Primary Care Research & Evaluation
Under the direction of Rebecca Malouin, PhD, MPH, MS, assistant professor, the Primary Care Research and Evaluation Program was established in 2010 in the Department of Family Medicine and the Department of Pediatrics and Human Development. With a focus on the measurement and evaluation of new models of primary care, the program is comprised of several research and outreach projects in primary care.
The program is staffed by several research assistants, including Martie Callow (School of Social Work), Seven Mattes, MS (Department of Anthropology), Elizabeth Allen (Department of Epidemiology), Yuandong Wang and Xinge Ji (Department of Statistics and Probability), and Luzi Lin, MS and Haoran Tan, MS (graduates of Department of Statistics and Probability).
Dr. Malouin was the principal investigator (PI) on a large three-year grant from the Agency for Healthcare Research and Quality (AHRQ) which ended in September 2013. Entitled, “Comparative Effectiveness of Primary Care Practice Transformation by Two Payers,” the study assed the comparative effectives of the patient-centered medical home pilots of two region health plans on outcomes such as patient, physician and staff experience, quality of care, and patient outcomes. The results of the study have been presented at the Conference on Practice Improvement and the American Anthropological Association Annual Meeting. The program also hosted a The Great Lakes Conference on Primary Care Practice Transformation in Buffalo, NY, to present the results of this study to key stakeholders and to discuss the future of primary care in the United States and Ontario, Canada. Key stakeholders from Dr. Malouin and co-PI Dr. Heath Howards’ project, “Understanding Primary Care Transformation in the Niagara Region of Ontario from the Perspective of Practices and Programs,” were invited to attend the conference as well. This study, funded by a Canadian Studies Grant Award from the Canadian Embassy, explored the experience of primary care providers and staff during the implementation of the clinical services plan as promoted by the Hamilton Niagara Haldiman Brant Local Health Integration Network.
In addition, Dr. Malouin is PI on a second large AHRQ grant, “Defining and Building a Patient-Centered Medical Home,” which aims to assess the correlation between a commonly used medical home recognition tool and primary care attributes and the relationship of each to clinical outcomes, and is also a co-investigator on a National Institutes of Health Fogarty Center grant to build capacity in monitoring and evaluation of health programs in Malawi. The program recently submitted an application to PCORI to evaluate the implementation of a new tool to address polypharmacy in nursing homes, ARMOR (Assess, Review, Minimize, Optimize, Reassess), with the tool’s creator Raza Haque, MD. ARMOR is a tool which consolidates recommendations and guidelines for addressing polypharmacy, into a stepwise, interactive tool to be used by interdisciplinary care teams within the nursing home.
The program conducted a study in conjunction with the Department of Family Medicine, to measure primary care attributes of primary care residency practices in the Family Medicine Residency Program Network. The baseline survey of physicians, residents, clinical staff, and administrative staff in each residency practice was completed in 2009, with a follow-up survey completed in 2012. The results of this study were presented at the 2013 North American Primary Care Research Group (NAPCRG) Annual Meeting in Ontario, Canada.
The program released a new monograph, “Positioning the Family and Patient at the Center: A Guide to Family and Patient Partnership in the Medical Home,” in the spring of 2013, which was published by the National Center for Medical Home Implementation and the American Academy of Pediatrics. The monograph includes case studies of tools, processes, and best practices in family-centered care in pediatric medical homes. The development of the monograph was funded by the American Academy of Pediatrics’ National Center for Medical Home Implementation through a cooperative agreement with the Health Resources and Services Administration Maternal and Child Health Bureau.
In addition to research grants and contracts, the program has active local, national and international research and consultation projects. The program continues to support the evaluation of the Network180 Behavioral Health Homes Pilot in Kent County, Michigan, which has the goal of creating specialty behavioral health homes with the establishment of an ongoing relationship with primary care providers. The program also has funds from the Bentz family to support research on communication between primary care providers and educators about children with special health care needs, and is preparing a manuscript examining how communication between schools, clinical healthcare providers, and parents is measured and understood through a review of current literature. The program has recently provided consultative support to the Michigan Primary Care Transformation Project (MiPCT), the State Innovations Model grant from CMS, the Patient-Centered Primary Care Collaborative (PCPCC), and Mathematica Policy Research.
The program is currently working on several innovative new projects:
- Communication Between Primary Care Physicians, Schools and Families of Children with Special Healthcare Needs: Form, Mode and Content: The objective of this study is to understand, from the perspective of primary care physicians in Michigan, their experience with and awareness of best practices in communication with educators and families on the medical management of, and care plans for, children with special health care needs in elementary school. This work is generously supported by the Norman Kagan Endowed Scholarship in Graduate and Professional Studies and the Linda Jean Bentz Memorial Fund.
- Women’s Perceptions of Group Pelvic Floor Muscle Training in Primary Care During Pregnancy: The objective of this study is to assess health care provider and pregnant women’s acceptability of, barriers to, facilitators of, and improvements to group pelvic floor muscle training in primary care. This work is done in collaboration with Elie Mulhem, MD, associate professor of family medicine at Oakland University William Beaumont School of Medicine. The pilot work at Michigan State University is generously supported by a seed grant from the Michigan State University Clinical and Translational Sciences Institute.
- Dissemination of Results from the Enhancing Child Healthcare in Oregon Learning Collaborative: In collaboration with the Oregon Rural Practice-based Research Network, the program has been consulting on analysis and reporting of results of the Oregon practices participating in Enhancing Child Healthcare in Oregon (ECHO) Leaning Collaborative, a demonstration project to improve the quality of health care for children.
In addition to research grants and contracts, the program has active local, national and international research and consultation projects. The program continues to support the evaluation of the network180 Behavioral Health Homes Pilot in Kent County, Michigan, which has the goal of creating specialty behavioral health homes with the establishment of an ongoing relationship with primary care providers. The program provided consultative support to the Michigan Primary Care Transformation Project (MiPCT), the State Innovations Model (SIM) grant from CMS, the Patient-Centered Primary Care Collaborative (PCPCC), and Mathematica Policy Research.