Practice-Based Research Network Studies
Transitioning Patients from the Emergency Department to Primary Care Utilizing Community Health Workers (2012-2015)
The National HCH Council received a CMMI Health Care Innovation Award in June 2012. The project seeks to address the over-reliance of persons experiencing homelessness on Emergency Department service’s at safety net hospitals. To refer these populations to appropriate primary care settings, this project will employ Community Health Workers (CHWs) to target patients experiencing homelessness who frequently seek access to primary care in Emergency Departments and other hospital settings, regardless of insurance status. This project seeks to accomplish the triple aim of CMS through CHW interventions to transition care of homeless person from inappropriate hospital utilization to HCH primary care sites funded by the Health Resources and Services Administration (HRSA). The National HCH Council has partnered with 10 HCH sites to accomplish this goal. Darlene Jenkins, Director of Research and Evaluation for the National HCH Council, is the principal investigator of this project.
A collaboration with Drs. Linda Weinreb and Carole Upshur at the University of Massachusetts Medical School. The study aims are: 1) Describe the prevalence and correlates of past year risky alcohol and drug use, and their co-morbidity with mental and physical health conditions, among homeless women receiving primary health care services in HCH programs; 2) Describe access to substance abuse treatment, among women in this sample with past year risky alcohol or drug use, including the rate and correlates of perceived barriers to, and motivation to seek, substance abuse treatment, and the acceptability and perceived helpfulness of having primary health care providers in HCH programs assist with these issues; and 3) Identify potentially innovative approaches to prevent and treat substance abuse and mental health problems among women who seek primary health care in HCH programs.
Nicotine Anonymous Feasibility Study (2013-2014)
Nicotine Anonymous (NicA) is a 12-step, peer-support group for smoking cessation. Two members of the HCH Practice-Based Research Network (Providence, RI and Nashville, TN) are implementing NicA meetings at their sites for three months to explore the feasibility of hosting these meetings within the HCH setting. If the NicA groups are found to be feasible, the National HCH Council will seek funding to test the effectiveness of NicA for smoking cessation with individuals who are homeless.
Demonstrating the Value of Enabling Services (2011-2014)
This collaboration with the Association of Asian Pacific Community Health Organizations (AAPCHO) aims to provide training and technical assistance to HCH grantees on the implementation of a standardized tracking system for documenting enabling services. In 2011, National HCH Council staff provided in-person training to four HCH sites to implement the tracking system as part of a pilot project. Molly Meinbresse coordinated this project and presented results at the 2012 National HCH Conference and 2012 Region 9 HCH Conference. The National HCH Council is continuing the collaboration with AAPCHO, in addition the Health Outreach Partners, to develop a training curriculum for health centers to implement the enabling services data collection model. The curriculum was presented as part of the West Coast HCH Regional Training in August 2014 and materials are available here.
Traumatic Brain Injury in Homeless Patients: Prevalence & Impact on Health & Health Care (2010-2014)
A research proposal was submitted in 2010 by Drs. Lillian Gelberg, Pam Diamond, Stephen Hwang, Barbara Wismer, and Carol Waldmann to AHRQ for R03 funding. The aims were to determine: 1) the prevalence of traumatic brain injury (TBI) among homeless patients; 2) the association between history of TBI and health status (including physical, mental, substance abuse, and cognitive impairments; 3) the association between history of TBI and health care utilization; and 4) the extent that TBI is under-recognized and there are opportunities to improve quality of care. Ten PBRN sites signed agreed to participate in the study. The original proposal was not funded so the group resubmitted in 2011 to AHRQ without success. Currently, HCH Medical Directors are being surveyed regarding TBI diagnosis and treatment practices. Survey results will hopefully assist with future research endeavors on the topic.
Provision of Contraceptive Services to Homeless Women: Results of a Survey of Health Care for the Homeless Providers (2012)
Barry G. Saver, Linda Weinreb, Lillian Gelberg & Suzanne Zerger. Women & Health, 52(2):151-61. The investigators surveyed HCH providers regarding the availability of contraceptive services at their projects and barriers to providing those services. The survey revealed that a majority of the participants provided some form of contraception (i.e. condoms, oral, injectable) but that very few provided the most effective forms of contraception (i.e. intrauterine devices, implants).