data sharing arrangements when adding large group practices, members through regional health information organizations, and members through independent practice associations; Aim 3: Conduct an observational comparative effectiveness and safety study of different therapies for major depression. As part of this study, evaluate the ability to track episodes of depression care and relate patient specific outcomes to these episodes; Aim 4: Develop a robust management and governance structure that will support the potential rapid growth of the network and responsiveness to various stakeholders with an interest in working with the network;  Aim 5: Exchange knowledge and data with the diabetes consortium as appropriate.  To date, this project has resulted in dramatic growth in the DARTNet community, and the depression study is underway.
Principal InvestigatorDavid West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


SAFTINet: Scalable Architecture for Federated Therapeutic Inquiries Network
This multi-state project will allow researchers, health policy experts, payers, and clinicians to better understand the impact of a wide variety of health care interventions on health outcomes for minority, underserved and socioeconomically disadvantaged populations.  We will  assemble a learning communtiy dedicated to the aforementioned populations and build a secure technology to allow authorized and authenticated stakeholders to answer important questions regarding issues ranging from treatment options to care delivery options.
Principal InvestigatorLisa Schilling, MD​
Funding Agency: AHRQ
Contact Information: 303-724-2254




Mental Health:


Practice Redesign to Improve Depression Care - PRIDE Care
This project plans to integrate depression components into the protocol of a current NIDDK-funded protocol and add depression-specific endpoint measures, emphasizing chart review of patients with depression and non-random selection of patients with depression for interview.  The practice change intervention for the two protocol (NIDDK and NIMH) proposals are virtually identical, except that the current NIDDK protocol has been modified to incorporate our learning from the most recent preliminary studies.
Principal InvestigatorDavid West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170



Primary Care:


Connecting Primary Care Practices with Hard-to-Reach Adolescent Populations TO#8
With the participation of a community, practice staff, and teen representatives from each practice, develop and implement the Out-of-Office Outreach (Facebook, Twitter) and In-Practice Engagement (netbook) technologies at four practice sites: two in urban underserved areas and four in rural areas. Assess the use and perceived utility of the technological components and Assess the impact of the interventions on adolescent health care.
Principal InvestigatorDavid West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


Improving Efficiency in Primary Care Practices  PBRN TO #5 (14)
The specific aims of our investigation are:
Specific Aim 1: Develop a report based upon a review of literature and secondary data: Develop a report summarizing two complementary research efforts. The first employs published research, commentary, and expert input to describe the presence of inefficiency waste in primary care practice, ways to reduce such waste, and process redesign techniques that can be employed in the primary care setting.
Specific Aim 2: Develop a report summarizing the results from a two part in-depth research in primary care practices: Part One: Collect and analyze qualitative and quantitative observation data from seven purposefully selected primary care practices based on the criteria stipulated in the Task Order. Part Two: collect and analyze qualitative and quantitative data from an additional eight, purposefully selected, primary care practices.
Specific Aim 3: Develop and disseminate the decision guide: based on the findings in Specific Aims 1 and 2, develop a preliminary Decision Guide on Waste Reduction in Primary Care to provide guidance to primary care practices seeking to identify and understand inefficiency waste and the possible approaches available to reduce or eliminate such waste.
Principal InvestigatorDavid West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


Integrating Primary Care Practices and Community based programs to Manage Obesity TO#9
In a 24-month project linking primary care practices to an existing community resource, we will use a multiple time trial quasi-experimental design with a mixed methods analysis to evaluate primary outcomes at the practice level and secondary outcomes at the patient level.  Practices (n=5 to 7) will be recruited at one time point and evaluated as the unit of analysis. Patients (n=12-20 per practice) will be recruited by practices using a rolling recruitment strategy and evaluated at the patient level accounting for nesting within practices. Control participants from an original pilot study of the YMCA-DPP will be used as a retrospective control group and will be supplemented by two additional groups of patients within each office, those that are referred to the community resource, but do not engage and those that attend educational activities within the practices but do not seek a referral to the community resource.
Principal InvestigatorDavid West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


Management by Primary Care Clinicians of Patients Suspected of Having Community Acquired MRSA Infections AHRQ PBRN TO# 4 Mod# 1
The purpose of this study is to test interventions specifically designed for two health networks to optimize treatment for SSTIs consistent with the CDC CA-MRSA guidelines.  We are working with three health networks during this study, Medical Clinic of North Texas (MCNT), Wilmington Health Associates (WHA), and Denver Health and Hospital Association (DHHA).  DHHA is only participating in the pre-intervention phase of the project since they have a system-wide intervention to improve MRSA care in place.
Principal Investigator David West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


