Research Projects

Current Research

Every year we help clinicians formulate their research questions, translate them into research projects, and help them implement and analyze the data. Below is a list of our current on-going research within the NNE CO-OP PCBRN.

Magnifying glass over the words "data collection" on a piece of paper

A Comparison of Low-burden Data Collection Methods Using a Study on Primary Care Telehealth and Burnout

PI: Timothy Burdick, MD, MBA, MSc

Telehealth is a common tool for delivering primary care services yet the differential impact on clinician perceived stress, based on setting and experience, requires study.  By comparing low burden data collection methods on primary care telehealth and burnout and incorporating different surveys to assess primary care provider (PCP) perceptions this card study will investigate the relationship between telehealth modality (clinic, phone, video) and PCP stress perception. As the first card study it will be used to evaluate the card study methods for conducting a card study by surveying all participating PCPs.  In comparing different methods of delivering point-of-care observational surveys (Card-studies) and evaluating the impact on PCP burnout in the context of telehealth, this study will recognize the burden, benefits, and potential improvements for future card studies, ultimately enhancing engagement and relevance.

Words "Long COVID" spelled out in single letter tiles

A Study of Long COVID in Primary Care with the Northern New England CO-OP PCBRN

PI: Neil Korsen, MD, MSc; Darlene Peterson, MD

Studies have estimated that Long COVID prevalence ranges from 10% to 50%. Despite Primary Care’s crucial role managing these patients, Long COVID is especially understudied in primary care. This pilot study seeks to fill this gap by employing a low burden point-of-care clinical encounter survey (Card Study) and through this innovative approach, collect data from sixty primary care providers across CO-OP practices in the Northern New England (NNE) region. By characterizing Long COVID as it manifests in primary care and examining Long COVID’s prevalence, symptoms, impairment level, and management approaches, we will help spur more advanced research studies that enhance patient care, guide treatment, and engage other NNE CO-OP members to investigate Long COVID in primary care.

A medical professional holding a stylus and phone with the words "COVID-19 Vaccine" overlayed onto the image and a 3D rendering image of a a COVID-19 virus

COVID-19 Vaccine and Booster Hesitancy Perception Study

PI:  Maureen Boardman, MSN, FNP-C, FAANP

COVID-19 vaccine hesitancy was highest in rural communities in 2021 with 21% of all rural US residents saying that they would “definitely not” be immunized against COVID-19 compared with 10% of urban residents. As of 2021, only 58.5% of people in rural areas had the first dosage of the primary vaccination series compared to 75.4% of urban counties. We created this study to explore the why behind COVID-19 hesitancy disparities of rural and urban populations. We’ve distributed patient surveys to three federally qualified health care centers in Maine, New Hampshire, and Vermont. These surveys ask about hesitancy for COVID-19 vaccination series, booster series, and overall vaccine hesitancy. Primary care clinicians are also being surveyed in the three states to understand what their perceptions of their patient population’s hesitancy beliefs are and first hand experiences. 

A person with gloves holding a vial labeled HPV Vaccine

HPV Vaccine Expanded Age Range

PI:  Maureen Boardman, MSN, FNP-C, FAANP

In 2019 the CDC updated 2006 guidelines on HPV vaccine eligibility by expanding the age range of individuals that qualify. Currently, unvaccinated or inadequately vaccinated individuals between the age of 27- 45 can be vaccinated for HPV based on risk and clinical shared decision making. However, we know little about patient and clinician perspectives on the new age expansion and the shared-decision making process for HPV vaccination eligibility which is why we proposed a study to evaluate patient and clinician perspectives. Two surveys were created to evaluate patient and clinician perceptions and perceived barriers for HPV vaccination and shared decision-making. Our first survey focused on patients between 27- 45 at three clinic sites in Vermont and three clinic sites in New Hampshire while our second survey focused on clinicians who see patients between the ages of 27- 45 in Vermont or New Hampshire. Our goal is to get a total of 300 completed surveys from patients and 300 from clinicians.

Clinician holding up a sign with the word "Epilepsy".

Increasing Epilepsy Self-Management Access by Embracing a HUB and Spoke Model

PI:  Elaine Kiriakopoulos, MD, MPH, MSc

Despite mounting evidence of the benefits of epilepsy self-management (ESM) programs, the matter of bringing self-management programs to clinical centers has been challenging.  Dartmouth Health’s HOme-Based Self-management and COgnitive Training CHanges lives (HOBSCOTCH) Institute for Cognitive Health and Well-Being has made measurable progress of addressing neurocognitive difficulties and improving the quality of life in people with epilepsy with a central support and an intervention that is telehealth delivered by trained Cognitive Coaches.  This implementation science project will build upon the success of the HOBSCOTCH program by proposing partnerships with primary care practices, to integrate the HOBSCOTCH Institute’s resources and streamline the referral process for PWE to access ESM support.  Over the course of 5 years, 53 clinical sites, including CO-OP practices, will be recruited to receive the learning sessions that provide the evidence-based resources for ESM and in doing so, will support epilepsy care for patients and contribute to the development of a comprehensive replicable model for community and family practice systems nationwide. This project (2023-2028) is supported by Cooperative Agreement grant funding from the Centers for Disease Control and Prevention (1-NU58DP007541-01-00).

The word "Opioid" spelled out on a chalk board accompanied by a needle and pill bottle.

Opioid Prescribing Patterns and Analysis of Secular Trends

PI:  Constance van Eeghen, DrPH, MBA

Primary care providers are increasingly called upon to treat chronic pain patients at risk of addiction yet prescribing practices require robust study.  A pilot study is a necessary first step to study the feasibility of data collection in primary care for future effectiveness studies related to opioid prescribing patterns.  Since state-wide standardization and ability to capture prescriptions that were filled, rather than prescribed, are in prescription drug monitoring program (PDMP) data, PDMP will provide a reliable source for measuring adherence to required and best practices prescribing opioids.  Four rural primary care clinics in Northern New England were recruited to collect opioid prescribing data from state PDMPs and electronic health records to evaluate key indicators of adherence to best practices to improve treatment of patients with chronic pain and reduce risk of opioid misuse.

Past Research

The CO-OP has over 40 years of research including our widely used Charts. Below is a selected list of our completed projects in recent years.