Volume 19, Issue 2
Spring/Summer 2007
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CHS Research News
Vol 19, Issue 2, Spring/Summer 2007
Center News
by Rebecca Hughes and Joan DeClaire
HMO Cancer Research Network funded at $20 million: CHS leads
national collaboration
The National Cancer Institute (NCI) has awarded a multi-site, cooperative
grant of more than $20.2 million to the
HMO Cancer Research Network (CRN).
Group Health Center for Health Studies will keep providing scientific and
administrative leadership for the CRN. MacColl Institute Director Ed Wagner,
MD, MPH, a senior investigator at the Center, serves as principal
investigator of the CRN.
This new grant will enable the Network to continue its research
activities for another five years. The CRN, which was originally funded in
1999, has been hailed as a model of collaboration among research
institutions.
The grant will launch new studies related to cancer prevention and
treatment. In addition, the CRN will develop research programs to study the
dissemination and impact of new treatments, as well as methods to recruit
more cancer patients into important clinical trials. This new phase of the
CRN will also focus on mentoring and supporting young investigators and
improving and standardizing automated data sources.
The work began May 1, with grant dollars distributed among 13 research
centers based in integrated health care delivery organizations (plus one
affiliate institution) from Massachusetts to Hawaii. Several studies involve
investigators from leading comprehensive cancer centers collaborating with
the Network. The first research studies to be launched under the new grant
will relate to topics such as: using electronic records to improve cancer
prevention; and helping patients better understand messages about cancer
prevention and screening.
“The CRN’s success demonstrates the important contribution that
scientists and research centers can make when they are associated with large
health care delivery organizations,” said Dr. Wagner. “We’re particularly
enthusiastic about this.”
This is the third round of funding to the Network from NCI. The CRN is
part of the HMO Research Network, which also includes other multi-site
research programs: the Vaccine Safety Datalink (VSD); the HMO Center for
Education, Research and Therapeutics (CERT); and the Coordinated Clinical
Studies Network (CCSN).
“Within the past year, there seems to be an almost exponential increase
in appreciation of the potential of the CRN and the HMO Research Network
among officials of the National Institutes of Health and other research
organizations,” said Martin L. Brown, PhD, chief of the NCI’s Health
Services and Economics Branch.
Top
New Findings & Highlights
Suicide attempts decline after depression treatment: Study
sheds new light on FDA warning for antidepressants
In a study of more than 100,000 patients treated for depression, suicide
attempts declined during the first month of treatment—whether that treatment
consisted of medication, psychotherapy, or both. The findings, published by
Group Health researchers in the July American Journal of Psychiatry,
show a similar pattern for populations of adolescents and young adults (up
to age 24) as for older adults.
The study sheds new light on the “black box” advisory that the U.S. Food
and Drug Administration (FDA) placed in 2004 and has revised since then,
said Greg Simon, MD, MPH, a Group Health psychiatrist who led the study. The
advisory—which has concerned many patients, families, and care
providers—warns that suicidal behavior may emerge soon after people younger
than 25 start treatment with newer antidepressant medications called
selective serotonin reuptake inhibitors (SSRIs). It was spurred by
randomized placebo-controlled trials showing that starting to take an SSRI
can make thoughts of suicide more common among some teens and young adults.
Dr. Simon’s study is the first published research to compare the risk of
suicide attempts before and after the start of treatment with not only
antidepressants but also psychotherapy. It is based on computerized medical
and pharmacy records for more than 109,000 patients who started treatment
for depression at Group Health from 1996 to 2005.
In the study, suicide attempts were about twice as common among patients
up to age 24 as among older adults. However, the time pattern was the same
for both age groups, regardless of the type of treatment they received:
Suicide attempts were most likely during the month before treatment started,
falling by at least 50 percent in the month after treatment began, with
steady declines thereafter.
At all time points—up to three months before and six months after
starting treatment—patients who received their antidepressant prescription
from a psychiatrist tended to be most likely to attempt suicide. Those who
received it from their primary care doctor were least likely to attempt
suicide, with levels in between for those who got individual psychotherapy
from a therapist other than a psychiatrist. “That’s not because seeing a
psychiatrist makes you want to kill yourself,” said Dr. Simon. Rather, he
suggested, these results reflect the fact that people with severe
depression, who tend to be more suicidal, are more likely to be referred to
psychiatrists, while those with milder depression stick with their primary
doctors.
