|Cancer Screening and Prevention||Effective cancer screening tests reduce morbidity and mortality related to cancer. However, use of effective cancer screening tests among eligible individuals remains below national targets. Our research group is working with primary care practices, health systems, insurance providers, and patients in Washington, Wyoming, Alaska, Montana and Idaho to develop and test systematic approaches for improving cancer screening including breast, colorectal, and lung cancer throughout the region.||
ProCRCScreen: Adaptation and implementation of an evidence-based colorectal cancer screening program in a Community Health Center
BeneFIT: Collaboration with Medicaid health insurance plans to implement and evaluate a mailed Fecal Immunochemical Test program to increase colorectal cancer screening rates
SEAStudy: Accuracy of electronic health records to identify patients at high risk for lung cancer
New Hampshire Patient Navigation Program: Testing replication of an effective patient-navigation program to promote completion of colonoscopy in underserved populations.
|Cardiovascular Disease||Cardiovascular disease (CVD) is the leading cause of death and disability in the U.S., and an emerging epidemic in developing countries worldwide. Researchers across our department are developing and testing strategies to decrease CVD risk factors, examining adherence to contraceptive guidelines for women with CVD, and screening athletes for risk of sudden cardiac death.|
Blood pressure kiosks: Implementation of a Self-Service Blood Pressure Kiosk in a Primary Care Clinic.
Center for Sports Cardiology: multiple studies on surveillance, diagnosis and the prevention of sudden cardiac arrest and sudden cardiac death in young athletes.
MESA: We are associated with the Multi-Ethnic Study of Atherosclerosis, an ongoing longitudinal cohort initiated in 2000 to investigate risk factors for subclinical CVD. Participants include 6814 adults age 45-84 years at baseline of four racial/ethnic categories, White, Black, Hispanic and Chinese, at six US clinical sites.
|Child Health and Infection||We have significant expertise in research to improve the diagnosis of serious illness in children in primary care settings, including infections, leukemia, and diabetes. A current focus is on improving the use of vital signs in children. Acute infections are a huge component of the workload in Family Medicine, and we are completing several large cohort studies to improve diagnosis and risk stratification of children and adults with respiratory infections, trials of corticosteroids for acute cough and sore throat, and new point of care tests to help guide antibiotic use.|| |
Point of Care CRP tests: Acceptability and feasibility of using a point of care test for C-reactive protein in Family Medicine clinics in Washington, Wyoming, Idaho and Montana
Novel diagnostics for infection: Development of new lateral flow assays for infections in primary care
TARGET: Cohort study of 8,000 children to develop better risk predictors of hospitalization in children presenting to primary care with acute cough.
Cough Complications Cohort: A study of 30,000 adults and children with acute respiratory symptoms to derive prognostic scores for guiding antibiotic use.
|Dementia and Cognitive Impairment||With the aging of America, one of the most significant health problems we face today is cognitive decline. We have expertise in conducting large observational cohort studies as well as clinical trials associated with cognitive decline and dementia. Studies in which cognition data are available include the Cardiovascular Health Study (CHS), the Multi-Ethnic Study of Atherosclerosis (MESA), and the Ginkgo Evaluation of Memory Study (GEMS). These studies were coordinated at the UW Collaborative Health Studies Coordinating Center (CHSCC, UW Dept. of Biostatistics) with which Dr. Fitzpatrick is affiliated (Richard Kronmal, PhD, PI). These studies welcome new investigators to use biospecimens and data to develop new manuscripts or ancillary studies.|| |
CHS is a prospective study of older adults (age 65 years and older) designed to evaluate risk factors for CHD and stroke at four US sites. The cohort was developed in 1989 with 5201 participants and events follow-up continues.
MESA: The Multi-Ethnic Study of Atherosclerosis is an ongoing longitudinal cohort initiated in 2000 to investigate risk factors for subclinical CVD. Participants include 6814 adults age 45-84 years at baseline of four racial/ethnic categories, White, Black, Hispanic and Chinese, at six US clinical sites.
GEMS originated as a four center clinical trial (n=3069) to evaluate the effect of Ginkgo biloba on the prevention of dementia in adults 75 years of age and older. The study ended in 2008 but an ancillary study to evaluate cholesterol subtypes is currently in place.
|Global Primary Care||Countries with strong primary care systems typically have better health outcomes. Our research group is working across a number of areas of key importance to improve the provision of primary care in low and middle-income countries globally. This includes conducting research on non-communicable diseases such as hypertension and diabetes, helping to implement smoking cessation services in Asia, improving recognition of children with acute illness in sub-Saharan Africa, and assessing quality of primary care delivered.|| |
Diabetes in Cambodia: Improving the diagnosis of diabetes with low cost diagnostics
Supporting LIFE: Feasibility of mHealth decision support tools for health workers in Malawi
Vital signs: Systematically assessing the diagnostic value of vital signs in children in low and middle income countries, and developing new low cost sensors.
