Additional Completed Projects

• The STEP study: STanding Elderly blood Pressure: The standing measurement of blood pressure in elderly in the primary care clinic: A standardized approach

  • Principal investigator: Cory J. Ingram, M.D.

  • Orthostatic hypotension is a risk factor for falls in the elderly. This study implemented a standardized approach to measure standing blood pressure in order to identify orthostatic hypotensive patients older than 65 to ensure that their primary care providers were aware of the condition and addressed it accordingly.

    Results demonstrated that a standardized approach to measuring elderly patients' blood pressure standing is feasible in an ambulatory clinic and has an influence on the care provided.

• Summer Publishing Series: A tool for equipping rural physicians for academic achievement

  • Principal investigator: Stephanie Nainani, M.D.

  • A series of classes on scientific publishing was offered to physicians, midlevel providers, administrators, students and community members from three Mayo Clinic Health System sites in southeastern Minnesota.

    The first class focused on choosing a journal, choosing a topic, manuscript structure and organization, and conducting a literature review. The second class reviewed students' first drafts, revising and refining the manuscript. The final session highlighted the submission process, ethics, legal matters, uniform journal requirements, peer writing groups and additional support.

    Evaluations were favorable, and outcomes included one case report and several other projects under way.

• The characteristics of individuals or tools used by individuals with controlled diabetes vs. those with uncontrolled diabetes

  • Principal investigator: Guillermo Pons, M.D.

  • A comparison of diabetic populations between two health care systems found no significant differences in numerous patient characteristics. Researchers concluded that neither the sociodemographic, biochemical indices or clinical markers reviewed in this pilot were helpful in predicting glycemic outcomes.

    However, studied sites did differ in approaches to patient education and the conduct of general medical office visits and focused diabetes visits. Results showed that diabetes education and nutrition education had a significant effect on hemoglobin A1C levels. This suggests that health care systems should emphasize and encourage patient participation in diabetes education and nutrition visits.

• Community/clinic integration for preventive service receipt in racially diverse adults: Partnering with community health workers

  • Principal investigator: Paul V. Targonski, M.D., Ph.D.
  • Diverse patients require unique solutions to the same health problems in order to achieve equivalent health outcomes. Using an electronic medical record review, this study evaluated the impact of community health worker (CHW) referral on the receipt of preventive services and hypertension control within a Somali community of adult medical patients. It was shown that a one-time referral to a CHW resulted in higher rates of receipt of preventive services in vaccination and cancer screening.

• Community-based resources awareness survey

  • Principal investigator: Paul V. Targonski, M.D., Ph.D.
  • Goals of the Minnesota Statewide Health Improvement Program include obesity management and tobacco cessation. This Web-based standardized survey collected information from health care providers regarding their awareness and use of community-based resources. Responses to the survey will facilitate active referrals of patients to appropriate resources within and outside of medical facilities.

• DAD: The impact of decision aids to enhance shared decision making for diabetes (R34)

  • Principal investigator: Victor M. Montori, M.D.

  • In addition to healthy lifestyles, patients with type 2 diabetes must adhere to complex drug therapy programs to prevent complications, but patients rarely involve themselves in decisions about these programs.

    Previous studies of innovative decision aids used to facilitate shared decision making between the patient and health care provider in academic practices found that their use promoted patient involvement in choice and adherence to treatment. This trial tested the efficacy of decision aids for cardiovascular disease prevention and glycemic control in a community setting.

• Use of Hmong-language translators as community advocates to improve diabetes care among physicians' practices

  • Principal investigator: Cheri L. Olson, M.D.

  • This study was initiated in response to suboptimal standard diabetes metrics seen in Hmong patient populations with diabetes. The team investigated whether providing special training in diabetes care management to nonmedical Hmong-language interpreters, and having them make frequent contact with Hmong patients who have diabetes, improved the patients' blood sugar control as evidenced by their hemoglobin A1C scores. In addition, the team implemented care coordination meetings and increased provider-interpreter communication.

    Participating providers noticed improved communication and cross-cultural understanding of issues related to diabetes care.

• Community health care access collaborative mental health issues

  • Principal investigator: Paul V. Targonski, M.D., Ph.D.
  • A Web-based survey was conducted at the community level to determine referral patterns by community mental health providing organizations in Olmsted County, Minnesota. Social network analytic methods were applied to describe current organizational interactions, communications and service structures. Results were shared with community health care access collaborative members to aid in their determination of next steps in addressing local mental health care needs.

• Office associate study

  • Principal investigator: Rodney A. Erickson, M.D.
  • The "office nurse," or clinical associate, is a key member of a family medicine team. The performance on the metrics of diabetes scores, patient satisfaction and productivity of a clinical team (clinician and associate) was studied in relation to the nurse's level of training. Results showed that a higher level of office associate education improved performance on diabetes scores and patient satisfaction, with productivity being the same across all groups.

• Employee TB-screening project

  • Principal investigator: Daniel R. Stahl, M.D.

  • This study examined existing tuberculosis-screening policies and procedures for employees of critical-access hospitals across rural Minnesota. The findings shed light on current expectations and guidelines for TB surveillance of health care professionals, including whether Centers for Disease Control and Prevention (CDC) recommendations were being followed.

    Of particular interest was the finding that 71 percent of the hospitals screened annually for TB, counter to CDC recommendations. Moreover, many hospitals did not follow CDC recommendations for tuberculin skin test (TST) administration or interpretation, nor did all refer individuals with positive test results for treatment.

• Sep 26, 2012
• ART401478