“Our study indicates that there’s nothing specific to antidepressant
medications that would either make large populations of people with
depression start trying to kill themselves—or protect them from suicidal
thoughts,” said Dr. Simon. “Instead, we think that, on average, starting any
type of treatment—medication, psychotherapy, or both—helps most people of
any age have fewer symptoms of depression, including thinking about suicide
and attempting it.” That said, he likened population-based studies—both
observational studies such as this one and randomized controlled trials of
medications—to “circumstantial evidence” about what happens to individual
patients.
Like other psychiatrists, Dr. Simon has seen a few depressed patients
start having suicidal thoughts while taking antidepressant medication
despite never having thought about suicide before then. He hypothesizes that
subgroups of people may be vulnerable to becoming more agitated or suicidal
after taking these drugs. “We hope to learn how to identify these people in
advance,” he said.
Dr. Simon published an earlier
paper showing that the risk of
suicide attempts decreased in the weeks after patients started taking
antidepressant medication. His new study strengthens his earlier conclusion
that for populations of people, even teens and young adults, suicide
attempts tend to be rarer right after starting antidepressant medication
than beforehand. He echoed the FDA’s recommendations that doctors
regularly monitor their patients
during treatment with antidepressants to ensure that they are receiving the
right medication at a dose that helps them feel better. “If people feel
agitated or suicidal, they should seek help from a doctor or therapist,” he
added.
The National Institute of Mental Health funded the study, whose other
author is James Savarino, PhD, a programmer analyst at Group Health Center
for Health Studies.
Top
Low libido in menopause linked to trouble sleeping
Women whose sexual desire diminishes during menopause are more likely to
report disturbed sleep, depression symptoms, and night sweats, according to
Group Health research in the June American Journal of Obstetrics and
Gynecology.
To the best of the research team’s knowledge, this marks the first time
that sleep disturbance has been independently associated with diminished
sexual desire during or after menopause.
The paper is based on data from Group Health's Herbal Alternatives for
Treatment of Menopause Symptoms (HALT) study.
Other results from this study,
showing that the herbal supplement black cohosh did not relieve menopausal
hot flashes or night sweats (hot flashes during sleep), were reported in the
Annals of Internal Medicine in 2006.
All 341 of the women were chosen to be in the study because they were age
45 to 55 and had hot flashes, night sweats, or both. Of them, 64 percent
reported diminished sexual desire, 43 percent slept poorly, and 18 percent
had major depression.
“It seems reasonable that night sweats can disturb sleep,” said Susan D.
Reed, MD, MPH, the paper’s lead author. Dr. Reed is an associate professor
of obstetrics and gynecology and epidemiology at the University of
Washington and an affiliate investigator at Group Health Center for Health
Studies (CHS). “And poor sleep can reduce energy for everything, including
sex.”
However, Dr. Reed cautioned against inferring cause and effect between
depression and low libido. “They are each so complex that the interactions
can be difficult to tease apart.”
Dr. Reed noted a well-established “catch 22”: Like depression itself,
treating depression with a selective serotonin reuptake inhibitor (SSRI),
the most common type of antidepressant medication, can interfere with
interest in sex. Likewise, she added, although systemic hormone therapy with
estrogen can reduce vaginal dryness, it can also lower women’s natural
testosterone, which affects some women’s libido.
“Before starting any drug treatment for changes that happen in menopause,
women need to weigh their individual risks and benefits with their doctors,”
said Dr. Reed, whose clinical practice is at the Women's Clinic at
Harborview Medical Center in Seattle. She advocates beginning with self-care
to lessen depression and sleep problems.
“Our work reinforces the difficult time some women have during the
menopause transition, and the importance of other symptoms happening at the
same time,” said Katherine M. Newton, PhD, associate director of CHS and
principal investigator of the HALT study. “We are planning future studies to
explore further the associations between depression, night sweats, sleep,
and libido, including genetic determinants.”
