Randy Brown, MD, PhD, FASAMOpioid Overdose Prevention and Naloxone Use Survey

The primary goal of this study is to describe the circumstances related to opioid overdose, and the use of naloxone use by laypeople. As such, the study aims to conduct a survey of people who receive naloxone (the opioid overdose antidote) or who obtain clean injection equipment from one of two community resources that provide these services. By surveying opioid users directly about their first-hand experience with opioid overdose, the study team seeks to be able to develop and disseminate highly tailored educational materials and local policy advice based directly on the lived experience of this population.

Jennifer Edgoose, MD, MPHDeveloping a Strategy to Increase Underrepresented-in-Medicine in the Wisconsin Healthcare Workforce

The purpose of this project is to identify undergraduate students from Wisconsin who are underrepresented in medicine and have an interest in pursuing a health professional career and ask them about past exposure to pipeline programs and mentorship related to healthcare professional careers and their views of the effectiveness of such interventions. The overall goal of this project is to gain a better understanding of how to increase diversity in the Wisconsin healthcare workforce.

Rachel Grob PhD / Nancy Pandhi, MD, PhD, MPHDIPEx USA

The goal of this project is to launch an innovative, accessible database that provides residents of Wisconsin and the U.S. with reliable information about patients’ and caregivers’ experiences with a wide variety of health conditions. It deploys an internationally-recognized model for collecting and disseminating patients’ own perspectives on health and health care (Database of Patient Experiences, or DIPEx) and an award-winning user-friendly web platform (“healthtalkonline,” or HTO) that features representative audio and video clips of patients talking in their own voices.

David L. Hahn, MD, MS2017 WREN convocation of Practices: How to get more joy out of your practice

The purpose of the overall project is to address burnout via an appreciative approach that emphasizes ways to increase joy in practice. The overall project goals are to plan for, implement, and evaluate a 2017 WREN Convocation of Practices during which appreciative approaches will be applied to (1) enhance clinician and team self-care (Whole Health self-enhancement training) and (2) provide practical ideas and strategies to increase team and patient well-being in specific clinical situations such as (i) creating more rewarding patient encounters; (ii) improving shared decision making (SDM) and (iii) creative strategies to help clinics achieve a Whole Health mindset and general approach to care and community engagement. We believe that practicing Whole Health approaches that enhance the meaningfulness of clinical encounters will improve both clinician and patient well-being (although in this project we will be measuring effects only on Convocation attendees, not on patients).

Adrienne R Hampton, MDAn individualized yoga program delivered in a group setting for the treatment of chronic pain in a low-income population: A feasibility study

This study will explore the therapeutic potential of a yoga program for the treatment of chronic pain which combines individual instruction with the efficiency of a group setting, in a community health center population. Future research directions could include larger prospective cohorts, or perhaps a randomized controlled trial to evaluate the effectiveness of an individualized yoga intervention delivered in a group setting in a low-income population.

Supriya Hayer, MDValidating a Young Children’s Version of the Wisconsin Upper Respiratory Symptom Survey (WURSS-Kids/WURSS-K)

The scientific goal of this project is to validate a new patient-centered outcomes tool for assessing acute respiratory illness (ARI) in children. We also hope to help community collaborators understand how to effectively recognize acute respiratory infections early on, so as to take the appropriate preventive measures to enhance the health of the communities they each service. The information we disseminate through this study may serve as a tool for planning healthier community environments, tracking progress of public health programs, and advocating to state and federal levels for new policies and resources. The project is expected to result in a validated WURSS-Kids questionnaire and have substantial long-term effects. It will also be made available to other researchers nationally and internationally, furthering pediatric ARI research in general. Use of the instrument may facilitate the development and implementation of improved policy through the ability to accurately assess ARIs.

Daniel Jarzemsky, MDHealth Factor Outcomes for a Community-based Fitness and Nutrition Social Support Program (Empower)

This project plans to correlate significant outcome data from the electronic medical record with measurements and surveys from the Empower program. Our goal is to demonstrate physical activity and improved nutrition reduces obesity and is linked to improvements in Health Outcome Factors (hypertension, lipid disorders, diabetes, and quality of life).

Jennifer Lochner, MDCare delivery changes associated with Primary Care Delivery Model Redesign (PCR)

The study will analyze the following Epic data from DFMCH clinics: primary care office visits per panel member per year; non face to face primary care clinic contacts per panel member per year; non primary care office visits per panel member per year including urgent care visits and specialty care visits. This data will be trended over time and overlaid with the timeline of the Primary Care Delivery Model Redesign (PCR) rollout to the clinics as well as the timing of the implementation of the new physician compensation plans. Analyses will involve an interrupted time series design allowing clear associations between changes in these outcomes and care model and compensation intervention changes.

