1. NYCRING NEWS
S P R I N G 2 0 0 7V O L U M E 1 I , I S S U E 1
NYC RING Network
Institute for Urban Family Health
(Manhattan & Bronx)
Beth Israel Department of Family
Medicine
Beth Israel Residency in Urban
Family Practice
Bronx-Lebanon Hospital Center
(Bronx)
Fulton Park Family Practice
Ogden Family Medical & Dental
Center
Montefiore Medical Center
(Bronx)
Montefiore Medical Group
-Castle Hill
-Comprehensive Family Care
Center (CFCC)
-Comprehensive Health Care
Center (CHCC)
-Family Health Center
-Fordham Family Practice
-Marble Hill Family Practice
-University Ave. Family Practice
-West Farms Family Practice
-Williamsbridge Family Practice
South Bronx Health Center for
Children and Families
(Bronx)
North Bronx Healthcare Network
(Bronx)
Health Care Center at Gun Hill
Healthcare Center at Tremont
Saint Joseph's Medical Center
Family Health Center (Yonkers)
Private Practice (Bronx)
Riverdale Family Practice (Morrow)
Staff
Diane McKee, MD, MS
Program Director
Paul Meissner, MSPH
Network Coordinator
Stacia Maher, MPH
NYCRING Website
http://www.nycring.org
Bronx BREATHES
In an effort to increase collaboration among NYC RING sites and create a
mechanism for initiating small projects, we are forming task force committees
for the following three core areas of focus within NYC RING: 1) diabetes and
metabolic syndrome, 2) behavior change and 3) depression. We are looking
for clinicians, educators and researchers from within the NYC RING commu-
nity to participate as members on these task force committees. There will be an
initial face to face organizational meeting and then most subsequent meetings
will be conducted through conference calls and emails on a regular basis. The
groups will receive administrative support from network coordinator Stacia
Maher.
The tasks force committees would have the following goals for their area
of focus: 1) identify existing measurement tools that are in use, 2) create a list
of measurable outcomes, 3) identify pilot studies that would be initiated, 4)
and suggest ways to build on these activities to include network wide collabo-
ration. While we would like these pilot studies to result in grant submissions, it
is important that NYC RING stimulate the sharing of information to improve
practice. If you are interested in joining one of these tasks forces please contact
Stacia Maher at 718-430-2749 or at smaher@aecom.yu.edu.
Call to join NYC RING Task Force Committees
In this newsletter we take the opportunity to highlight an important project
taking place in the NYC RING network, Bronx BREATHES – Bronx Einstein
Alliance for Tobacco-free Health. Bronx BREATHES is funded by the New
York State Department of Health Bureau of Tobacco Use, Prevention, and
Control. The Principal Investigator of the project is Steven Bernstein, MD
(sbernste@montefiore.org) and project manager is Saba Jearld, MPH
(sjearld@montefiore.org).
The State’s comprehensive tobacco control program aims to prevent initia-
tion of tobacco use, reduce use of tobacco products through promotion of ces-
sation, reduce the social acceptability of tobacco products through promotion
of cessation, and eliminate exposure to secondhand smoke through a three-
pronged strategy: community mobilization, media and counter-marketing, and
cessation. Bronx BREATHES is one of 19 Tobacco Cessation Centers in the
state that are charged with the overall mission to promote that providers advise
their patients to quit smoking. Bronx BREATHES has three main goals:
(Continued on page 4)

2. P A G E 2
N Y C R I N G N E W S
Highlights from Current NYC RING Site Visits
This year Paul Meissner and I have
been visiting NYC RING member sites to
learn about current quality improvement
projects and research initiatives. We typi-
cally attend a provider meeting and talk
informally with the staff. It is the best way
for us to stay informed of the wide array
of projects and interests that exist within
our network. It also allows us to consider
ways to build on these activities to include
network wide collaboration.
The sites we have visited so far in-
clude the Family Health Center, Fordham
Family Practice, the Health Center at Tre-
mont, South Bronx Family Health Center,
West Farms Family Practice, Institute for
Urban Family Health and Bronx Lebanon.