The National Institute on Aging and the National Center for Complementary
and Alternative Medicine funded the study. The other authors are Andrea
LaCroix, PhD, Louis Grothaus, MA, and Kelly Ehrlich, MS, of Group Health
Center for Health Studies.
Top
Phone-based therapy eases depression long term
When people receive brief telephone-based psychotherapy soon after
starting on antidepressant medication, strong positive effects may continue
18 months after their first session. So concludes a Group Health study in
the April Journal of Consulting and Clinical Psychology.
This paper describes one more year of follow-up since a 2004 Journal
of the American Medical Association (JAMA) report on the same random
sample of Group Health patients.
“With close to 400 patients, this is the largest study yet of
psychotherapy delivered over the telephone,” said Evette J. Ludman, PhD,
senior research associate, Group Health Center for Health Studies (CHS), the
paper’s lead author. “It’s also the first to study the effectiveness of
combining phone-based therapy with antidepressant drug treatment as provided
in everyday medical practice.”
Long-term positive effects of initially adding phone-based therapy
included improvements in patients’ symptoms of depression and satisfaction
with their care, said Ludman. At 18 months, 77 percent of those who got
phone-based therapy (but only 63 percent of those receiving regular care)
reported their depression was “much” or “very much” improved. Those who
received phone-based therapy were slightly better at taking their
antidepressant medication as recommended, but that did not account for most
of their improvement. And effects were stronger for patients with moderate
to severe depression than for those with mild depression.
“We were surprised at how well the positive effects were maintained over
time,” said Ludman. “As with weight control, maintaining improvement is the
hardest part of treating depression.”
As is usual in clinical practice, the patients’ primary care doctors
diagnosed their depression and prescribed their antidepressants. Half of the
patients also received eight sessions of telephone psychotherapy during the
first six months, then two to four “booster” sessions in the second six
months as well as medication follow-up and support from masters-level
therapists.
The patients and therapists never met face to face, only over the phone,
said Ludman. Patients weren’t always easy to reach by phone, and the
therapists worked hard to reach them all. Therapists followed a structured
protocol for psychotherapy. They encouraged the patients to identify and
counter their negative thoughts (cognitive behavioral therapy), pursue
activities they had enjoyed in the past (behavioral activation), and develop
a plan to care for themselves.
“The patients participated more fully in psychotherapy and completed more
sessions than do most depressed people in the community,” said Ludman.
Nationally, only about half of insured patients receiving depression
treatment make any psychotherapy visit, and less than a third make
four or more visits. By contrast, in this study, three in four patients
completed at least six phone therapy sessions. This is striking, she added,
because the study did not include people who were already in counseling or
planning to be.
“Giving psychotherapy to people with depression who were not seeking
therapy may help them significantly,” said Ludman. Depression symptoms,
including feeling discouraged and avoiding other people, can prevent people
from seeking help. One in four depressed people who make appointments for
in-person therapy are no-shows. “They slip through the cracks,” she added.
Few of the patients who received phone-based therapy—even fewer than
those who did not receive it—sought in-person therapy. “This suggests the
phone-based therapy met their needs, without whetting their appetite for
more,” said Ludman. Phone-based therapy is more convenient and acceptable to
patients than in-person psychotherapy, she said.
Next, Ludman said, the researchers plan to explore the combination
treatment’s cost-effectiveness and impact on work and home life. They also
want to compare the effectiveness of phone-based treatment with that of
in-person visits.
The National Institute of Mental Health funded the study. The other
authors are Greg E. Simon, MD, MPH, and Michael Von Korff, ScD, senior
investigators at CHS; and Steve Tutty, MA, now a doctoral student in
clinical psychology at Brigham Young University in Provo, Utah.
Top
Research Highlights
Computer-aided detection (CAD) designed to improve how
radiologists interpret mammograms may actually make readings less accurate,
according to a
study conducted at Group Health and two other health
plans participating in the Breast Cancer Surveillance Consortium. Published
in the April 5 issue of the New England Journal of Medicine, this
study shows that women who got screening mammograms at centers using CAD
devices were more likely to be told their mammogram was abnormal and thus
undergo a biopsy to rule out breast cancer. But use of CAD did not clearly
improve the detection of breast cancer. The lead author is Joshua Fenton,
MD, MPH, of the University of California at Davis. CHS co-authors are Linn
Abraham, MS; William Barlow, PhD; and Affiliate Investigator Joanne Elmore,
MD, MPH, of UW.
