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Current Projects and Grants


 
 
 
 
  

Vaccine Preventable Disease:

 


Randomized Intervention Trial to Evaluate a Vaccine Social Media Website

Primary Investigator:  Sean O’Leary (UCD – Subcontract) / Jason Glanz (Kaiser – Prime)

Funding Agency:  AHRQ – Agency for Healthcare Research and Quality

The objective of this research study is to conduct a randomized intervention trial to measure the effectiveness of an interactive, social media website for parents who are concerned about vaccines.


Immunization Delivery in Obstetrics and Gynecology Settings

Primary Investigator:  Amanda Dempsey

Funding Agency:  CDC – National Center for Immunization and Respiratory Diseases

Although there are several vaccines recommended for women of reproductive age, vaccination rates in this population are low.  In this project, we will develop, implement, and evaluate a vaccination program designed to improve the ability of obstetrician-gynecologist offices to deliver vaccines and ensure that their patients are vaccinated.  This study will be conducted in public, private, and managed care obstetrician-gynecologist clinics serving women of diverse backgrounds, and will provide important information to help guide future public health efforts to achieve high rates of immunization in women of reproductive age.  A vaccine implementation “toolkit” will be developed as part of the project.


Improving Vaccination Coverage among Adolescents

Primary Investigator:  Kevin Dombkowski (MI Prime PI) / Amanda Dempsey (UCD PI – sub)

Funding Agency:  CDC – National Center for Immunization and Respiratory Diseases

Under-utilization of adolescent vaccines is a major public health concern because it leads to an increased risk of acquiring and transmitting vaccine preventable diseases.  The innovative intervention approaches we propose will be able to improve upon proven strategies for increasing immunization (i.e. reminder/recall systems) and also explore novel methods for improving adolescent vaccine delivery (e.g. tailored messaging) that have been successfully applied to other preventive health care behaviors, but have not been evaluated in the realm of adolescent vaccination.  Our efforts will be translated into an immunization provider toolkit which would enable our methods to be implemented in a much broader population, potentially having a substantial impact adolescent vaccination rates.

 

The REDIVAC Study – Reducing Delay in Vaccination of Children Study

Primary Investigator:  Amanda Dempsey

Funding Agency:  NIH – Eunice Kennedy Shriver National Institute of Child Health & Human Development

Interventions to reduce infant under-vaccination are needed to counteract the increasing number of vaccine-preventable disease outbreaks.  Our intervention is designed to be delivered to mothers during the most critical time in their vaccination decision-making, without placing an increased burden on clinicians or the clinical encounter.  Because of this, and the fact that our intervention is web-based, it has the capacity to be implemented on a large scale for relatively little cost, and could therefore become an important public health tool with a substantial potential to reduce the incidence of vaccine-preventable diseases.

 

Cultural Tailoring of Educational Materials to Minimize Disparities in HPV Vaccination

Primary Investigator:  Amanda Dempsey

Funding Agency:  PCORI

The focus of this proposal is on improving HPV vaccination among Latinas, who have the highest risk for developing invasive cervical cancer compared to all other racial/ethnic groups.  The long-term objective of this research is to compare 3 different educational approaches to informing HPV vaccine decision-making among Latinas.  The Aims of the study are to:

  • Culturally tailor an existing decision-support tool about HPV vaccines to the informational needs of Latinas
  • Compare the impact of the culturally tailored tool to an untailored tool and to the “standard of care” on patient-centered outcomes related to the vaccination decision.
  •  Compare the impact of these approaches on Latinas HPV vaccine use.

 

Strengthening Physician Communication about Adolescent Vaccines

Primary Investigator:  Amanda Dempsey

Funding Agency:  CDC – National Center for Immunization and Respiratory Diseases

The overarching goal of this proposal is to develop and test a 3-phase intervention to improve provider-level communication and recommendation for the HPV vaccine for adolescent patients.  Our intervention is based on principals of the Precaution-Adoption-Process Model and will target provider-patient communication before, during and after the clinical encounter so as to have the potential to impact various stages of parents’ decision-making about the vaccine.  If our intervention proves efficacious, it could have a significant public health benefit by decreasing adolescents’ risk for the sequelae from HPV infection.

