糖心少女

From Implementation to Impact: A Process Evaluation of King County's Medicaid-Funded Nutrition Support Program

Investigators
Melissa Knox, Department of Economics
M. Pia Chaparro, Department of Health Systems and Population Health
Jessica Jones-Smith, Department of Health Systems and Population Health
Jing Li, The CHOICE Institute, Department of Pharmacy
Elizabeth Kimball, Public Health – Seattle & King County,

Project abstract
We propose a process evaluation of the King County implementation of nutrition supports for Medicaid patients with food insecurity and chronic disease. This program is part of Washington鈥檚 Medicaid demonstration waiver, and the results of our evaluation can inform policymakers and other stakeholders as they seek to understand the best way to implement services supporting patients with health-related social needs.

Our evaluation will also be used by our team to generate preliminary data and a thorough understanding of implementation barriers and facilitators, both of which will be used in the future to produce an application for NIH R01 funding for an evaluation of the impact of this program on clients鈥� health and health care spending using the Medicaid Clinical Data Repository, a newly available administrative data source for which our team is developing a policy evaluation use case in partnership with Public Health-Seattle & King County data scientists.

Coach IQ: Coaching safety-net clinics to improve colon cancer screening equity

Investigators
Peggy Hannon, Department of Health Systems and Population Health
Allison Cole, Department of Family Medicine
Thuy Vu, Department of Health Systems and Population Health
Brooke Ike, Department of Family Medicine
Tenney Davis, Department of Health Systems and Population Health
WWAMI Practice-based Research Network (WPRN)
Washington Association of Community Health (WACH)
Washington Breast, Cervical, and Colon Health Program (BCCHP)

Project abstract
Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. CRC screening reduces mortality and is recommended for adults ages 45鈥�75. Some populations report low screening rates: ages 45-49 (compared to adults over 50); with no health insurance; and Latinos. Our proposal addresses the human health and social and economic equity pillars of population health.

Safety-net health systems serve patients regardless of ability to pay. We developed a program, 鈥淐oachIQ鈥� and pilot-tested it with individual clinics. CoachIQ was designed to (a) address clinics鈥� unique contexts and barriers to improving their CRC screening approach and (b) ensure that clinics鈥� efforts to improve CRC screening equally benefit all their patients. Pilot-test results showed that CoachIQ increased clinics鈥� CRC screening rates and reduced disparities for Latino patients.

This project鈥檚 goal is to expand CoachIQ鈥檚 reach and impact by adapting it to be implemented at the health system level and address screening disparities for three priority populations 鈥� patients ages 45-49, patients without health insurance, and Latino patients. We will collaborate with community partners to adapt CoachIQ and implement it with three safety-net health systems (each operating multiple clinics). Our outcome evaluation will test whether CoachIQ increases overall CRC screening and increases equity in CRC screening for our priority patient populations. We will share findings and practical tools with safety-net health systems with our community partners: the Breast, Cervical, and Colon Health Program, the WWAMI Region Practice and Research Network and the Washington Association for Community Health.