Meta-LARC Projects and collaborations

Implementing Networks’ Self-management Tools Through Engaging Patients and Practices (INSTTEPP)

INSTTEPP LogoUnder leadership of Meta-LARC Director L.J. Fagnan, MD, four PBRNs participated in a project to implement AHRQ's self-management support (SMS) library/toolkit in local clinics. The participating PBRNs were WREN, IRENE, ORPRN, and SNOCAP.

Using a community-participatory model called Boot Camp Translation, we engaged clinicians, care managers and patients across 16 practices to translate what matters to help patients increase self-management of chronic conditions like diabetes or chronic pain. The Boot Camp participants challenged one another to get beyond the numbers and to emphasize the importance of starting with relationships and trust before you can share successes and hold one another accountable. The groups modified tools from the AHRQ library to create a Diabetes Health Guide, a personal action plan, and a problem-solving worksheet.

While practices were modifying and beginning to use these tools, we surveyed patients at the practice who had chronic conditions but were not part of the Boot Camp process. One of the surveys used was the Patient Assessment of Chronic Illness Care (PACIC). Some of the questions on the PACIC survey were whether the practice:

  • Asked to talk about my goals in caring for my condition(s)
  • Gave me a copy of my treatment plan
  • Thought about my values, beliefs, and traditions when s/he recommended treatments to me
  • Helped me make a treatment plan that I could carry out in my daily life

PACIC results were significantly better after practices had begun to use the self-management support tools than before. Overall patients noticed improvements in care and experienced improved health status.

Manuscript development is under way, and monthly meetings continue with Meta-LARC support to complete analysis and dissemination.

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A Community-based Assessment of Skin Care, Allergies and Eczema (CASCADE)

Eric Simpson, MD, a dermatology researcher at OHSU, was funded by the National Institute of Arthritis and Musculosketal and Skin Diseases  to complete a planning project within Meta-LARC in preparation of a large-scale, community-based trial on use of skin barrier protection to prevent onset of atopic dermatitis in infants. The intervention centered around daily use of an oil-based emollient from birth through two years of age to prevent onset of atopic dermatitis. The planning project occurred in five participating Meta-LARC PBRNs: ORPRN, WREN, IRENE, SNOCAP, and Duke PCRC. This project set up a data coordinating center, a manual of operations, training materials for practices, and creation of a protocol steering committee. In March 2016 we completed a U01 submission to NIAMS to conduct a 5-year, large-scale trial to enroll 1,244 newborns across four states: Oregon, Wisconsin, Colorado and North Carolina. If funded, the trial would begin in January 2017.

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PBRN Research Certification Methods Program

This 10-month fellowship program is co-directed by Jim Werner, PhD, at Case Western Reserve University and Meta-LARC Director LJ Fagnan, MD. The goal of the program is to develop a new generation of investigators who are equipped to conduct high-impact practice-based research and to develop and lead practice-based research networks. In its inaugural year (September 2015-July 2016) 16 fellows graduated from the program. In the second year there are 53 fellows (46 mentors) from the U.S. and Canada enrolled.

Interested in applying to be a future fellow? Learn more.

2015-16 Fellows

2015-16 PBRN Fellows

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