Dhulikhel Heart Study: A prospective longitudinal cohort study to evaluate risk factors for CVD in the adult residents of Dhulikhel, Nepal. Baseline data collection is underway with plans for 20 years of follow-up.
International Quitline Institute: Initiative to train tobacco cessation workers in Low- and Middle Income Countries
Stroke in Vietnam: We conducted a surveillance of risk factors for stroke in Da Nang, Vietham, in collaboration with the Ministry of Health, and developed a stroke registry at Da Nang Hospital.
|Health Workforce||The health workforce is the backbone of any health care delivery system. Our research group houses three federally funded centers conducting quality research necessary to develop a strong and quality health workforce in the US: 1) Center for Health Workforce Studies (CHWS), 2) WWAMI Rural Health Research Center (WWAMI RHRC), and 3) the Collaborative for Rural Primary care Research, Education, and Practice (Rural PREP). In addition, our group conducts collaborative research with other organizations across the nation on topics such as enhancing primary care training, workforce shortages, models of team-based care, allied health professions, and behavioral health workforce. Our group also provides technical assistance to assist governmental agencies with workforce planning.|| |
Health Workforce Research Center: Current projects include i) Characteristics of Physician Assistant Students Planning to Work in Primary Care, ii) Characteristics of Veterans in Allied Health Care Jobs, iii) Pathways for Military Veterans to Enter Allied Health Careers, iv) The Workforce Needed to Integrate Behavioral/Mental Health Workforce with Primary Care, v) Impacts of Greater Use of Low Skilled, Low-wage Workers in Health Care Delivery
State Workforce Planning Technical Assistance for the National Governors Association
Health Care Cost Institute State Health Policy Program: study on unrestricted access to physical therapy on health spending
National Family Medicine Residency Graduate Follow-up Survey
|Medical Student Education Scholarship||The University of Washington Family Medicine Medical Student Education Section develops and delivers innovative, high-quality training to medical students who will serve the evolving needs of the diverse individuals, families, and communities of the WWAMI region.|
Our mission is to encourage and develop students who will serve rural communities, the urban underserved and other vulnerable populations. We recognize health as a matter of social justice. All individuals, families and communities have a right to health and access to medical care.
Family medicine is the foundation of health care for all, providing patient care that is patient-centered and evidence-based. We believe family medicine is a foundation for the development of all physicians. We value education that is innovative, relationship-centered and community-based, emphasizing population health, community engagement, service learning and continuous quality improvement. We value inter-professional and inter-disciplinary collaboration that promotes teamwork, professionalism and respectful treatment of students, patients and colleagues. We embrace diversity among our students, staff and faculty and support professional and personal development for all.
Washington Academy of Family Physicians
Society of Teachers of Family Medicine
Idaho Academy of Family Physicians
WWAMI Area Health Education Centers
WWAMI Medical Education Campuses
Department of Family Medicine Clinical Faculty
WWAMI Clinical Teaching Sites
The Productivity Study Project
|Primary Care Innovations||We are engaged in numerous research activities around the design, development, testing and implementation of new technologies and innovations in primary care. This includes using mobile phones and text messaging for improving health care, exploring the use of point of care diagnostic tests that can offer ""one stop"" care without the need for waiting for test results, testing and implementing new electronic devices to diagnose and monitor blood pressure in clinic waiting rooms or at home, and developing data sharing infrastructure to support quality improvement and research using electronic health record data. We work closely with experts from industry, UW research labs, and primary care clinics in Seattle and across the WWAMI region.|| |
Please view the Primary Care Innovations Lab section for further information on current projects.
mHealth: Measuring primary care patients’ use of mobile health technologies
Lifelog: Assessing patient and primary care provider preferences for sharing mobile health data
Blood pressure kiosks: Implementation of a Self-Service Blood Pressure Kiosk in a Primary Care Clinic.
POCKET study: evaluating the current use and implementation of point of care tests in Family Medicine clinics in the WWAMI region.
