Design, creation, and use of the Test Us Bank (TUB) COVID-19 sample biorepository.

Shortly after the first case of SARS-CoV-2 was diagnosed a public health emergency (PHE) was declared and a multi-agency response was initiated within the US federal government to create and propagate testing capacity. As part of this response, an unprecedented program designated Rapid Acceleration of Diagnostics (RADx) Tech was established by the National Institutes of Health (NIH) to facilitate the development of point-of-care tests for the COVID-19. The RADx Tech Clinical Studies Core (CSC), located at the University of Massachusetts Chan Medical School (UMass Chan), with partnering academic, private, and non-governmental organizations around the country, was tasked with developing clinical studies to support this work.

Dependent Adult Abuse Trends in Iowa, 1984 to 2023.

Introduction: Little is known about trends in the incidence of dependent adult abuse (DAA).

Objectives: To determine the annual incidence of DAA in Iowa from 1984 to 2023. Trends in abuse rates were evaluated for their associations with calendar year, number of caseworkers and abuse laws, political party, and unemployment.

Comparative Performance of Common Fecal Immunochemical Tests : A Cross-Sectional Study.

Background: Despite widespread use of fecal immunochemical tests (FITs) for colorectal cancer (CRC) screening, data to guide test selection are limited.

Objective: To compare the performance characteristics of 5 commonly used FITs, using colonoscopy as the reference standard.

Design: Cross-sectional study.

Iowa family physician's reporting of elder abuse: 20-year follow-up.

The purpose of this project was to assess changes over 20 years, between family physicians perceived magnitude of elder mistreatment, physician knowledge of state laws, barriers to reporting suspected cases, and what is done in practice. Questionnaires were mailed to 1,080 physician members of the Iowa Academy of Family Physicians. Thirty-six percent of physicians returned the questionnaire.

Personal and Professional Physical Activity Practices among Sports Medicine Physicians.

Less than a quarter of the population achieves the recommended Physical Activity Guidelines for Americans. Physicians who achieve the guidelines themselves may be more likely to promote them to patients given strong evidence physicians' personal health habits influence their patient counseling practices. We surveyed primary care and sports medicine specialty physicians about personal exercise habits and beliefs and patient counseling practices.

Challenges in Use of Practice-based Research Networks for a Medical Device Trial to Detect SARS-CoV-2.

Introduction/objectives: Primary care practice-based research networks (PBRNs) participated in a point of care (POC) device study funded by by the National Institutes of Health and led by the University of Massachusetts Chan Medical School (UMass) to speed the development, validation, and commercialization of POC tests to detect SARS-CoV-2. The purposes of this study were to describe the characteristics of participating PBRNs and their respective collaborators in this device trial and describe complications challenging its execution.

Methods: Semi-structured interviews were conducted with lead personnel from participating PBRNs and UMass.

Food Intake Compared to Exercise Association with Obesity in Children Ages 3-6.

METHODS: RESULTS: DISCUSSION:

Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated With Fecal Immunochemical Test Collection Errors.

Purpose: The purposes of this study were to determine if (1) certain demographic characteristics (potential predictors) of participants, and (2) clock-drawing test results (as a screening test for cognitive impairment) were associated with fecal immunochemical test (FIT) sample collection errors.

Methods: Patients scheduled for an upcoming colonoscopy were asked to collect stool samples using 5 different FITs. Patients completed a questionnaire that included the clock-drawing test.

Primary Caregiver Retention and Perceptions of Retention Strategies in a 36-Month Prospective Childhood Caries Study.

Introduction/objectives: This paper reports on participant retention from an ongoing prospective, multi-site cohort caries risk study involving parent/infant pairs. The objectives were to: (1) compare the retention rates at each intermediate contact (every 4 months) and dental visit (every 18 months) across the 3 clinical sites, (2) assess primary caregivers' perceptions at the end of the study about the retention efforts used in this longitudinal study, and (3) determine whether primary caregiver baseline demographic characteristics and child's baseline caries experience were associated with retention.

Methods: 1325 primary caregiver-child pairs recruited at the child's first birthday were followed for 36 months at 3 sites.