Many patients newly diagnosed with atrial fibrillation, a heart
disorder that can cause stroke due to blood clots, did not receive the
anticoagulant warfarin in a
study at Group Health conducted by the University of
Washington’s (UW) Cardiovascular Health Research Unit (CHRU). The study
appears in the February 12 issue of Archives of Internal Medicine.
Designed to assess compliance with antithrombotic therapy for stroke
prevention and identify patient characteristics associated with warfarin
use, the study found that atrial fibrillation classification, rather than
stroke risk factors, was strongly associated with use of the drug. Study
co-authors include CHS Senior Investigators Lisa Jackson, MD, MPH, and Bruce
Psaty, MD, PhD, and Group Health Pharmacy Manager Jennifer B. Hrachovec,
PharmD. CHRU Research Associate Nicole Glazer, MPH, is the lead author.
People who regularly get preventive health exams are more likely
to complete recommended colorectal, breast, and prostate cancer testing,
according to a
study of Group Health members published in the March 26
issue of Archives of Internal Medicine. In the study led by Joshua
Fenton, MD,MPH, of the University of California at Davis, researchers
analyzed data from more than 64,000 adults aged 52 to 78 enrolled at Group
Health between 2002 and 2003. CHS co-authors of the study are Roy Pardee,
JD, MA; Rob Reid, MD, PhD; and Affiliate Investigator Joanne Elmore, MD,
MPH, of UW.
The amount of time people engage in leisure-time physical
activity, even when it is non-strenuous, was associated with a lower risk of
nonfatal heart attack, according to a new case-control study of
telephone interviews conducted with about 4,000 Group Health patients
between 1986 and 2002. CHS Senior Investigator Bruce Psaty, MD, PhD, and his
colleagues from the UW Cardiovascular Health Research Unit were among
co-authors of the
paper, which appeared in the February 22 issue of the
Annals of Epidemiology. They found that the risk of heart attack
declined as the time spent on total leisure-time physical activity,
including non-strenuous activity, increased. This effect was seen up to the
median for such activity. Beyond the median activity level, however, this
association did not continue. The lead author was Gina S. Lovasi, PhD, of
Columbia University’s Institute for Social and Economic Research and Policy,
in New York.
“Are Continuity of Care and Teamwork Incompatible?” is
the title of a
commentary by MacColl Institute Director Ed Wagner, MD,
MPH, and Associate Director of Preventive Care Rob Reid, MD, PhD, in the
January 2007 issue of the journal Medical Care. The pair commented
on a Harvard
study of clinician-patient interactions in
multi-disciplinary primary care teams that found discontinuities in care
were associated with negative care experiences. Wagner and Reid point to
evidence regarding improvements in quality of chronic illness care when
non-physician team members take on tasks such as preventive procedures and
self-management support. “More concerted attention needs to be given to
testing ways that we can make teams function as a ‘coherent whole’ that is
visible to and appreciated by patients,” they concluded.
Adolescents with asthma are more likely to smoke if they have
anxiety or depression, according to a
paper by CHS Research Associate Terry Bush, PhD, that
was published in the May 2007 issue of the Journal of Adolescent Health.
The researchers conducted telephone interviews with a population-based
sample of more than 700 11- to 17-year-olds and their parents, including a
structured psychiatric interview to assess anxiety and depressive disorders.
Smoking was found to be more common among youth with mental health
disorders. After controlling for important covariates, youth with more than
one anxiety and depressive disorder were at over twofold increased risk for
smoking. The investigators, including CHS Associate Investigator Paula
Lozano, MD, MPH, concluded that interventions for youth with asthma should
consider screening for and targeting anxiety and depression.