  

ACO/Public Health Collaborative Preventive Care Delivery to Priority Populations

Primary Investigator:  Allison Kempe

Funding Agency:  Agency for Healthcare Research and Quality (AHRQ)

The Institute of Medicine recently highlighted the importance of creating partnerships between Accountable Care Organizations (ACO) and public health entities in order to broaden the scope and efficiency of delivering clinical preventive services to populations.  This proposal focuses on implementing and evaluating an evidence-based collaborative method of increasing immunization rates among preschool children, adolescents and adults with an ACO-Public Health collaborative.  The infrastructure we will create around immunizations will serve as the framework for future collaborative delivery of other preventive services.

 

Adolescent Vaccination in the Medical Home:  Established and Innovative Strategies

Primary Investigator:  Allison Kempe

Funding Agency:  CDC – National Center for Immunization and Respiratory Diseases

While there are several important new vaccines recommended for adolescents, ensuring that adolescents actually receive these vaccines will be difficult, particularly because most adolescents are not regularly seen by their primary care provider.  In this project, we will develop, implement, and evaluate an adolescent vaccination program, with the program designed to encourage adolescents to visit their usual primary care provider to receive vaccinations and other recommended preventive health services.  This study will be conducted in different types of primary care settings, such as public, private, and manage care clinics serving adolescent patients of diverse backgrounds, and will provide important information to help guide future public health efforts to achieve high rates of immunization in adolescents.

 

Rapid-cycle Survey Collaborative for Provider Input on Immunization Issues

Primary Investigator:  Allison Kempe

Funding Agency:  CDC – National Center for Immunization and Respiratory Diseases

Primary care providers deliver the majority of vaccines in this country and are a critical source of information regarding the feasibility and acceptability of new or changing vaccination recommendations.  This project will provide a mechanism for obtaining rapid turnaround information about provider knowledge, attitudes and beliefs regarding immunization challenges on a national level.  These data will be presented at ACIP meetings and will assist the CDC in making policy recommendations about new vaccines, in developing strategies to improve vaccination coverage and in planning for urgent immunization problems that arise, such as vaccine supply shortages.

 

Centralized IIS-Based Reminder-Recall to Increase Influenza Vaccination Rates

Primary Investigator:  Allison Kempe / Peter Szilagyi

Funding Agency:  NIH – National Institute of Allergy and Infectious Diseases

Despite U.S. guidelines for influenza vaccination of all children starting at age 6 months, only about half of children are vaccinated annually leading to substantial influenza disease in children and spread of disease to adults.  We will evaluate the impact of patient reminder/recall performed by state immunization information systems to improve influenza vaccination rates by using three clinical trials in two states.  We will assess effectiveness and cost-effectiveness of phone reminder/recall as well as mailed reminder/recall on improving influenza vaccination rates.  We will also compare the relative effectiveness of this type of patient reminder/recall to the child’s practice alone vs. reminder/recall to both the practice and other community-based immunization sites.  We will disseminate the state immunization information system-based reminder/recall system to all states for use of both seasonal and pandemic influenza vaccinations with the goal of lowering influenza morbidity.


Comparative Effectiveness and Healthcare Quality:

  

Effectiveness of ICP Monitoring in Pediatric Traumatic Brain Injury

Primary Investigator:  Tellen Bennett

Funding Agency:  NIH – Eunice Kennedy Shriver National Institute of Child Health & Human Development

The overall goal of this research is to improve outcomes in children with severe traumatic brain injury by rigorously studying the effectiveness of intracranial pressure monitoring and other interventions recommended by experts but with limited supporting evidence.​


P3RC:  Parent-Provider Partnerships for Referral Communication in the Medical Home

Primary Investigator:  Chris Stille

Funding Agency:  HRSA – Health Resources and Services Administration

The overall goal of this study is to adapt and test a brief, feasible intervention using a communication tool and brief parent coaching to increase the capability of parents of CYSHCN to exchange and use medical information in partnership with their child’s physicians when their children require subspecialty referral.  We hypothesize that the use of tools to coordinate referrals between physicians and parents will facilitate increased communication between PCPs and specialists, and that parents trained in information exchange and care planning will experience increased self-efficacy in interacting with their child’s physicians.  By improving the timely development of a well-coordinated treatment plan, this will lead to greater family-centered care, more efficient medical care, and improved clinical outcomes.​


Building a Network of Parent and Pediatric Stakeholders for Improving Child Health in Colorado

Primary Investigator:  Sean O’Leary

Funding Agency:  PCORI – Patient Centered Outcomes Research Institute, Eugene Washington Engagement

The purpose of this proposal is to develop a sustainable collaborative of parents, providers and other stakeholders to develop and inform patient-centered outcomes research (PCOR) questions related to child and adolescent health issues.  We will do this within the infrastructure of a large practice-based research network (PBRN).  The process for developing this collaborative will be tracked, so that one of the important products of this projects will be a user-friendly ‘lessons learned’ workbook for other PBRNs interested in community engagement.  This proposal focuses on children, which sets it apart from many other PCORI projects and community engagement projects in general.