How Well are Serious Illness Conversations Documented and What are Patient and Physician Perceptions of These Conversations?

The Serious Illness Care Program (SICP), developed in 2011 by Ariadne Labs, restructures care so that knowing and then honoring patients' wishes becomes part of routine care. 1) summarize patient perceptions of use of the Serious Illness Conversation Guide (SICG) components, 2) assess whether a serious illness conversation was documented in the electronic health record (EHR) and identify the SICG components that were included, 3) summarize clinician perceptions of use of the SICG components, and 4) assess the association of documented SICG components with the patient's perception of the SICG discussion. Clinicians at three family medicine offices were trained in serious illness conversations using the SICG.

Trained Clinician's Documentation of Serious Illness Conversations and Use of Billing CPT 99497.

Advance care planning (ACP) involves patients and family members in discussions with clinicians about their values, goals, and preferences regarding future medical care. To (1) assess whether an ACP conversation using the Serious Illness Conversation (SIC) was initiated and documented; (2) assess which components of SIC were documented; (3) determine how frequently clinicians trained to use the SIC guide used ACP billing codes during the study time period, (4) determine whether there was a significant difference in mortality risk score according to documentation of each component of the SIC. Thirteen clinicians at three family medicine offices were trained in the Serious Illness Care Program and asked to document SICs in the electronic medical record (EMR).

Tooth Eruption and Early Childhood Caries: A Multisite Longitudinal Study.

The purpose of this study was to assess the relationship between the number of teeth present at 12 months and decayed, missing, or filled surfaces (dmfs) at 30 and 48 months. Data are from a longitudinal, multisite study with clinical dental examinations conducted at 12, 30, and 48 months of age. Spearman correlation and chi-square tests assessed relationships between teeth present at 12 months and dmfs at 30 (n equals 1,062) and 48 months (n equals 985).

Impact of Medical Scribe Experiences on Subsequent Medical Student Learning.

Introduction: Many US pre-health professional students prepare for applying to medical training by transcribing clinician-patient encounters. Scant literature of the effects of scribing experiences before starting medical training exists. We conducted a study to investigate student perspectives about medical scribing's educational impact on clinical skill development.

Comparative effectiveness of five fecal immunochemical tests using colonoscopy as the gold standard: study protocol.

Background: There are nearly 50,000 colorectal cancer (CRC) deaths in the United States each year. CRC is curable if detected in its early stages. Fecal immunochemical tests (FITs) can detect precursor lesions and many can be analyzed at the point-of-care (POC) in physician offices.

Improving Iowa Research Network Patient Recruitment for an Advance Care Planning Study.

Introduction/objectives: In February 2019, recruitment began in Iowa Research Network offices for a Patient-Centered Outcomes Research Institute (PCORI) funded Advance Care Planning (ACP) study to be conducted in 7 primary care practice-based research networks across the United States and Canada. The main study trained clinicians and nursing staff in serious illness care conversations and requested they refer eligible patients. Eligible patients were those with serious illness or frailty expected to live 1 to 2 years.

Electronic Health Record Algorithm Development for Research Subject Recruitment Using Colonoscopy Appointment Scheduling.

Introduction: Electronic health records (EHRs) are often leveraged in medical research to recruit study participants efficiently. The purpose of this study was to validate and refine the logic of an EHR algorithm for identifying potentially eligible participants for a comparative effectiveness study of fecal immunochemical tests (FITs), using colonoscopy as the standard.

Methods: An Epic report was built to identify patients who met the eligibility criteria to recruit patients having a screening or surveillance colonoscopy.

Use of the Fluoride Varnish Billing Code in a Tertiary Care Center Setting.

Dental caries is the most common chronic disease in children from birth through 5 years of age. Application of fluoride varnish (FV) is recommended for children younger than 6 years every 3 to 6 months by the United States Preventive Services Task Force. The purposes of this study were to (1) assess use and reimbursement of Current Dental Terminology (CDT) D1206 and Current Procedural Terminology (CPT) 99188 codes, which are the billing codes for FV application; (2) determine when and by whom each FV code was used; and (3) summarize the associated clinical notes.