Bobby Nourani, DOMultiple modality integrative care for chronic low back pain: A quality improvement project

The overall goal of this quality improvement (QI) project is to evaluate the effectiveness of multi-modality integrative care for chronic low back pain (CLBP), among the most challenging conditions treated in primary care. Societal costs of CLBP are high and national organizations have called for new therapeutic options. The sources of pain in CLBP vary per patient; peripheral and central pain generators exist in different tissue types. No single therapy has proven generally effective. Therapeutic response may benefit from treating pain using a variety of approaches intended to address both neuropathic and nociceptive pain, therefore the use of multi-modality care has been advocated.

David Rabago, MDHypertonic dextrose injection therapy (prolotherapy) for painful knee osteoarthritis: An open label feasibility study of functional outcomes in support of extramural funding.

Research support to conduct an open-label feasibility study of objectively assessed functional measures after prolotherapy (PrT) for painful knee osteoarthritis (KOA), a necessary step in the preparation of future intra- and extra-mural grant applications.

Marlon Mundt, PhDTeam Communication Networks in Electronic Health Records (EHR) and Quality of Care for Patients with Cardiovascular Disease in Primary Care

This study will provide a unique opportunity to evaluate EHR communication network structures within primary care teams in relation to CVD patient outcomes extracted from the EHR. The study will promote better primary care team performance in a pursuit of improved care for patients with CVD. This evaluation would allow developing analytical techniques to conduct future primary care evaluations with no additional burden or disruption for the health care providers in clinics.

Angela Black, PhDMindfulness and Black Women: What’s Cultural Relevance Got to Do With It?

The larger goal of the proposed study is to develop a culturally-relevant mindfulness-based intervention pilot for stressed black women across the lifespan. To accomplish this, focus groups will be conducted in the community that explore black women’s thoughts, beliefs, and reactions to select themes pertaining to mindfulness meditation, mindful movement, and mind-body awareness. Additionally, the proposed study intends to offer the focus groups in an informational, workshop style format that promotes stress reduction and mind-body awareness as wellness resources to Black women living in Madison.

Randy Brown, MD, PhD, FASAMTrauma and responsible opioid use study

In order to generate pilot data supportive of future NIH funding applications, the current study seeks to survey American trauma centers regarding current alcohol use screening practices, current opioid misuse risk screening practices, and barriers/facilitators to expanding current alcohol screening practices to include opioid misuse risk. These results will be used to support a future NIH R34application which will seek to pilot an opioid misuse screening protocol at a level I trauma center. The future R34-fundedclinical trial planning study would also develop and pilot test an intervention to prevent opioid misuse and progression to addiction. This intervention would subsequently be tested in an NIH-R01 funded, multi-site, randomized clinical trial.

David Hahn, MDINSTTEPP2: Creating and Sustaining Clinic-Patient Teams for Self-Management Support.

WREN recently participated in an AHRQ-funded P30 (Meta LARC) SMS toolkit evaluation called INSTTEPP that included patient advisors, clinicians and care managers at four WREN clinics (and at 12 other Meta-LARC sites). The purpose of INSTTEPP2 is for WREN to work with two of the four INSTTEPP clinics to create and sustain SMS work groups within clinics to pursue the following aims: (1) Explore the SMS needs of each clinic (what are our needs? How could this group fill that need? What’s the idea for our clinic?); (2) Define the membership and roles/responsibilities for a clinic SMS workgroup; (3) Find resources to sustain the group and (4) Create and pilot at least one SMS project within the initial 9-month period.

Randy Brown, MD, PhD, FASAMSurvey of opioid misuse screening practices in Wisconsin pharmacies

The proposed project seeks to expand upon existing survey results and specifically target Wisconsin pharmacies in an effort to begin development of screening and brief intervention (SBI) procedures practical for administration in pharmacies. In addition to facilitators of and barriers to opioid misuse risk screening, pharmacist knowledge about and comfort with opioid overdose prevention education and naloxone distribution to laypeople will be explored. (Distribution of naloxone, the opioid overdose antidote, to laypeople, was made legal in Wisconsin in the spring of 2014 with the passage of the Heroin Overdose Prevention and Education legislative package.)

David Hahn, MDStakeholder Engagement: Practice-Based Research from the Practice Participant Perspective

The purpose of this study is to perform a qualitative study into the experience of clinic teams who’ve participated in Wisconsin Research and Education Network (WREN) Practice Based Research studies. WREN will conduct focus groups (clinicians, staff and administrators, if present) surrounding the question “How has participation in practice-based projects impacted you and/or your practice?”