 

SAFTINet: Optimizing Value and Achieving Sustainability

Primary Investigator:  Lisa Schilling

Funding Agency:  AHRQ – Agency for Healthcare Research and Quality

This project seeks to enhance the capabilities of an existing data network, the Scalable Architecture for Federated Translational Inquiries Network (SAFTINet), by improving its ability to answer impactful questions about the best health care treatments and the best way to provide health care, with special emphasis on the poor and disadvantaged.  For this project, we will bring together a diverse set of stakeholders with different perspectives regarding health care (e.g. providers, patients, payer, policy experts, etc.) to inform enhancements to the data network and plan for sustainability.


Risk Stratification in Older Persons with Acute Myocardial Infarction:  SILVER-AMI

Primary Investigator:  Dan Matlock (UCD sub) / Sarwat Chaudhry (Yale prime)

Funding Agency:  Yale School of Medicine through NHLBI

The SILVER-AMI study is a 5-year project focusing on older persons with heart attacks.  Older persons, aged greater than 75 years, represent a large and growing segment of the acute myocardial infarction (AMI) population.  Their high burden of comorbid conditions and concomitant lower physiologic reserve render this group more complex and fundamentally different from younger AMI patients.  Despite being at high risk for adverse clinical outcomes after AMI, they remain understudied.  The overall objective of this study is to develop comprehensive risk stratification tools for older adults who have recently had and AMI.  By generating knowledge about the potent risk factors for a range of clinical and patient-centered outcomes, we hope this study will lay the foundation for the development of effective interventions.

 

Organizational Interventions for SSI Prevention in Pediatric Spinal Surgery

Primary Investigator:  Lisa McLeod

Funding Agency:  AHRQ – Agency for Healthcare Research and Quality

Despite the existence of guidelines for prevention of surgical site infections following pediatric spinal fusion procedures, many children continue to receive care that is not consistent with evidence-based practice; and for those that do, the effectiveness of this practice does not appear to be consistent across or even within hospitals.  This project will use quantitative and qualitative methods to explore hospital-specific organizational factors that distinguish high versus low performance in SSI prevention.  These findings will serve as the foundation to execute a multi-center trial comparing the effectiveness of a tailored, multi-disciplinary approach to designing, implementing, and evaluating a patient-focused and patient-informed intervention to reduce SSIs and the preventable harms resulting from them.

 

The effect of Part C eligibility policy change

Primary Investigator:  Beth McManus

Funding Agency:  HRSA – Health Resources and Services Administration

The purpose of this project is to examine the relationship between Part C eligibility and therapy service utilization, therapy access-sensitive utilization, and spending among infants and toddlers with developmental delays and disabilities.  Restricting Part C eligibility appears, on the surface, to be a way for states to reduce spending.  However, reductions in access to therapy can potentially lead to increased cost utilization downstream if the needs of infants and toddlers with developmental delays and disabilities are not met.  This research will address 1) MCH Title V programs to inform the design and implementation of the ACA and 2) coordination of efforts between Medicaid and Title V and Strategic Research Issue III:  Services and Systems to Assure Quality of Care for MCH population.

 

Implementation Research Agenda:  Appropriate Use of Clinical Preventive Services

Primary Investigator:  Elaine Morrato

Funding Agency:  AHRQ – Agency for Healthcare Research and Quality

Clinical preventive care works only if the right people get the right care at the right time.  Some preventive services are not used enough, while others are over-used at potential harm, and major disparities exist.  This conference will develop a national research agenda on the appropriate delivery of clinical preventive services in primary care and will disseminate and refine a Consensus Statement with researchers and funders nationally using innovative multi-modal approaches.


A multicenter trial of a shared decision support intervention for patients and their caregivers offered destination therapy for end-stage heart failure

Primary Investigator:  Larry Allen

Funding Agency:  PCORI

Our research plan aims to study the effectiveness and implementation of a novel shared decision support intervention for patients with one of the most common chronic progressive conditions – heart failure – who are offered a prototype invasive technology – destination therapy left ventricular assist device (DT LVAD).  The proposal’s primary objective is to improve upon the current education, decision making, and informed consent process, so that patients and their caregivers are better equipped to “compare the effectiveness of alternative approaches across a range of patient-centered outcomes”.