Providers and patients emphasize different barriers to weight
management, according to a
study co-authored by CHS Assistant Investigator David
Arterburn, MD, MPH. The research, conducted at a Los Angeles Veterans
Administration primary care clinic, shows that providers were more likely
than patients to perceive that patients lack self control to stay on a diet
and that fattening food in society and lack of time for exercise were prime
factors in weight gain. The providers also expressed more interest in
helping patients with weight management than patients desired. Patients were
more likely than providers to state that weight problems should be managed
on one’s own; talking to a provider is not helpful; providers blame them for
their weight problem; and that appointments contain sufficient time for
weight discussion. Led by Alicia R. Ruelaz, MD, of Cedars-Sinai Medical
Center, the research appears in the January 30 online edition of the
Journal of General Internal Medicine.
Top
New Funding
The following grants are among several projects recently funded at CHS:
HMO Cancer Research Network: A
five-year multi-site, cooperative grant of $20.2 from the National Cancer
Institute to launch new studies related to cancer prevention, treatment, and
health literacy.
Community-Based Self-Management of HIV and Chronic Disease:
A five-year, $3,072,231 grant from National Institute of Mental Health to
conduct a randomized controlled trial of a self-management intervention to
improve treatment adherence and quality of life among older persons living
with HIV/AIDS and other comorbid chronic conditions. This trial will test
the efficacy of a telephone-based intervention with 450 people aged 50 and
older living with HIV/AIDS and other chronic conditions who will be
recruited from AIDS Service Organizations and randomly assigned to one of
three study arms. Participants will receive either: (1) 10 sessions of
individually tailored telephone counseling plus a self-help book on HIV
self-management, (2) 10 didactic telephone group sessions plus a self-help
book on HIV self-management, or (3) only a self-help book on HIV
self-management. The principal investigator is Sheryl L. Catz.
Shared Medical Records and Chronic Illness Care: A
four-year, $1,116,341 grant from Agency for Healthcare Research and Quality
to evaluate peer and nurse-mediated support over the Web for older patients
with diabetes. The principal investigator is James D. Ralston.
Strategies to Improve the Primary Care Management of Adolescent
Depression: This project is funded by four grants from the
University of Washington (a two-year, $79,003 subcontract funded by a
National Institutes of Health K-Award; a nine-month, $31,950 subcontract
funded by the UW Royalty Research Fund; a nine-month, $61,000 subcontract
funded by the Group Health Community Foundation; and a six-month, $20,450
subcontract funded by Children's Hospital Steering Committee award). Its
overall goal is to test the hypothesis that health service interventions
based on the Chronic Care Model can be used to efficiently deliver
developmentally appropriate and evidence-based treatments to adolescents
with major depression in primary care settings. The project will evaluate
clinical and demographic predictors of depression persistence to develop a
case definition for adolescents who would most benefit from intervention
versus watchful waiting. This will be the first longitudinal natural history
study of adolescent depression identified in primary care settings and will
provide key information for planning depression screening and treatment
interventions for adolescents in primary care. The CHS lead investigator is
David C. Grossman.
Descriptive Epidemiology and Clinical Course of Myelodysplastic
Syndromes (MDS) in a Health Maintenance Organization: A one-year,
$87,838 grant from Amgen to investigate and describe the epidemiologic and
clinical characteristics of MDS within Group Health Cooperative’s integrated
health plan population. The study will also explore predictors of MDS
diagnosis among high-risk patients and the utility of using electronic
health plan databases to identify MDS cases. The CHS lead investigator is
Erin J. Aiello.
Population-Based Surveillance for Influenza and Adverse Events
Potentially Associated with Receipt of Medical Countermeasures for Seasonal
and Pandemic Influenza: A one-year, $61,692 grant from Centers for
Disease Control and Prevention to provide weekly surveillance reports of
outpatient, emergency room, and inpatient pneumonia and influenza rates by
age. The study will also investigate use of admitting and discharge
diagnosis data to capture pneumonia and influenza hospitalizations. The
principal investigator is Lisa A. Jackson.
Oral Health Promotion in Well Child Care: A one-year,
$50,343 grant from Washington Dental Service Foundation to fund a quality
improvement project that will demonstrate the feasibility of integrating
oral health promotion practices into pediatric well child visits in primary
care clinics at Group Health. The study will assess the penetration of the
intervention as well as the levels of patient and provider satisfaction with
the services. It will also define and disseminate the optimal workflow for
the application of fluoride varnish to the children's teeth. The principal
investigator is David C. Grossman.
