Granted: COVID’s Impact on Cancer Patients
NW Heron Survey: Seeing Results
From the Beginning
On the Road
WSU Scientists Develop COVID-19 Tracking Tool for Rural Areas
New WSU Asthma Study Issues Call for Participants
Win-Win: Community Projects Underway
GRANTED | COVID’S IMPACT ON CANCER PATIENTS
Patrik Johansson, MD, MPH, Director
We are proud to announce that the Andy Hill Care Fund has awarded NW HERON a COVID-19 Response Grant to research the impact of COVID-19 on the well-being of rural and American Indian cancer patients in Washington state.
Leveraging the reach of our research network, the NW HERON team will examine the impacts of COVID-19 on selected measures of health, health care, personal, socio-cultural, and economic outcomes among cancer patients from 15 clinics serving rural residents and American Indians. Specifically, we will:
Conduct focus groups with rural and American Indian cancer patients and family members to solicit their unique perspectives on the effects of the COVID-19 pandemic on their well-being and health.
Create an instrument to assess rural and American Indian cancer patients’ perceptions of the impact of COVID-19 on health-related quality of life, emotional well-being, resilience, access to social and community support and health care, lifestyle factors, employment and financial stressors, food and housing security, knowledge about COVID-19, COVID-19-related health literacy, and participation in community and cultural practices and events.
- Survey 150 cancer patients seen at rural and American Indian-serving clinics that participate in NW HERON.
Why this study? Rural and American Indian patients face many challenges in receiving care. These include limited access to cancer treatments and cancer support providers, such as oncologists, mental health professionals, palliative care specialists, and social workers. In the absence of published studies or reliable data from the 30 rural counties and 29 federally recognized tribes in Washington state, it is imperative to directly hear from rural and tribal community members who are personally experiencing the impact of the COVID-19 pandemic. Only from them can we understand the true impact of COVID-19 among rural and American Indian cancer patients living in our state.
Findings from this study will provide preliminary data to participating health care systems, allowing them to adapt existing programs or identify new approaches to best meet the long-term needs of cancer patients during the pandemic.
Exploring future research opportunities
To address the urgent need for behavioral health care among our region’s primary care clinics, we are pursuing grants to support suicide prevention programs. We aim to develop and test suicide prevention interventions that 1) identify, prevent, and treat suicide risk within well-defined target populations, primarily high-risk and underserved groups, including rural and American Indian populations; and 2) are delivered within real-world settings where at-risk individuals are served.
NW HERON SURVEY | SEEING RESULTS
Justin Denney, PhD, Scientific Co-director
In December 2019, we launched a survey of 31 health care facilities to gather operational, programmatic, and clinical information as well as demographic data on their service populations. Using an online survey format and follow-up via email, we have achieved an 83% response rate to date. Among the most pressing and intractable clinical concerns reported by these facilities were management of patients with chronic conditions and those from vulnerable populations, in addition to behavioral health. Administrative concerns centered on ongoing challenges around attracting and retaining health care professionals.
Responding facilities were 80% public or federally qualified health centers; 20% were members of health care networks that employed between 1 and 100 physicians. All facilities provided primary care (e.g., family medicine, internal medicine, geriatrics). The total annual outpatient visits ranged from ~2,000 to ~180,000. Of the facilities providing inpatient hospital services (55%), the number of annual hospitalizations ranged from ~100 to ~4,000. Sixty percent of all facilities served a patient population that was primarily covered by public insurance.
We are further refining this survey and gathering data from additional partners to identify pressing concerns for NW HERON facilities and to partner in developing strategies to address them.
WHO WE ARE | NW HERON
Cole Allick, MHA, Outreach Coordinator and Tribal Liaison (Turtle Mountain Band of Chippewa Indians)
NW HERON is a transdisciplinary partnership of Washington State University’s Elson S. Floyd College of Medicine, the Institute for Research and Education to Advance Community Health, the Health Equity Research Center, and primary care clinics in Washington state and the surrounding region. The NW HERON team first reached out to primary care sites that had signed clinical affiliation agreements with the College of Medicine.
In December 2019, the NW HERON team initiated introductory conversations with a variety of primary care sites, including critical access hospitals, community health centers, tribally operated health care organizations, and Indian Health Service sites.