Some common themes that providers
would like to explore, or are currently ad-
dressing in quality improvement projects,
include improving delivery of service to
patients, obesity, depression, diabetes,
borderline hyperlipodemic and hyperten-
sive, and HIV.
A specific result of one of our site vis-
its was a discussion about building a regis-
try of smokers at the Family Health Cen-
ter. It was suggested that smoking status
could be placed on the CareCast problem
list. If this were done it could 1) encour-
age all providers to list smoking status
in CareCast for all their patients over a
certain age, 2) monitor compliance and
generate lists of patients without smok-
ing status on their problem lists, and 3)
encourage providers to list smoking
status for those who appear on the list as
"smoking status unknown", and con-
tinue to monitor progress in this effort
on an iterative basis. An initial project
may be to have smoking status listed on
the problem lists of a majority of pa-
tients in each practice. At a later stage,
we could monitor changes in smoking
status using this tool.
Paul and I plan to keep visiting sites
on a regular basis. If you have any spe-
cific topics that you would like to see
addressed at your site please let me
know. Also let us know if you would
like to have us at one of your upcoming
provider meetings. I can be reached at
718-430-2749 or at
smaher@aecom.yu.edu.
Stacia Maher, MPH
NYC RING Coordinator
Ideas?
As always we hope to achieve a balance of projects within NYC RING- some
more focused on quality improvement, some on “research”, some externally funded,
some pilot-scale projects without funding, some led by researchers, others led by our
clinician colleagues. Opportunities for clinicians who have a specific interest or
"burning question" exist to take advantage of the resources of NYC RING. We would
love to hear from you!
Please contact Stacia Maher, the NYC RING Program Coordinator at
smaher@aecom.yu.edu or 718-430-2749 if you have any ideas or need assistance with
getting a project started.
We’re on the web at
http://www.nycring.org

3. P A G E 3V O L U M E 1 I , I S S U E 1
Steven Bernstein, MD, with funding from the New York State Department of Health to the Albert
Einstein College of Medicine, has been the principal investigator for Bronx BREATHES, a Tobacco
Cessation Center since 2004. Dr. Bernstein is Associate Professor of Clinical Emergency Medicine at
the Albert Einstein College of Medicine. He also holds appointments in the Albert Einstein Cancer
Center and the Bronx Center to Reduce and Eliminate Ethnic and Racial Health Disparities, a Project
EXPORT center funded by the NIH’s National Center for Minority Health and Health Disparities. Dr.
Bernstein is residency-trained and board-certified in internal medicine and emergency medicine, with
additional fellowship training in hematology-oncology, and a postdoctoral fellowship at the Robert
Wood Johnson Clinical Scholars Program at Yale University, where he trained in clinical epidemiol-
ogy, study design and biostatistics. Dr. Bernstein has been interested in emergent presentations of to-
bacco-related illness for over 15 years. With an initial Priority Populations grant from Legacy in 2001,
he was one of the first investigators in emergency medicine to work in this area. Currently, Dr. Bern-
stein oversees additional tobacco-related projects with funding from NIH/National Institute on Drug
Abuse and the Robert Wood Johnson Foundation.
Saba Jearld, MPH. Ms. Jearld holds a Master of Public Health degree from Columbia University ,
Mailman School of Public Health. Ms. Jearld is responsible for the day to-day management of Bronx
BREATHES and provides coordination support for Dr. Bernstein's other tobacco-related projects. She
has multiple years of experience coordinating programmatic, administrative, evaluation, and research
operations for public health research & service projects in the area of HIV/AIDS and work-site health
initiatives. Prior to working with Bronx BREATHES Ms. Jearld was a Project Coordinator within the
Department of Sociomedical Sciences at Columbia University * Mailman School of Public
Health. During her tenure at Columbia University she coordinated the efforts of two HIV/AIDS,
HRSA Ryan White-funded, research/service projects - Partnership for Family Health, a consortium
providing comprehensive, multidisciplinary, medical, dental, mental health care and social services to
HIV infected and affected families; and - Northern Manhattan Pediatric and Perinatal Adherence Ini-
tiative, a multi-site, theory-based intervention aimed at improving adherence to antiretroviral therapy
among HIV positive pregnant women, adolescents, children and their caregivers. In addition, Ms.
