Public Health and Healthcare

CPDE works with community-based and healthcare organizations focused on improving health and healthcare systems through programming, community outreach and quality improvement initiatives in healthcare settings. Evaluation activities include needs assessments, training evaluation, stakeholder interviews and survey data to inform program design, improvement or outcome assessment.

Condition-specific Patient-Reported Outcome Measurement Development

This project focuses on developing a generalizable model to integrate generic and condition-specific patient-reported outcome (PRO) measures into a single measure. This model is being tested with patients with heart failure or osteoarthritis of the knee. CPDE faculty and staff have led the study with colleagues at Northwestern University and have conducted and overseen activities including: recruiting participants from across the US to participate in focus groups, interviews and a panel survey; convening and consulting stakeholders (patients, caregivers, clinicians); analyzing qualitative data and producing crosswalks with existing PRO measures; developing new condition-specific PRO instruments and disseminating findings to advisory boards and through presentations and publications.

Patient Reported Outcome (PRO) Measure Implementation

This three-year study examined the implementation of patient-reported outcomes (PROs) across five clinical practice settings to assess readiness of practice sites to implement PROs, experience implementing PROs and brief patient feedback on the experience. CPDE's mixed method study evaluated the variations in implementation, including facilitators and barriers for implementation among providers and staff using baseline and follow up surveys, semi-structured interviews, and analysis of PROs.

Geriatric Workforce Education Project

Funded by a grant from the Health Resources and Service Administration (HRSA), the Geriatric Workforce Enhancement Project (GWEP) is a three-year grant supporting the development of a rural health care workforce servicing older adults in northern New Hampshire and southern Vermont. The GWEP is intended to improve health outcomes among older adults through better integration of geriatrics with primary care, enhanced chronic care management between primary and specialty care, advance care planning and establishment of Advanced Directives, and increased patient and family engagement and self-efficacy in health care management. Project activities include site-level training in Quality Improvement and health care delivery for geriatric patients, and enhanced partnerships and increased referrals between primary care practices and community-based organizations and resources. Evaluation of the GWEP uses a crossover design, and employs a comprehensive, mixed-methods approaching including semi-structured interviews with GWEP practice champions, and baseline, end-point, and one-year follow-up surveys of GWEP team members and Practice Managers.

North Country Health Consortium Quality Improvement Program for Obese Adults

The goal of the program is to implement the evidence-based Clinical Microsystems quality improvement (QI) model to improve health outcomes for obese adults in four, participating Federally Quality Healthy Centers (FQHC) located in Northern New Hampshire. Each FQHC identifies the component(s) of the clinical microsystems that would be most useful for its practice and the NCHC project coordinator works with the FQHC quality improvement team for up to six months to implement the components into the practice. The evaluation included pre/post interviews with key agency staff to learn about the barriers and facilitators to implementing the QI project.

Molar Express

The overall goal of Molar Express is to improve the oral health status of the uninsured and underinsured children of Coos and Grafton County and seniors without access to an affordable dental home. The project implements a care coordination model to help patients and families overcome barriers to care and treatment. The overall evaluation approach is a multi-level, mixed methods, longitudinal transformation evaluation design (Schifferdecker & Reed, 2009). In this design, multiple qualitative and quantitative data are collected over time, and data are analyzed and triangulated throughout the study to inform later phases of implementation and evaluate achievement of outcomes. Survey data are collected from students, parents, nurses, seniors, and senior center staff. Whenever possible, we will continue to use (with past school participants) or assign (with new participants) confidential IDs to track data over time, including services received, knowledge, behaviors and oral health.

InSHAPE® Together - a project of the Prevention Research Center at Dartmouth

This two-year study involved a cross-case and within-case study design using a mixed methods approach in three communities. Each community recruited thirty participants sharing the common goals of increasing physical fitness, enhancing nutrition and improving their communities. The overarching goal of InSHAPE® Together was to test the Action Learning Collaborative model in a 9-month intervention to increase physical activity and improve nutrition through the establishment of realistic and time-framed health goals and the development of a process for meeting these goals at the individual, team, and community levels.