Top
People and Programs
Robert Wood Johnson Foundation president will present 2007
Birnbaum address
Risa Lavizzo-Mourey, MD, president of the
Robert Wood Johnson Foundation
(RWJF), has accepted Group Health Center for Health Studies’ invitation to
present the 2007 Hilde and Bill Birnbaum Endowed Lecture in Seattle on
Thursday, November 15.
The title of her lecture is, “Aligning the Forces of Health Care for
Quality and Fairness for All.”
Lavizzo-Mourey is a Seattle native who has a long and distinguished
career in medicine, health policy, and research. Prior to joining RWJF in
2001, she served in a variety of roles at the University of Pennsylvania,
including professor of medicine and health care systems, director of its
Institute on Aging, and chair of its division of geriatric medicine. She has
also served as deputy administrator of the Agency for Health Care Research
and Quality. She was a former member of the White House Task Force on Health
Care Reform and served as a consultant to the White House on issues of
health policy. A member of the Institute of Medicine, she earned her MD
degree at Harvard Medical School, followed by an MBA at the Wharton School
of the University of Pennsylvania.
Invitations to the lecture and luncheon will be mailed in September.
Top
NCQA honors Dr. Ed Wagner for improving chronic illness care
nationally
Ed Wagner, MD, MPH, director of the MacColl Institute for Healthcare
Innovation at Group Health Center for Health Studies (CHS), was among
four winners to receive 2007 Health Quality Awards from the National
Committee for Quality Assurance (NCQA). The awards, presented every two
years, honor individuals and organizations whose energy, efforts, and vision
have substantially helped improve U.S. health care quality.
The other three winners were Senator Chuck Grassley (R-Iowa), Kansas
Governor Kathleen Sebelius, and the “Let’s Just Play Go Healthy Challenge,”
a television program sponsored by the Alliance for a Healthier Generation.
Winners in 2005 included Senator Hillary Rodham Clinton and Congressman Newt
Gingrich, and actress Mary Tyler Moore, chairman of the Juvenile Diabetes
Research Foundation. The awards were presented at a dinner in Washington,
D.C., on March 15.
Wagner, who was the founding director of CHS, is best known for his
leading role in developing and disseminating the Chronic Care Model through
a national program funded by the Robert Wood Johnson Foundation (RWJF). The
model is an evidence-based framework that describes what a health system
must provide to help patients with conditions such as diabetes, heart
disease, and depression to get the kind of care they need, when they need
it. It is estimated that more than 100 million Americans now live with at
least one chronic condition, and that number will rise as the population
ages.
"Dr. Wagner deserves particular praise for taking theoretical ideas about
caring for the chronically ill and turning them into actionable concepts,"
said NCQA President Margaret E. O'Kane. "For example, NCQA borrowed heavily
from his work when we developed the criteria for our ‘Physician Practice
Connections’ program, which awards practices that use up-to-date information
systems to enhance patient care.”
Wagner also serves as principal investigator for the HMO Cancer Research
Network, a National Cancer Institute–funded consortium of 13
health-plan-based research organizations. Among his many local and national
committee involvements, he served as co-chair of the task force that led to
the creation of the Puget Sound Health Alliance, a regional
multi-stakeholder collaboration committed to improving quality and reducing
costs.
Since 1998, the MacColl Institute has served as the national office for
RWJF’s
“Improving
Chronic Illness Care” national program. Under Wagner’s leadership, the
program has supported broad dissemination and testing of the Chronic Care
Model, especially among safety net provider organizations, such as federally
funded community health centers, public hospital systems, and the Indian
Health Services. Organizations worldwide have embraced and adapted the
Model, finding that it often results in healthier populations and holds
promise for reducing health care costs.
“Ed Wagner’s work is helping to prevent and alleviate suffering among
people with chronic health conditions throughout the United States,” said
Eric B. Larson, MD, MPH, executive director of Group Health Center for
Health Studies. “As a result of Ed’s leadership and focus on collaboration,
the American health care system now has an effective model to address
problems in chronic illness care.”
