Current Research Projects
Developing Infrastructure for Patient-Centered Outcomes Research at Denver Health
The funding source of the Center for Health Systems Research, this project combines research training for current physician staff with electronic data structure development and pilot projects in outcomes research. Its long term goal is to expand outcomes research capacity in a safety net healthcare system. AHRQ R24 HS022143-01
An Intervention to Increase Engagement with Hypertension Care for American Indian Patients
The goal of this project is to evaluate an intervention in American Indians that has shown promise in improving self-care behavior in another minority patient group. The intervention relies on a psychological process known as values-affirmation and involves a specific writing exercise administered immediately before a clinic visit. It is presumed to have its effects through reducing the effects of stereotype threat, under which the behavior of minority individuals is altered by concerns their behavior will be judged according to stereotypes. AHA 15SFDRN24180024
Improving Symptoms and Quality of Life in Advanced Chronic Heart Failure
The major goal of this project is to conduct a randomized clinical trial to evaluate a palliative symptom management and psychosocial care intervention to improve quality of life in patients with heart failure. NIH/NINR R01 NR013422
PCOR Pilot Projects
Text Messaging for Weight Loss (PI – Fischer)
This study demonstrated that text message support, developed using the DPP curriculum and implemented six times weekly over 12 months, can lead to weight loss in patients with prediabetes at one year. This model addresses cost and accessibility and promotes behavioral modification and weight loss among patients of low socioeconomic status.
Dual Protection against Teen STIs and Pregnancy (PI – Rinehart)
This study investigates the efficacy of a text message-based intervention on knowledge, motivation, self-efficacy and behavior, and aims to decrease the incidence of sexually transmitted infections and unintended pregnancy in adolescents.
Denver Health Asthma Management Program (PI – Anderson)
This is Comparison Effectiveness Research study compares differing levels of texting interventions in patients with persistent asthma. The two texting interventions include 1) texting only an individual with asthma and 2) texting an individual with asthma and an important person in that individual’s life such as a parent or spouse. These two intervention cohorts will be compared to a control group receiving usual care at Denver Health.
Recent Research Projects
Integrated Model of Individualized Ambulatory Care for Low-income Children and Adults (Health Care Innovation Award: 21st Century Care)
The major goals of this project, funded by the Center for Medicare & Medicaid Studies’ Innovation Center, are to create an ambulatory care model that will provide individualized care for patients' medical, behavioral and social needs. 1C1CMS331064-01-00
Advancing Measures for Risk Adjustment and Performance Assessment – Subproject 5
This subproject of a Program Project based at Dartmouth investigated the impact of patient-reported measures on outcomes of care for elderly patients with multiple co-morbidities. NIH/NIA AGO 19783
High Value Healthcare Collaborative (HVHC) Sepsis Project
This project used Lean methods to identify operational challenges in order to improve compliance when implementing a sepsis bundle based off the Surviving Sepsis Campaign guidelines. With corrections of identified gaps between daily clinical operations and standardized bundle care, it is thought that improvements could be made in a triple aim approach: 1) Improve care by 5% over three years 2) Improve health by 5% with a relative reduction over 3 years in the number of patients requiring long term acute or sub-acute nursing care after an episode of severe sepsis 3) Reduce Cost: $12.5 million savings over three years.
High Value Healthcare Collaborative (HVHC), Shared Decision Making Program
With the assistance of a health coach and decision aids, patients are empowered to make informed decisions about their healthcare. The project aimed to reduce utilization and costs that have been shown to occur when patients are engaged and empowered to make health care decisions based on their own values and preferences . CMS-1C1-12-0001
Integration of Behavioral and Physical Care in a Safety Net Health Care System
Implementation and evaluation of an integrated care model at Denver Health that includes the availability of onsite clinical psychologists and a psychiatrist as well as a telephonic depression and anxiety program.
The Association between Providers' Ethnic/Racial Biases and Hypertension Control
Physicians’ implicit racial and ethnic attitudes and their relationship to blood pressure control. NHLBI R01 HL88198-01A1
An Intervention to Reduce the Effect of Racial and Ethnic Bias in Hypertension Care
The effect of a novel intervention on patient-provider interaction and subsequent patient self-care behavior. NHLBI R21 HL089623-01A2
Latinos Using Cardiovascular Health Actions to Reduce Risk
Interactive Voice Recognition Technology for the Management of Hypertension. Colorado Department of Public Health. NHLBI 1 U01 HL079160
- Fisher HH, Fischer IP, Pereira RL, Furniss AL, Rozwadowski JM, Moore SL, Durfee MJ, Gutierrez-Raghunath SG, Tsai AG, Havranek EP. Text Message Support for Weight Loss in Patients with Prediabetes: A Randomized Clinical Trial. Diabetes Care 2016; doi:10.2337/dc15-2137
- Blair IV, Havranek EP, Price DW, Hanratty R, Fairclough DL, Farley T, Hirsh HK, Steiner JF. Assessment of biases against Latinos and African Americans among primary care providers and community members. Am J Public Health 2013; 103: 92-8.
- McCormick EV, Durfee J, Vogt TM, Daley MF, Hambidge SJ, Shlay J. Physician attitudes regarding school-located vaccinations. Pediatrics. 2012 Nov; 130(5):887-96. doi: 10.1542/peds.2011-2962. Epub 2012 Oct 1.
- Fischer HH, Eisert SL, Everhart R, Durfee MJ, Moore SL, Soria S, Stell D, Rice-Peterson C, Mackenzie TD, Estacio RO. Nurse-run, telephone-based outreach to improve lipids in people with diabetes. American Journal of Managed Care2012. 2012; 18(2):77-84.
- Fischer HH, Moore SL, Ginosar D, Davidson A, Rice-Peterson C, Durfee MJ, MacKenzie TD, Estacio RO, Steele AW. Care by cell phone: text messaging for chronic disease management. American Journal of Managed Care2012; 18(2):e42-e47.
- Fischer HH, Eisert SL, Durfee MJ, Moore SL, Steele AW, McCullen K, Anderson K, Penny L, Mackenzie TD. The impact of tailored diabetes registry report cards on measures of disease control: a nested randomized trial. BMC Medical Informatics and Decision Making. 2011 Feb 17; 11:12. doi: 10.1186/1472-6947-11-12.
- Padilla R, Davidson A, Havranek EP, Steiner JF, Beaty BL, Bull S. A comparison of different measures of acculturation with cardiovascular risk factors in Latinos with hypertension. J Immigrant Minority Health 2011; 13: 284.
- Fischer HH, Villacres A, Durfee MJ, McCullen K, Mackenzie TD. Diabetes population management by telephone visits. Telemedicine Journal and e-Health. 2011 Apr 14. [Epub ahead of print].
- Padilla R, Gutierrez Ragunath S, Fernald D, Havranek EP, Steiner J, Bull S. Designing a cardiovascular disease prevention web site for Latinos: Qualitative community feedback. Health Promotion Practice 2010; 11: 140-7.
- Eisert SL, Durfee MJ, Welsh A, Moore SL, Gabow PA, Mehler PS. 2008. Changes in Insurance Status and Access to Care in an Integrated Safety Net Healthcare System. Journal of Community Health. Volume 34, Issue 2 (2009), Page 122. Published online 2008 Oct 21, DOI: 10.1007/s10900-008-9136-
- Steiner JF, Ho PM, Beaty BL, Dickinson LM, Hanratty R, Zeng C, Tavel HM, Havranek EP, Magid DJ, Estacio RO. Socio-demographic and clinical characteristics are not clinically useful predictors of refill adherence in patients with hypertension. Circ CV Quality Outcomes 2009; 2: 451-457.