Neuromuscular Blockade and Perioperative Outcomes

Primary Investigator:  Karl Hammermeister

Funding Agency:  Anesthesia Patient Safety Foundation (APSF)

The overall objective of this proposal is to assess the relationship between the intraoperative use of neuromuscular blockade (NMB) and its reversal with choline esterase inhibitors with 30-day respiratory complications, 30-day mortality and morbidity, late mortality, and lengths of stay in a carefully evaluated and followed population of 19,189 patients undergoing major surgery in the Veterans Health Administration (VHA).  Our goal is to help resolve the current controversy regarding the potential adverse postoperative effects of intraoperative neuromuscular blockade and its reversal.

 

Center for Research in Implementation Science and Prevention (CRISP)

Primary Investigator:  Allison Kempe

Funding Agency:  Agency for Healthcare Research and Quality (AHRQ)

The Center for Research in Implementation Science and Prevention (CRISP) will bring together local and national experts in primary care and public health delivery to conduct research on ways to increase use of preventive health services within primary care settings.  The Center will develop “toolkits” and publish articles to guide primary care providers in how to improve delivery of preventive health in order to meet national public health goals.  CRISP’s research projects address three top priorities of the SUPSTF and ACIP:  Immunization delivery in children, prevention of cardiovascular diseases in adults and prevention of obesity in children and adults.  The projects are synergistic and unified by a thematic focus on collaboration between public health systems and private practices and methodological innovations in HIT and research in PBRN settings.

 
 

Oral Health:

  


 

Obesity/Nutrition:

  


 

Children with Special Needs:

 
 
 

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

Primary Investigator:  Olle Sahler – University of Rochester / Diane Fairclough – sub at UC Denver

Funding Agency:  NIH / National Cancer Institute

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.  

 
 
 

Mental/Behavior/Developmental Health:

 
 
 

Bright By Three Mobile App

Primary Investigator: Mandy Allison

Funding Agency:  Daniels Fund

This grant will inform and engage families, helping parents to become their child’s first teacher.

 

 

Metabolic Screening:  Prioritizing Implementation Strategies for Mental Health

Primary Investigator:  Elaine Morrato

Funding Agency:  NIH – National Institute of Mental Health

Cardiovascular disease is the leading cause of reduced life expectancy for adults with mental health disorders, and importantly, use of some antipsychotic medications contributes to increases cardiovascular risk.  Diabetes and dyslipidemia screening in high-risk populations is clinically recommended and cost effective.  The goal of this study is to identify the key physician practice barriers affecting current low rates of glucose and lipid testing in mental health patients taking antipsychotics in order to prioritize the most efficient implementation strategies for improving screening.

 
 
 

Asthma/Pulmonary Health:

 
 
 Analysis of Medical Home Characteristics and Asthma Control Using SAFTINet Data

Primary Investigator:  Marion Sills

Funding Agency:  HRSA – Health Resources and Services Administration

This project will evaluate the Patient-Centered Medical Home model among children with asthma treated in a network of safety net primary care practices.  Childhood asthma treated in a network of safety net primary care practices is a good context for studying the impact of the PCMH for several reasons: 1) improving asthma outcomes asthma is cost-effective, as asthma is one of the most common and costly chronic conditions of childhood, 2) asthma is a condition amenable to appropriate monitoring and management in primary care settings, and 3) as this population is more likely than patients without chronic illness to incur poor outcomes, we are more likely to detect an effect, because the variation in outcomes for this subgroup is smaller.

 

Evaluation of the Colorado Asthma Toolkit Program in Primary Care Using SAFTINet Data

Primary Investigator:  Marion Sills

Funding Agency:  NIH – National Heart, Lung, and Blood Institute

Asthma is one of the most common chronic health conditions and can generally be well controlled through appropriate monitoring and management, yet many primary care providers do not follow NHLBIs asthma management guideline, resulting in poor asthma outcomes.  This project will study asthma outcomes in primary care practices that participated in a program designed to give providers working with poor and minority patients the tools to follow guidelines for asthma care.  By helping us to understand how to improve asthma care for patients in greatest need, this project can help to promote better health outcomes for patients with asthma.


 

Primary Care:

 

 
Quality Improvement:

 
 
 

Surgical Outcomes: