NP3 Grants Connect Community-based Primary Care Clinicians, Northwestern Scientists
On any given night, nearly 20,000 people sleep along Chicago’s streets, in its parks or within one of the city’s 50 homeless shelters. When combined with the 57,000 residents temporarily staying with friends or family, Chicago has a homeless population that could fill every downtown hotel room — twice over.
“The challenges that a homeless person faces each day are numerous and too often these individuals cycle in and out of emergency rooms and hospitals and there is little coordination with the community-based clinic where they receive the bulk of their healthcare,” says Bruce Doblin, MD, clinical instructor of Medicine: General Internal Medicine and Geriatrics and a physician at Heartland Alliance Health.
Doblin and Matthew O'Brien, MD, associate professor of General Internal Medicine and Geriatrics, were recently awarded a Northwestern Primary Care Practice-Based Research Program (NP3) Seed Grant to explore “Data Systems to Track Homeless Healthcare Services and Outcomes in Chicago.”
“We hope to create the best system for understanding and tracking the care provided in the Chicago area to individuals experiencing homelessness,” says Doblin. “This project, we hope, will identify ways in which healthcare organizations across the city can partner to create a better system of care that allows for sharing information and care coordination.”
The homelessness project is one of four practice-based research seed grants recently awarded by NP3, which is designed to support research partnership development and collaboration between community-based primary care practices and academic researchers. These one-year awards are supported by the Northwestern University Clinical and Translational Sciences (NUCATS) Institute, the Center for Community Health (CCH), and the Division of General Internal Medicine and Geriatrics. CCH has a presence in the NUCATS Institute, as well as Northwestern’s Institute for Public Health and Medicine, and provides community and stakeholder engagement infrastructure across the research spectrum.
Practice-based research is important because a lot of research is either not done in real-world settings or done in specialty clinics in a way that may make it not generalizable to primary care.”
“Practice-based research is important because a lot of research is either not done in real-world settings or done in specialty clinics in a way that may make it not generalizable to primary care,” says Jeffrey Linder, MD, MPH, FACP, chief of General Internal Medicine and Geriatrics in the Department of Medicine and the Michael A. Gertz Professor of Medicine. “What helps make the NP3 program successful is the manner in which it combines experienced researchers with frontline primary care physicians to craft research projects that are important to primary care and to patients.”
The other three 2020 NP3 Practice-Based Seed Grants will fund a range of topics, including projects on gun violence, sexual and gender minorities, and basic questions about the organization of primary care.
Primary Care Visit Length
Principal investigators David Liss, PhD, General Internal Medicine and Geriatrics and Marilyn Pearson, MD, Northwestern Medicine, will be “Examining the Impact of Primary Care Visit Length on Health Care Use and Outcomes.”
“So much of what we’ve done as far as patient care, scheduling, and visit length has been driven by market pressures and demand,” says Marilyn Pearson, Health System Clinician of Medicine: General Internal Medicine and Geriatrics. “Many patients complain bitterly that they no longer have the relationship they once had with their primary provider. I am excited to see whether or not the amount of time we spend with patients actually produces dividends in either outcomes, quality of care or patient satisfaction.”
Screening for Gun Violence
Principal investigators Audrey Brewer, MD, MPH, General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, and Bruce Rowell, MD, Lawndale Christian Health Center, will explore “Screening for Gun Violence in the Primary Care Setting.”
“The crisis of violence continues to deeply impact families and children, unstopped by the coronavirus pandemic,” says Rowell. “Although healthcare professionals and healthcare systems have many things to focus on, we need to press ahead to learn on how we can better screen and intervene to address and hopefully prevent gun violence and its impacts on kids and families.”
Rowell and Brewer will be evaluating a four-question tool which was originally developed in an emergency room setting to screen teens for their risk of experiencing gun violence.
“We hope to better identify these teens and refer them and their families to resources to try to prevent that future violence,” says Rowell. “As part of this study, we hope to enhance our own referral connections with various community organizations, including those established by local churches that work with at-risk youth.”
Bi+ Patient Perceptions
A group of researchers from Howard Brown Health, Northwestern University and Bisexual Queer Alliance Chicago will use their NP3 Seed grant to address patient perceptions in a different manner.
“Our study takes a novel approach to primary care because we are focused on improving primary care engagement for an understudied and often invisible patient population — bisexual, pansexual, queer, and fluid (collectively “bi+”) people,” says Lauren Beach,PhD, research assistant professor of Medical Social Sciences. “Our community engaged study will be among the first to undertake formative research to learn more about the primary care experiences of bi+ people as the dedicated focus of a project. These studies are urgently needed to inform development of tailored interventions to increase the engagement of bi+ people in primary care services.”
Compared to peers of other sexual orientations, bi+ people are less likely to have health insurance or to report a primary care provider. The study team says that the lack of access to and engagement in primary care contributes to broad-ranging health disparities impacting bi+ populations.
“There is an urgent need to undertake studies that center and uplift the voices and experiences of bi+ people to improve the health of bi+ populations,” says Beach. “This NP3 Seed Grant provides our team support to develop a deeper understanding of the barriers and facilitators impacting primary care engagement for bi+ people as part of larger efforts to promote health equity for bi+ people. Our team is very passionate about this work, and we are excited to have received this award.
To learn more about the NP3 program, please visit the program website or email np3@northwestern.edu.
The research projects discussed in this article are supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422.
Written by Roger Anderson
