Describes joint efforts between our Univ. of Colorado practice-based research networks and our CCTSI community engagement core.

1. Partnering with communities in Colorado
Don Nease, MD
Vice Chair for Research - Dept. of Family Medicine

2. The Colorado Context
• Long history of pioneering work in
Practice-Based Research Networks
• Melding of PBRN work and
Community Engagement in the High
Plains Research Network
• 2040 Partners for Health, serving the
neighborhoods surrounding
Anschutz Medical Campus
• Federally funded Colorado Clinical
Translational Sciences Institute has a
robust Community Engagement core

3. Colorado CTSI
•Community engagement woven into the
DNA of CCTSI - PACT Council &
Community Liaisons (HPRN & 2040)
•Practice-based research work is
understood through this lens

4. Communities of Solution
• Concept first described in 1967 in
Folsom report
• Aims to dissolve the boundaries
between medical practice, public
health and community members
• Ideally data boundaries are
dissolved as well
• Implicitly underlies much of what we
do
• The Folsom Group. Communities of
Solution: The Folsom Report
Revisited. Annals of Family
Medicine. 2012 May 14;10(3):250–
60.

5. Bootcamp Translation
• Developed by Jack Westfall in HPRN
• Presumes that expertise on how to
translate/implement evidence lies in the
community
• 4-12 month process that begins with
establishing a level knowledge base
• Face to face meetings interwoven with 30
minute phone meetings
• Products disseminated with the community
as partners
• CDC, PCORI and AHRQ funded
• Reference: Norman N, Bennett C, Cowart S,
Felzien M, Flores M, Flores R, et al. Boot
Camp Translation: a method for building a
community of solution. J Am Board Fam
Med. 2013 May;26(3):254–63.

6. AI - BCT - Depression
• Arose out of voices from
2040 (urban) and HPRN
(rural) communities
• Extends BCT through
Appreciative Inquiry's focus
on "what's working"
• Qualitative Comparative
Analysis applied to distill
"key components"

7. Example success
• Joe is my neighbor. He really struggled with some sort of mental illness for
many months. We used to get together in the backyard for a beer and bbq.
But for about a year and a half, he became more withdrawn. He lost his job
and rarely left the house he inherited from his parents. I went over and tried
to get him to go see the doctor, but he does not drive due to poor vision. He
lost most of his sight in combat in the Vietnam war. I was busy working and
could not take him to the doctor. About a year ago, our neighbor across the
alley, Dan, retired from teaching; 40 years teaching math in the public
schools. The neighbor had plenty of time on his hands and he offered to
take Joe to the doctor. Dan and I talked to Joe several times about the need
to see a doctor, and Joe finally agreed. Joe went to the doctor several times
in one month, then nearly every month for the past year. Dan drove him to
every appointment, and to the counseling sessions at the mental health
center in the next town over; about 25 miles. Joe has done really well. He is
back involved in his veterans group and is walking around town every day
the weather permits. He even walked to his last doctor’s appointment (about
2.5 miles). We have resumed our weekly backyard beer and brats. And
Dan joins us occasionally. I think Joe is doing better because he is back
involved in the community, not stuck in his house day in and day out.

8. QCA output
Hypothetical Data Table with Treatment Adherence as an Outcome
Patients
geographically
close to mental
health provider
No co-pay for
mental health
services
High Patient
income
Outcome:
Treatment
Adherence
Case 1 Yes Yes No YES
Case 2 Yes Yes No YES
Case 3 Yes No Yes YES
Case 4 Yes No Yes YES
Case 5 No No No NO
Case 6 Yes Yes Yes YES
Case 7 No No No NO

9. Translation
• Community and Academics
join to develop the
intervention
• Goal: Turn the random
success into the norm!
• Pilot in a stepped-wedge
design so all locales get the
intervention

10. Where we are now
• Initial grant proposal not
funded by PCORI but...
• All but one reviewer very
positive
• Working with our community
partners to see what can be
piloted
• Resubmission in Fall