Jonas Lee, MDAfrican American Appreciative Inquiry

Appreciative Inquiry is a change model used by organizations and communities that avoids focusing on problems, but instead identifies what is already working well, envisioning a future state built upon the assets of an organization or community. Research will be conducted through` a series of focus groups and individual interviews with residents to discover the ways in which local health care providers and systems have positively impacted engagement in personal health care, promoted healthier lifestyles, and mitigated the effects of institutional racism in our health care system. Through qualitative analysis of these interviews, we can hear the voice of our community as a first step in designing effective solutions to address health disparities.

Ildi Martonffy, MDHow Doctors Birth: How our experiences shape our practice

The project aims to explore physicians’ own choices in their pregnancies and birth processes, and how these choices may or may not inform the care of patients. Physicians’ birthing narratives will be coupled with quantitative data consisting of information on medical training and family development history. Female Family Medicine physicians and Obstetricians from Dane County who have received training in labor and delivery will be asked to participate in the study.

Tanya Schlam, PhDCan Smartphone Games Help Smokers Quit?

The objective of the research project is to determine whether smartphone games can help smokers distract themselves, suppress their cravings, and increase their chances of quitting. The proposed research will determine whether smartphone games add to a standard of care smoking treatment (pharmacotherapy plus counseling) by further suppressing craving and enhancing cessation success.

Brian Arndt, MDIdentifying Gaps in Practice Management Curriculum: A Survey of Recent Family Medicine Residency Graduates

This project intends to 1) Distribute a practice management curriculum survey to family medicine residency graduates (2010-2012) to identify which practice management topics are being covered during residency, how effectively they are being taught, and opportunities to cover topics not previously covered; 2) Interpret and publish survey results to inform residency programs how to improve development of future practice management curricula.

Brian Arndt, MDEngaging in community conversations, developing partnerships in health

This project aims to perform a stakeholder analysis/community needs assessment related to obesity involving residents, faculty, and community partners. Funding from the small grant will support Verona residents and faculty to work with community members to identify collaborative strategies to help community members lose weight and become healthier.

John Beasley, MDImproving PrimAry Care Through Industrial and Systems Engineering (I-PrACTISE) Development

This project intends to a) secure resources to re-convene national experts in 2014 to continue the development of a national I-PrACTISE agenda; b) increase collaboration between primary care and Industrial and Systems Engineering that results in funded projects locally; and c) find and implement funding mechanisms to sustain these activities.

Randy Brown, MD, PhD, FASAMPharmacotherapeutic intervention to improve treatment engagement among alcohol-dependent veterans after hospital discharge

Dr. Brown was awarded an ICTR Type-2 grant in fall 2012 to fund a research project for inpatient veterans at the William S. Middleton VA with alcohol dependence/ abuse. The over-arching goal of the ICTR pilot feasibility study is to understand the impact of medication adherence upon engagement in behavioral treatment for alcohol use disorders. The specific objective of the ICTR study is to conduct a pilot randomized study of prescribed oral naltrexone (taken orally once daily) vs. long-acting injectable naltrexone (30-day duration of action) administered prior to hospital discharge. The ICTR budget of $50,000 did not allow room for subject compensation for study participation. The purpose of this grant is to provide financial incentives for study participants following each study visit. The financial incentives will play a key role in increasing subject recruitment.

Sandy Kamnetz, MDInfluences of the Primary Care Clinic Environment on Patients and Staff

The goal of this project is to explore how different primary care clinic environments affect the following processes outside of the examination room: (1) patient experience, (2) staff-patient interaction, (3) and staff interaction. The study will conduct a comparative case study analysis of three community family medicine clinics with different environmental designs using observations and focus groups.

Jonas Lee, MDPatient Activation Measure in High Utilizers

The Patient Activation Measure (PAM) is a validated tool measuring patient involvement in self management. Like the Stages of Change model, specific strategies can be employed to different stages of patient activation in order to encourage self management of health issues. The level of patient activation has been directly correlated with outcomes in several chronic diseases. However, there have been no studies examining the relationship of patient activation to inappropriately high utilization of health care services. This study seeks to examine if a correlation exists between utilization of healthcare services to patients sense of self efficacy in healthcare. A DFM Small Grant would be used to pay the fee for utilization of the PAM. The project will also be part of the Summer Student Research and Clinical Assistantship program.

Maggie Wallace, PharmDCase study analysis of successful development of inter-professional education in US health professional programs

This project is designed to evaluate the common steps to successful implementation of Interprofessional Education (IPE) programs at universities with successful IPE programs. Key staff from each of the identified IPE programs will be interviewed using a semi structured interview design to collect information on each of the IPE programs. A multisite case study approach will be used to describe key common themes.