Program Brief
This program brief summarizes a number of ongoing and recently completed research pursuits sponsored by the Agency for Healthcare Research and Quality, in which information technology, educational programs, cooperative partnerships, and analyses of care are being used to improve health outcomes in United States indigenous populations.
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Contents
Introduction
Enhancing Knowledge To Improve Health and Health Care
Developing Data and Research Capacity
Building Relationships and Fostering Collaborative Activities
For More Information
Introduction
The mission of the Agency for
Healthcare Research and Quality
(AHRQ) is to improve the quality, safety, effectiveness, and efficiency of
health care for all Americans. Toward this aim, AHRQ continues its support
for research and other activities
designed to improve quality and
address disparities in health care for its
priority populations, including
American Indians and Alaska Natives
(AI/ANs). This document updates a
previously published (2006)
program
brief with new information on AHRQ
activities specifically relevant to the AI/AN population.
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Enhancing Knowledge To Improve Health and Health Care
Asthma Education Conference for
Tribal Health Officers Serving the
Aberdeen Area. The major goal of this
September 2006 regional conference on
asthma was to inform Northern Plains
tribal health agencies about the current
state of knowledge, research, and
treatment of asthma, its potential
environmental health triggers,
prevention strategies, and
environmental improvement measures.
Topics covered included exposures to
everyday types of indoor and outdoor
contaminants, such as environmental
tobacco smoke, allergens and
endotoxins, molds, insects, dust mites
and other biological contaminants,
chemical contaminants such as
pesticides and formaldehyde, exhaust
from wood-burning stoves, and motor
vehicle exhaust.
Conference
participants included tribal health
representatives and directors, Indian
Health Service (IHS) staff, emergency
medical workers, nurses, and
pediatricians working with 18 tribes in
a four-State region served by the
Northern Plains Tribal Epidemiology
Center. (Principal Investigator: David
Osterberg, University of Iowa; Grant
HS16435, 06/01/06-05/31/07)
Survey of AI/AN Patient Experiences
With Care. In collaboration with the
Choctaw Nation Health Service
Authority, AHRQ and the RAND
Corporation developed an 81-question
survey instrument to assess patients';
experiences with Choctaw Nation
health care facilities.
The instrument
will not only help establish benchmarks
to track patients'; experiences with care
but also support the facilities in their efforts to evaluate the need for internal
quality improvements. The survey is
now publicly available for download at
https://www.cahps.ahrq.gov/content/products/AI/PROD_AI_AIIntro.asp.
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Developing Data and Research Capacity
North Carolina-American Indian
Network Study of Clinical Outcomes. This project brings together 54
providers, 21 of which are American
Indian, with the goal of creating a
research network of primary care
providers who largely serve American
Indian patients in Robeson County,
North Carolina, a rural county that is
home to most of the 50,000+ members
of the Lumbee Tribe who live in the
State.
In addition to creating the
network of primary care practices where
disease- and tribe-specific data can be
collected, researchers will estimate
diabetes prevalence in adults and
children as well as pilot data collection
on processes of care for diabetes.
The
creation of the network, measurement
of prevalence, and results of the pilot
study will result in assessment of the
needs for further work to improve the
identification and care for diabetes in
the community. (Principal Investigator:
Bonnie Yankaskas, University of North
Carolina at Chapel Hill; Grant
HS15989, 08/01/06-07/31/08)
Building Health Services Research
Capacity for Tribes in Montana and
Wyoming (Infrastructure
Development and Research).
This continuation grant builds upon its
earlier capacity-building success during
which the Montana-Wyoming Tribal
Leaders Council developed a shared
data resource and research infrastructure
for participatory research among a
majority of the 10 Tribes it serves.
The
continuation project will further build
capacity for health care research on the
priority health issues identified by the
Tribes and continue to support
culturally appropriate health programs.
Three new research studies are planned:
(1) evaluation of interventions to
promote healthy weight among women;
(2) examination of factors that
contribute to breast and cervical cancer
outcomes; and (3) design and
implementation of a “healthy
reservations” model program for
system-wide health improvement on
reservations. (Principal Investigator:
Gordon Belcourt, Montana-Wyoming
Tribal Leaders Council; Grant
HS14034, 9/30/03-9/29/11)
Implementation and Promotion of
Health Information Technology Tools
and Processes in the Indian Health
System. AHRQ is assisting the Indian
Health Service in enhancing its health
information systems to improve quality
of care and patient safety. For example,
AHRQ is:
- Supporting development,
enhancement, and implementation
of a graphical user interface for the
current IHS information system, the
Resource and Patient Management
System (RPMS). This interface to
the RPMS electronic health record
(EHR) permits direct provider order
entry and documentation, thus
improving data quality and patient
safety. It also embeds elements of
electronic decision support for IHS
care providers.
- Assisting IHS in improving
outcomes in chronic illness care and
preventive services through:
-
Building an infrastructure for
quality improvement and
collaborative learning.
- Adapting and implementing the
Chronic Care Model in Federal,
tribal, and urban facilities. The
model was developed by the
Improving Chronic Illness Care
Program of the Macoll Institute
for Healthcare Innovation.
- Maximizing functionality of a
new RPMS component, the
Integrated Case Management
Application, or iCARE. This
tool is designed to integrate
multiple perspectives on clinical
and community care in a single
software application to enhance
the ability to manage patient
populations.
- Providing ongoing funding and
technical assistance for an evaluation
of the deployment and impact of
RPMS-EHR. AHRQ is assisting the
evaluation team at the Urban Indian
Health Institute (part of the Seattle
Area Epidemiology Center) and
Harvard University with evaluation
methodology, design, and analysis.
Support for IHS Optometry Program
Services Survey. AHRQ is providing
consultation and technical assistance to
IHS in the development of a survey
instrument that will gather data on
optometric services delivery by IHS
providers.
AHRQ staff helped design
the survey and refine the questionnaire
in cooperation with the IHS survey
committee. AHRQ will collect and
compile the data from an estimated 100
health care sites and provide the results
to IHS for analysis.
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Building Relationships and Fostering Collaborative Activities
International Meeting on Indigenous
Child Health. This collaborative
conference will focus on innovative
clinical care models and communitybased
public health approaches for
children and youth in First Nations,
Inuit, Metis, American Indian, and
Alaska Native communities.
The
conference will be planned and jointly
sponsored by a number of U.S. and
Canadian organizations and agencies.
While the health care systems in the
United States and Canada differ, there
are many similarities in terms of
providing culturally effective care to
indigenous children and youth.
Therefore, this conference will strive to
bring exposure to successful models of
care and unique research implemented
at the community level, disseminate
effective strategies, and provide
opportunities for providers to gain
valuable skills that can be utilized
immediately. (Principal Investigator:
Sunnah Kim, American Academy of
Pediatrics; Grant HS16753, 12/01/06-
11/30/07)
Central Kenai Peninsula Health
Collaborative Technology. This project
assessed the status of technological
resources of a federally qualified health
center for uninsured and underinsured
patients, a mental health clinic, a longterm
care provider, and a local acute
care hospital serving a population of
Alaska Natives, disabled, and poor
patients.
The study team prepared a
plan for implementing health
information technologies to allow for
area-wide electronic communications
and connectivity with an electronic
health record and a Web-based data
system for patient support. (Principal
Investigator: Susan Caswell, Central
Peninsula General Hospital; Grant
HS14902, 09/30/04-09/29/06)
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For More Information
Additional information on AHRQ's
activities relevant to AI/ANs may be
found in the AHRQ program brief,
“AHRQ Research and Other Activities
Relevant to American Indians and
Alaska Natives” (AHRQ Pub. No. 06-
P021).
The brief is available from the
AHRQ Publications Clearinghouse by
calling 800-358-9295 or sending an E-mail
to AHRQPubs@ahrq.hhs.gov.
For details about the projects listed
above and other AI/AN-related
activities at AHRQ, contact:
Wendy Perry
AHRQ
Senior Program Analyst for
AI/AN Health
540 Gaither Road
Rockville, MD 20850
E-mail:
Wendy.Perry@ahrq.hhs.gov
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Current as of February 2007
AHRQ Publication No. 06 (07)P021-1
Internet Citation:
AHRQ Research and Other Activities Relevant to American Indians and Alaska Natives—Update 2007. Program Brief. Agency for Healthcare Research and Quality, Rockville, MD. AHRQ Publication No. 06 (07)-P021-1, February 2007. http://www.ahrq.gov/research/amindup.htm
540 Gaither Road Rockville, MD 20850