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Objective: This study was conducted to test the effectiveness of a theory-based interactive voice response (IVR) intervention to improve adherence to controller medications among adults with asthma.Methods: Fifty participants aged 18 to 65 years who had a physician diagnosis of asthma and a prescription for a daily inhaled corticosteroid, attended a baseline visit and a final visit 10 weeks later. Participants randomized to the intervention group received 2 automated IVR telephone calls separated by one month, with one additional call if they reported recent symptoms of poorly controlled disease or failure to fill a prescription. Calls were completed in less than 5 minutes and included content designed to inquire about asthma symptoms, deliver core educational messages, encourage refilling of inhaled corticosteroid prescriptions, and increase communication with providers. Adherence was tracked during 10 weeks, with objective measures that included either electronic monitors or calculation of canister weight. Participants completed the Asthma Quality of Life Questionnaire, the Asthma Control Test, and the Beliefs in Medications Questionnaire (BMQ) during both visits.Results: Adherence was 32% higher among patients in the IVR group than those in the control group (P ‫؍‬ . Patients often do not adhere to treatments for chronic health conditions, with the consequence that many conditions are poorly controlled. In the treatment of asthma, fewer than half of prescribed daily controller medication is typically taken by patients.1,2 In a report about refill patterns among 5500 patients with asthma, only 43% filled their inhaled corticosteroid more than once during 12 months. 3 In another study, each 25% decrease in refilled medication was accompanied by a doubling of the hospitalization rate. 2 Adherence rates among children are similarly poor 4,5 and remain so even in the face of recent exacerbation. 6 Considerable attention has been directed at changing health behavior and increasing adherence to treatments for chronic health conditions. The World Health Organization in 2003 published a call for action to improve treatment adherence across diseases, continents, and cultures, 7 and the This article was externally peer reviewed.

BACKGROUNDWe examined reports to a primary care, ambulatory, patient safety reporting system to describe types of errors reported and differences between anonymous and confi dential reports.METHODS Applied Strategies for Improving Patient Safety (ASIPS) is a demonstration project designed to collect and analyze medical error reports from clinicians and staff in 2 practice-based research networks: the Colorado Research Network (CaReNet) and the High Plains Research Network (HPRN). A major component of ASIPS is a voluntary patient safety reporting system that accepts reports of errors anonymously or confi dentially. Reports are coded using a multiaxial taxonomy.RESULTS Two years into this project, 33 practices with a total of 475 clinicians and staff have participated in ASIPS. Participants submitted 708 reports during this time (66% using the confi dential reporting form). We successfully followed up on 84% of the confi dential reports of interest within the allotted 10-day time frame. We ended up with 608 relevant, codable reports. Communication problems (70.8%), diagnostic tests (47%), medication problems (35.4%), and both diagnostic tests and medications (13.6%) were the most frequently reported errors. Confi dential reports were signifi cantly more likely than anonymous reports to contain codable data.CONCLUSION A safe and secure reporting system that relies on voluntary reporting from clinicians and staff can be successfully implemented in primary care settings. Information from confi dential reports appears to be superior to that from anonymous reports and may be more useful in understanding errors and designing interventions to improve patient safety.

PURPOSE We wanted to describe community-based participatory research in practice-based research networks in the United States. METHODSWe surveyed all identifi ed practice-based research networks (PBRNs) in the United States to fi nd out whether they had a mechanism for obtaining feedback or involvement from the community of patients served by PBRN physicians. We asked open-ended questions on how they involve community members and whether they had plans for future involvement of community members and/or patients. RESULTSWe received 46 completed questionnaires (71% response rate). Twentyfour reported that they have some mechanism to involve community members and/ or patients in their research. No PBRN reported full participatory methods; however, several PBRNs reported active involvement by community members to generate research ideas, review research protocols, interpret results, and disseminate fi ndings.CONCLUSION While perhaps not meeting the classical defi nition of CBPR, some PBRNs are involving community members and patients in their research. There is a wide spectrum of involvement by community members in PBRN research. Many PBRNs reported plans to involve community members in their research. We believe that community involvement will enhance PBRN research. INTRODUCTIONC ommunity-based participatory research (CBPR) is an emerging model of research aimed at enhancing the relevance and value of clinical research by involving patients and community members. 1 Growing out of grassroots community organizing, CBPR has emerged as an important method in primary care and epidemiologic research.2 CBPR is a "systematic investigation, with the collaboration of those affected by the issue being studied." 3 One goal of CBPR is to ground clinical research in real-life patient experience. CBPR is a participatory, cooperative, and colearning process for researchers and community members.The growing popularity and effective use of this approach is supported in the literature. Community-based participatory research has been conducted on nearly all aspects of health care, including ambulatory mental health care, 4 rural care of patients with human immunodefi ciency virus infection, 5 community adolescent diabetes prevention, hospitalized malnourished children, 6 and health promotion in immigrant women. 7 Several agencies and organizations important to primary care are also recognizing the importance of this research approach. A document entitled "Responsible Research with Communities: Participatory Research in Primary Care" was adopted as organizational policy by the North American Primary Care Research Group Board of Directors at its annual meeting in 1998. 8,9 Practice-based research networks (PBRNs) have been doing participatory research for decades by actively involving practicing primary care physicians in generating research ideas and conducting research in their 10,11 This participatory research model, however, does not usually involve another key stakeholder in primary care practice-based research-the patien...

Background: The birth outcomes of undocumented women have not been systematically studied on a large scale. The growing number of undocumented women giving birth in the United States has important implications for clinical care and public health policy. The objective of this study was to describe birth outcomes of undocumented immigrants in Colorado.

Objective The National Institutes of Health (NIH) spend billions of dollars annually on biomedical research. A crucial, yet currently insufficient step is the translation of scientific evidence-based guidelines and recommendations into constructs and language accessible to every-day patients and community members. By building a community of solution that integrates primary care with public health and community-based organizations, evidence-based medical care can be translated into language and constructs accessible to community members and readily implemented to improve health. Methods Using a community-based participatory research approach, the High Plains Research Network (HPRN) and its Community Advisory Council developed a multi-component process to translate evidence into messages and dissemination methods to improve health in rural Colorado. This process, called Boot Camp Translation has brought together various community members, organizations, and primary care to build a community of solution to address local health problems. Results The HPRN has conducted 4 Boot Camp Translations on topics including colon cancer prevention, asthma diagnosis and management, hypertension treatment and management, and the patient-centered medical home. Each Boot Camp follows a standard agenda that requires flexibility and creativity. Thus far, the HPRN has used Boot Camp Translation to engage over a thousand rural community members and providers. Dissemination of Boot Camp messaging through the community of solution has led to increased colon cancer screening, improved care for asthma, and increased rates of controlled blood pressure. Conclusions Boot Camp translation successfully engages community members in a process to translate evidence-based medical care into locally relevant, culturally appropriate language and constructs. Boot Camp Translation is an appropriate method for engaging community members in patient-centered outcomes research. Boot Camp Translation may be an appropriate first step in building a local or regional community of solution aimed at improving health of the community.

The EQ-5D provides valid general HrQOL measurement post-MI.

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