Primary Care Medical Home  PBRN TO#6 (15)
The task order focuses upon a rapid mixed methods evaluation of primary and qualitative data of retrospective cost and clinical data from a primary care organization that we have identified, (WellMed) that has functioned for at least five years as a Patient Centered Medical Home.  These data are expected to assist policy makers in understanding the potential impact of the medical home model.  The evaluation of the WellMed model chosen for this task order, will provide valuable insight into the strengths, challenges, costs, and value associated with the model.
Our efforts for this task order include a retrospective evaluation analysis of economic and quality outcomes associated with mature primary care, patient-centered medical home practices.
Principal Investigator David West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


Reducing Inappropriate Prescribing of Antibiotics by Primary Care Clinicians TO# 16
A top priority for improving the quality of U.S. healthcare is the reduction of inappropriate antibiotic prescribing and, through the testing of strategies using multi-faceted interventions, we hypothosize that implementation of a clinician decision support system, with an active education component, will reduce the inappropriate use of antibiotics in primary care office practices.  There is a need to determine which aspects of successful interventions provide the greatest benefit in order to reduce the complexity and cost of their implementation, and thus improve the likelihood of their wide-spread uptake. 
The overall objectives are to 1) develop a clinical decision support tool for antibiotic prescribing; (2) recruit primary care practices and clinicians that are active in the PBRN to participate in the project; (3) assess the feasibility of implementing the intervention either through direct engagement with participating clinicians or limited pilot testing; (4) implement and formally evaluate the intervention strategy; and (5) disseminate project findings.
Principal InvestigatorDavid West, PhD
Funding Agency: AHRQ
Contact Information: 303-724-1170


Quality Improvement:


Accountability, Clinical Transformation and Improvement (ACT I):

A Committee made up of Senior Executives from UCH, UPI and SOM was established to create a formal joint partnership. This Committee was designed to update and improve the quality of care throughout the University of Colorado Healthcare Enterprise with the input from key stakeholders including patients, referring physicians, hospital leaders and third party payers. Our specific aims were to strengthen the ability to provide the highest quality of care, address new government and private purchasing strategies that foster competition amongst integrated systems, focus and communicate payment policies to reduce revenue if quality benchmarks are not met, along with a need to become more efficient and accountable across organizational boundaries. In the first year with this committee, three core priorities (Transitions/Readmissions, Referral process and Access to outpatient clinics for appointments) were identified and sub-committees formed to review current procedures and data, develop improvements based upon findings and supportive systems, and implement successful changes across the Enterprise consistently.

Principal Investigator:  David West​

Funding Agency: School of Medicine Grant

Contact Information: 303-724-1170


Surgical Outcomes:


Business Case for Reduction in Surgical Complication Rates in the VA (Vaughan-Sarrazin)
This research will provide important information on the system-wide costs to VHA associated with surgical complications and the potential cost savings of decreasing complications to specific thresholds. The aims are: determine the costs of surgical complications in VHA, adjusting for patient level determinants of costs and hospital-level variation across hospitals, the costs of complications for different types of surgical procedures and finally, calculate the reduction in costs associated with specific system-side reduction in surgical complication rates.
Principal InvestigatorBill Henderson, PhD
Funding Agency: VA
Contact Information: 303-724-1165


Decision Support for Safer Surgery (DS3)
The major goals of this project are to design, implement, test, and evaluate a decision support system to assist care providers in evaluating a patient’s surgical risks and to provide clinical guidance based on the CMS SCIP to reduce the risks.  Project Objectives:  1) Develop risk models to assist in patient risk evaluations and review and affirm SCIP processes of care; 2) Implement and integrate a clinical decision support system into the workflow of the care providers; 3) Test DS3 in two hospitals; 4) Measure and address barriers to implementation of decision support in the preoperative setting; 5) Measure the effect of DS3 implementation in concordance with SCIP process measures for the two hospitals.
Principal Investigator: Tomeh
Funding Agency: NIH/NINR
Contact Information:


Development, Implementation, and Evaluation of the Surgical Bed Management System
The major goals of this project are to construct, test, and evaluate a software module, the Surgical Bed Management System (SBMS), which will: 1) Use predicted length of stay to manage admissions and discharges within a hospital; 2) Use predicted and actual length of stay of a historical cohort of admissions (e.g., previous fiscal year) in a simulation model for strategic planning of bed capacity needs (e.g., the next fiscal year); and 3) Adjust length of stay for severity of illness, comorbidity, and surgical procedure so that this measure of efficiency may be credibly compared across physicians and hospitals.
Principal Investigator:  Rowell
Funding Agency: NIH/NCRR
Contact Information:  


Intra-operative Predictors of Adverse Outcomes
Project Objective:  To investigate whether there is any relationship between aberrations in intra-operative heart rate, blood pressure, temperature, and other continuously measured patient parameters and patient outcome, particularly survival after the patient is discharged from the hospital. 
Principal Investigator:  Monk
Funding Agency: VA Health Service R&D
Contact Information: 303-724-1170