Those using the Model in their chronic care programs include the Centers
for Medicaid and Medicare Services (CMS), the World Health Organization,
several state Medicaid programs, and accreditation programs run by the
National Committee for Quality Assurance and the Joint Commission.
Internationally, several national health care systems and Canadian provinces
are using the Model to redesign care.
Wagner is also well known for his research showing how community-based
senior programs linked to primary care can prevent disability. He has
written two books and more than 250 publications. He serves on the editorial
boards of Health Services Research, the British Medical Journal,
the Journal of Clinical Epidemiology, and the Journal of Cancer
Survivorship.
NCQA is a private, nonprofit organization dedicated to improving health
care quality. It develops health care evaluation tools including health plan
accreditation and HEDIS®, the most widely used set of health care
performance measures.
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Center for Community Health and Evaluation joins CHS
Group Health's
Center for Community Health and Evaluation (CCHE)—a team
that has been part of the
Group
Health Community Foundation for the past nine years—will soon become
part of Group Health Center for Health Studies (CHS).
With 11 employees and 12 contractors, CCHE serves nonprofit
organizations, foundations, and health departments by providing program
planning, assessment and evaluation, and data analysis. Its clients include
organizations such as The Robert Wood Johnson Foundation, health foundations
in seven states, Kaiser-Permanente, the American Cancer Society, King
County, and the University of Washington’s Northwest Center for Public
Health Practice.
CHS and CCHE leaders see the move as a plus for both centers.
“Over the past nine years, CCHE has developed a strong national track
record for its unique competencies at helping nonprofit organizations,
foundations, and health departments with program planning, assessment and
evaluation design, and data analysis,” says its Executive Director Eric B.
Larson, MD.
CCHE is expected to benefit from resources at CHS, which shares the same
mission, interests, and general business model as CCHE. The move also makes
sense for the Foundation, which is working to sharpen its focus on raising
funds to support Group Health and community programs.
Under the new structure, CCHE leader Bill Beery will report to Larson. A
planning team is working on details of the transition, which should be
complete by year end.
Top
Five researchers named CHS affiliate faculty
The Group Health Center for Health Studies (CHS) faculty voted in April
to accept five new
affiliate scientific investigators.
These are scientists employed by organizations other than CHS who have a
long-term collaborative relationship with CHS faculty that spans multiple
projects. They are accepted as affiliate members based on their scientific
excellence, contributions to the Center’s mission, ability to work
productively and collaboratively, service to and mentoring of CHS staff, and
timely provision of information requested for grant development for reviews
by the Human Subjects Review and Research Committees.
The new affiliate members are:
-
Douglas Conrad, PhD, a professor of Health
Services at the University of Washington (UW) and co-director of its
Center for
Health Management Research: An active Group Health member, Doug serves
on the Finance Committee of the Group Health Board of Trustees. He is also
a member of the Committee that oversees the affiliation agreement between
CHS and the UW School of Public Health. He has been involved in many CHS
studies, including the serving as co-investigator on Robert Wood Johnson
Foundation-funded study evaluating the impact of Group Health’s Access
Initiative.
- John Dunn, MD, MPH, a Group Health
pediatrician and chair of Group Health’s Immunization Advisory Committee:
He is board certified in pediatrics and received his Master of Public
Health degree from Harvard University. He has been working with CHS
investigators for more than five years on childhood immunization studies.
-
David Grembowski, PhD, a professor of Health
Services at the UW: He has been principal investigator on two studies of
the Group Health Access Initiative, as well as a study of the influence of
managed care on physician referral and health outcomes of patients with
depression or common pain problems.
-
Diane Martin, PhD, a professor of Health
Services at the UW: She has worked with CHS and UW faculty on research
related to the Group Health Access Initiative, including a new two-year
grant from the Agency for Health Research and Quality (AHRQ) to track
diabetes-specific outcomes.
-
Linda Teri, PhD, a professor of Psychosocial
and Community Health at the UW School of Nursing: She is also adjunct
professor in the UW School of Medicine’s Department of Psychiatry and
Behavioral Sciences and the UW Department of Psychology. She has been a
long-term collaborator with CHS on many studies of aging, dementia, and
Alzheimer’s disease.
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