Initial outreach focused on introducing NW HERON and soliciting input via a brief intake survey of the needs and concerns of partner sites, including suggestions for virtual conference topics. The outreach team continues to focus on introducing NW HERON to partners with existing clinical affiliation agreements as well as launching an additional survey to the outstanding potential partners.
Ken Roberts, PhD
Washington State University’s Elson S. Floyd College of Medicine is charged with developing affiliations with hospitals and clinics across Washington in both urban centers and rural communities. Our affiliate partners provide the opportunities where our medical students receive their clinical training, an important and necessary benefit to the College of Medicine. To date, we have established affiliation agreements with 145 clinical partners in over 40 towns across the state.
In 2020 alone, we have added almost 40 new affiliate partners. These relationships also benefit our clinical partners by providing resources and the expertise of College of Medicine faculty. NW HERON, our practice-based research network, is a key example of one such partnership where we work together to solve challenging problems in health care. We look forward to continuing to develop additional productive partnerships.
To learn more, go to https://ireach.wsu.edu/nwheron/practice-based-research-networks/.
FROM THE BEGINNING
Dedra Buchwald, MD, Scientific Co-director
As a Professor and Director of the Institute for Research and Education to Advance Community Health at the Elson S. Floyd College of Medicine, and NW HERON Scientific Co-director, Dr. Buchwald applies her background in public health, community-based research, and culturally competent primary care to the singular goal of improving the health and health care of underserved populations.
For over 30 years, Dr. Buchwald has worked with refugees, immigrants, and racial, ethnic, and cultural minorities to achieve this goal. Supported by more than 72 federally funded grants over her career, Dr. Buchwald’s research focuses on designing community-based interventions that target health disparities and the social determinants of health.
Dr. Buchwald’s first exposure to practice-based research networks (PBRNs) was at the University of Washington, but when she joined Washington State University, she saw unique opportunity to create a PBRN by building on the College of Medicine’s 200 affiliated clinical sites in rural, tribal, and underserved regions in central and eastern Washington. She realized the existing education affiliations and connections could serve as a foundation for a PBRN that partnered with WSU in research, education, and health care.
From this vision, NW HERON was born. Today, NW HERON provides valuable opportunities to WSU students in the medical and health professions, exposing them to sites in the network and further solidifying the PBRN infrastructure. Trainees learn about conducting research in a “real-world” setting and building ties with the communities that WSU serves as a land grant institution. Students are eager to associate with NW HERON; members of the first training cohort are now mentoring new cohorts of students and some have been engaged to work directly with their clinical sites, subject to the constraints of the pandemic.
ON THE ROAD
Director Patrik Johansson took to the road – leaning heavily on mask, sanitizer, and social distancing guidelines – to visit with clinics and practices that had expressed interest in joining the NW HERON PBRN. Since August, Ferry County Health; Palouse Medical, P.S.; Columbia County Health System; Garfield County Health District; Camas Center Clinic; and Newport Hospital & Health Services have signed affiliation agreements to join NW HERON.
More trips will be underway soon. If you’d like to schedule a visit to discuss or formalize participation of your clinic or practice in the PBRN, contact Patrik at Patrik.Johansson@wsu.edu.
|“We are extremely happy to be part of the NW HERON. We are looking forward to partnering with WSU to improve the health of our community and other communities outside of ours through the collaboration.”
-Aaron Edwards, CEO
Ferry County Memorial Hospital
|“Here we are, a small medical community, but we’re right here in the back door of WSU and we should take advantage of each other in doing research and furthering health care. We’re your back-door neighbor so we should have strong liaisons with each other to support this work.”
-Stephen Hall, MD, President
Palouse Medical. P.S.
|“The more we can quantify rural health disparities with data, particularly for small communities, the better off we will be, because it’s been a missed opportunity. We are very supportive of working with the NW HERON on research projects.”
-Shane McGuire, CEO
Columbia County Health System
|“We’re more than happy to be a part of the COVID study in cancer survivors to find out what if any gaps we may fill. We look forward to future endeavors as well with the NW HERON.”