Novel diagnostics for infection: Developing new lateral flow assays for infections in primary care
Vital signs: Developing new methods to measure capillary refill time to diagnose shock in children
Data QUEST: Aligning de-identified electronic health record data from a subset of diverse practices in Washington and Idaho to support research and quality improvement
Patient Preferences for Weight Loss in Primary Care: Measures the degree to which overweight and obese patients in primary care report willingness to participate in comprehensive weight loss programs.
Supporting LIFE: Feasibility of an android-phone based decision support tool for health workers in Malawi
Handheld Ultrasound: Establishing priorities for training and testing of handheld ultrasound devices in Family Medicine clinics.
|Reproductive and Womens Health||Family Planning and reproductive health care is an important part of primary care. Family Medicine researchers work within the Division of Family Planning in the Department of Obstetrics and Gynecology. Our mission is to investigate critical clinical questions and conduct innovative research to advance the field of family planning. We are conducting clinical trials that evaluate new contraceptive methods as well as methods to help treat contraceptive side effects. We evaluate how we can improve access to reproductive health care among disparate populations, including refugees.|
Reproductive Health in Disparate populations:
|Rural Health||Rural U.S. residents overall are poorer, have a higher burden of disease, are more likely to live in Health Professional Shortage Areas, and travel farther to access health care than their urban counterparts. Our research aims to inform local, regional, and national policy and practice to improve the health of vulnerable and minority rural populations. Research focus areas include rural health professional education, recruitment, retention, and competencies, as well as rural disparities in access to high quality care.|| |
Nurse practitioner and physician assistant education for rural practice
Rural patient access to and outcomes of home health services
Sustaining physician residency education in rural places
The supply of physicians to treat opioid addiction in rural patients
The supply and distribution of the rural behavioral health workforce
The potential of community paramedicine to fill rural healthcare gaps
|Tobacco and Other Substance Abuse||Prescription opioids are posing a substantial and growing health care problem as well, with an estimated 2.1 million people in the U.S. suffering from substance use disorders related to prescription opioid pain relievers in 2012. A greater availability of opioid prescribed drugs has been accompanied by alarming increases in the estimated number of overdose deaths due to these pain relievers, which have more than tripled in the past 20 years. Our collaborative research is testing strategies to support primary care practice change that can lower the risks of death and drug overdose among patients who are taking opioid medications for chronic non-cancer pain.Tobacco use continues to be the leading cause of disease, disability, and death in the US and the world, killing 480,000 people per year in the US and nearly 6 million globally. While tobacco prevention policies and programs have reduced overall prevalence of tobacco use in developed countries, health disparities have increased among disadvantaged populations, and tobacco-related disease and death in low-resource countries is rising. Helping people quit smoking and reducing involuntary exposure to secondhand smoke are the fastest and most effective ways to reduce the toll of the tobacco epidemic, locally, nationally and globally.|
Team-Based Safe Opioid Prescribing: Collaborating with remote rural practices to study the implementation of best practices for managing chronic opioid therapy among patients with non-cancer pain
UW Tobacco Studies Program:
The International Quitline Institute:
|Sports Medicine||Injuries afflict athletes of all ages and levels. Health outcomes such as death due to underlying cardiac conditions or traumatic brain injuries can be overlooked in what is considered to be a healthy population of individuals. Research from the Sports Medicine Clinic concentrates on developing methods of prevention for injuries and catastrophic events, improving diagnostic tools, and studying treatments for athletes.||Korey Stringer Institute|
Cardiovascular screening, sudden cardiac death prevention:
Incidence and etiology of sudden cardiac death and sudden cardiac arrest:
Injury prevention and treatment:
|Palliative Medicine||Palliative care, also known as palliative medicine, is specialized medical care for people living with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness – whatever the diagnosis. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a team of palliative care doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative or life prolonging treatment.||Cambia Palliative Care Center of Excellence|
|Health Equity and Workforce Diversity||Ensuring all individuals are afforded the opportunity to attain the highest possible standard of health, regardless of one’s social or economic position is essential to improving population health locally and globally. To facilitate this, it is critical to have a health workforce that is reflective of the diversity of the population and that healthcare professionals have the knowledge, skills, and abilities to identify and address the multitude of factors that impact individuals’ and communities’ health and well-being. Our work engages researchers, practitioners, patients, and communities to ensure health equity and facilitate diversity among all levels of the healthcare workforce. Through our studies on patient experiences, discrimination and health, and workforce diversity we aim to provide relevant and actionable insights to improve the health and well-being of individuals and communities.|