Prognostic Indices for Advance Care Planning in Primary Care: A Scoping Review.

Background: Patient identification is an important step for advance care planning (ACP) discussions.

Objectives: We conducted a scoping review to identify prognostic indices potentially useful for initiating ACP.

Methods: We included studies that developed and/or validated a multivariable prognostic index for all-cause mortality between 6 months and 5 years in community-dwelling adults.

Anxiety-Related Issues in Cancer Survivorship.

Purpose: The purpose of this qualitative study was to examine patient opinions about anxiety in cancer survivorship, particularly the role of the primary care provider in management of anxiety related to the trajectory of long-term cancer survivorship.

Methods: Respondents to a mass email (N=22,000) were invited to participate in 1 of 3 institutional review board-approved focus group meetings. Inclusion criteria were being an adult patient older than 25 years of age, having any type of cancer diagnosis, and being at least 18 months from treatment.

Use of Advance Care Planning Billing Codes in a Tertiary Care Center Setting.

Introduction: The Centers for Medicare and Medicaid Services released the final payment rules for reimbursement of advance care planning (ACP) effective January 2016. In its first year, 23,000 providers nationwide submitted 624,000 claims using the Current Procedural Terminology codes 99497 and 99498. The objectives of our study were to 1) assess the frequency of ACP codes used at a single academic tertiary care center in Iowa, 2) determine when and by whom the codes were used, and 3) summarize ACP clinical notes.

Practice-Based Research Networks Ceding to a Single Institutional Review Board: A Report From the INSTTEPP Trial and Meta-LARC Consortium.

Historically, a single research project involving numerous practice-based research networks (PBRNs) required multiple institutional review boards (IRBs) to be involved in approval of the project. However, to avoid redundancies, federal IRB regulations now allow cooperative research projects that involve more than one institution to use reasonable methods of cooperative IRB review and to cede authority for review and oversight of the project to a single lead IRB. Through ceding, a lead IRB has the authority for review and oversight of the project delegated by all participating sites' IRBs and becomes the IRB of record for the ceded sites.

Adapting Boot Camp Translation Methods to Engage Clinician/Patient Research Teams Within Practice-Based Research Networks: A Report From the INSTTEPP Trial and Meta-LARC Consortium.

Purpose: Boot camp translation is a proven process to engage community members and health professionals in translating and disseminating evidence-based "best practices" models for health prevention and chronic illness care. Primary care practice improvement studies, particularly involving patient-driven change, as seen with self-management support (SMS), require engaged practice teams that include patients. Models of engagement such as boot camp translation may be effective.

How to Translate Self-Management Support Tools Into Clinical Practice: A Report From the INSTTEPP Trial and Meta-LARC Consortium.

Purpose: Patient self-management is an inevitable part of the work of being a patient, and self-management support (SMS) has become increasingly important in chronic disease management. However, the majority of SMS resources available in the Agency for Healthcare Research and Quality SMS Resource Library were developed without explicit collaboration between clinicians and patients.

Methods: Translation of SMS tools derived from the library into primary care practices occurred utilizing boot camp translation in four different practice-based research networks (PBRNs).

Implementing Community-Created Self-Management Support Tools in Primary Care Practices: Multimethod Analysis From the INSTTEPP Study.

Purpose: With one-half of Americans projected to be living with at least one chronic condition before 2020, enhancing patient self-management support (SMS) may improve health-related behaviors and clinical outcomes. Routine SMS implementation in primary care settings is difficult. Little is known about the practice conditions required for successful implementation of SMS tools.

Impact of a Boot Camp Translation Intervention on Self-Management Support in Primary Care: A Report From the INSTTEPP Trial and Meta-LARC Consortium.

Purpose: Self-management support (SMS) is a pillar of the well-established chronic care model and a key component of improving outcomes for patients with chronic illnesses. The Implementing Networks' Self-management Tools Through Engaging Patients and Practices (INSTTEPP) trial sought to determine whether a boot camp translation process could assist small to medium-sized primary care practices with care managers implement SMS tools.

Methods: INSTTEPP used a stepped-wedge design across 16 practices from 4 practice-based research networks over 12 months.