Jearld was involved from inception with the Harlem Business Wellness Initiative - a health promotion
partnership, between Harlem businesses, health care organizations, and Columbia University focusing
on identification and referral for quality, low-cost health care and preventive services for employees of
small businesses in Harlem - funded through a CDC/ Health Protection Research Initiative grant.
N Y C R I N G N E W S
Featured Collaborators-
Steve Bernstein, MD & Saba Jearld, MPH
Bronx Week 2007 is taking place from Saturday, June 16 to Sunday, June 24. If you are interested in
having an event listed on the Bronx Week calendar of events and website please contact Lucille Roldan
at 718-590-3522 for an application. Applications are due March 30th.
New York State Health Foundation (NYSHealth) has announced two new initiatives to support their
objective to expand health care insurance to state residents who cannot afford to purchase their own
coverage or whose coverage is inadequate. For information on request for proposals on these two initia-
tives please visit their website at http://www.nyshealth.org/.

4. NYC RING Research Liaisons
Institute for Urban Family Health
Andreas Cohrssen, MD & Wendy Barr, MD
Bronx-Lebanon Hospital Center
Doug Reich, MD & Tony Lopez, MD, MPH
Montefiore Medical Group Castle Hill
Darwin Deen, MD, MS
Comprehensive Family Center Practice (CFCC)
Peter Bernstein, MD & Andrew Racine, MD
Comprehensive Health Care Center (CHCC)
Iman Sharif, MD & Galit Sacajiu
Fordham Family Practice
Marianne Dietrich, MD
Marble Hill Family Practice
David Savarese, MD
Family Health Center
Zack Rosen, MD & Matt Anderson, MD, MS
South Bronx Health Center for Children and Families
Peter Meacher, MD
University Ave. Family Practice
Robert Clarick, MD
West Farms Family Practice
Clement Landanno, MD
Williamsbridge Family Practice
Noel Brown, MD
North Bronx Healthcare Network Health Center Tremont
Jean Burg, MD
Saint Joseph's Medical Center
Our Mission
To define and strengthen the knowledge base and improve the practice of urban primary care by:
1. Identifying and addressing research and quality improvement questions important to primary care providers, patients, families, and
their communities
2. Defining and pursuing a research agenda focused on the specific health, disease, and health services issues of urban underserved
patients and communities, and
3. Providing a research resource for undergraduate and graduate medical education in primary and community health.
1. To provide training, technical assistance, and follow-up to health care institutions in the Bronx regard-
ing the design and implementation of systems to identify tobacco users at each patient encounter and provide
brief cessation counseling.
2. To identify and promote direct cessation services in the form of intensive behavioral counseling in group
or individual settings in the Bronx.
3. To increase the number of Bronx residents who use the services of the New York State Smokers'
Quitline.
While not formally a NYC RING project, Bronx BREATHES is an excellent example of how research can
be used to inform practice based change strategies. The program translates research into practice by educating
and training all Bronx health care provider organizations and clinicians in smoking cessation techniques. Re-
search illustrates that advice from a clinician doubles the quit rates of patients interested in quitting smoking.
Within the last two years, Bronx BREATHES has provided training and technical assistance for over 300 pro-
viders, ancillary staff, and administrators at over a dozen community health centers, ambulatory practices, and
hospitals. As a result, Bronx BREATHES provider partners now make more referrals, utilizing the Fax-to-Quit
referral system, to the NY State Smokers’ Quitline than any other state-funded cessation center provider part-
ners. In 2006 916 referrals were made by Bronx clinicians to the NY State Smokers’ Quiteline.
The efforts of Bronx BREATHES have been featured in the NY Daily News, the Norwood News, and on
BronxTalk and News12 the Bronx. As a testament to Bronx BREATHE’ commitment to provider and patient
education over 15,000 Bronx BREATHES brochures have been distributed to partners and the community.
These are available in both English and Spanish, and include a list of intensive smoking cessation programs in
the Bronx. The program has also distributed over 15,000 New York State Quitline referral cards, 300 New
York State Smokers Quitline Provider Quit Kits, and 2,000 pocket pharmacotherapy guides.
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