-Tom Wilbur, CEO
Newport Hospital & Health Services
“The Kalispel Tribe is truly excited to partners with WSU on the NW Heron project. This partnership will hopefully identify health care needs of tribe members and begin problem solving to meet thosehealth care needs. The Camas Center Clinic has enjoyed having WSU medical students train in the clinic. Patients and staff learn from the students as they gain valuable experience from being in a tribal medical clinic setting!”
From WSU Insider, July 29, 2020
SPOKANE, Wash. – Scientists at Washington State University Elson S. Floyd College of Medicine have launched one of the first tracking tools that provides a daily snapshot into COVID-19 cases in rural communities across the country. Using data from The New York Times and other sources, the COVID Urban Rural Explorer (CURE) focuses specifically on highlighting rural urban inequities in COVID trends by county and provides a weekly roundup of rural areas experiencing spikes in COVID-19 cases. More specifically, the CURE tracker enables users to identify rural counties with both limited hospital capacity and where cases are rapidly growing.
“There are several data dashboards out there showing COVID-19 cases and deaths across the country, but we noticed that few if any are focused on rural-urban disparities,” said Ofer Amram, lead developer of the tool and assistant professor in the Department of Nutrition and Exercise Physiology at the WSU College of Medicine. “Rural communities have far fewer resources and many unique challenges to preventing and treating COVID-19 such as few intensive care beds at critical access hospitals and insufficient contact tracing, so it’s critically important that we pay better attention to what’s happening in these communities.”
From WSU Insider, Aug. 12, 2020
In this new study funded by the National Institute of Nursing Research, young adults ages 18-26 in the Pacific Northwest will test a phone app to help them manage their condition during wildfire season.
Julie Postma, PI and associate dean for research at WSU’s College of Nursing is recruiting 60 participants who will complete questionnaires and agree to track their lung function using a spirometer for two months. She expects to use the study results to propose a future larger clinical trial. Participants could earn between $100 and $200 in Amazon gift cards depending on group assignment.
- Be 18-26 years old
- Have been diagnosed with asthma by a health care provider
- Own a smart phone
- Speak and read English
Contact: Ross Bindler, 509-590-5767 | Nursing.TRAK@wsu.edu
WIN-WIN | COMMUNITY PROJECTS UNDERWAY
Anthippy Petras, MSW, Project Manager
A cornerstone of NW HERON is to provide a training ground for the next generation of medical professionals who will address the most pressing issues facing our rural, tribal, and urban medically underserved clinics and communities. To best support our WSU Elson S. Floyd College of Medicine students and our clinical partners, we bring student and clinic leadership together to answer research questions and address ever-changing clinical needs.
Each student is required to complete 320 hours of scholarly research that will benefit our partnering clinics by addressing a community concern. Our students are tasked with employing a community-oriented primary care approach, defined as the practice of primary care with a focus on population responsibility. This approach is oriented to improving the health of a defined community served by the health care organization by relying on the participation of the community and coordinating all services involved with the health of the community.
This student and clinic relationship is a win-win. Our students gain problem-solving skills and sharpen critical reasoning as they prepare to enter the medical field. In turn, our partnering clinics benefit from having dedicated, focused, and driven student researchers on their team to address challenging topics and seek positive solutions.
It has been a rewarding eight months as we’ve met online with CEOs and executive leadership from across Washington state, hearing their COVID-19 concerns, discussing delivery systems, and exploring new approaches. We appreciate our partners’ warm welcome of our students as our teams conduct scholarly projects in their clinics.
|Clinic Partner Site||Research Focus|
|Camas Center Clinic||Telemedicine|
|Coulee Medical Center||Behavioral health|
|Klickitat Valley Health||Telemedicine|
|Ferry County Health||OB/Gyn services|
|Columbia County Health||TBD|
Why Should Your Site Join NW HERON?
Joining NW HERON is free for your primary care clinic. One of the primary goals is to share medical research with affiliated or similar clinics in your area.
NW HERON can link providers and practices with one another as well as with WSU faculty and students. By doing so, we can collectively address local health priorities and create and disseminate shared best practices.
The research and education activities of NW HERON are founded in Washington State University’s public, land grant tradition of service to community stakeholders, with an emphasis on meeting the needs of rural, tribal, and urban underserved communities.