October 5, 2020

Three New Special Interest Projects for UW HPRC

Focusing on Early Detection of Cognitive Impairment and Cancer Prevention

As part of the national Prevention Research Centers (PRC) network, the U.S. Centers for Disease Control and Prevention (CDC) awarded the University of Washington Health Promotion Research Center (UW HPRC) three new Special Interest Projects that will begin in the fall of 2020.

Each of these projects are outlined below.

Enhancing Early Detection of Cognitive Impairment

Annette Fitzpatrick
Annette Fitzpatrick

Topic Area: Healthy Aging, Dementias, and Alzheimer’s Disease

Principal Investigator: Annette Fitzpatrick, UW HPRC affiliate investigator from UW Department of Family Medicine within the School of Medicine

Duration & Funding: 2 years, $500,000

Overview: The goal of this study is to improve early detection of cognitive impairment — such as dementia — by reviewing, refining, testing, and evaluating components of the KAER model, which are used by primary care providers. The KAER model is a four-step process — developed by the Gerontological Society of America — to detect cognitive impairment and earlier diagnosis of dementia (Kickstart the cognition conversation; Assess for cognitive impairment; Evaluate for dementia; Refer for community resources).

Researchers will explore benefits and barriers of the KAER model while using focus groups and interviews with older adults, caregivers, families, and primary care providers to evaluate the KAER toolkit.

The study team will then select key KAER components identified for best practice within the UW Medicine system based on the qualitative data collected from focus groups and interviews, train and empower primary care providers to use those components for cognitive assessment in clinic visits, track practice metrics, and develop a package of local support services and resources to be used in provider consultations. A survey of all primary care providers will also be conducted to assess readiness to begin using the modified KAER model within UW Medicine.

Results from this study will be used to provide recommendations for practical application of the KAER model and initiate steps for integrating tools into a broader reach of primary care practices within the multi-state UW Medicine network.

Improving Genetic Counseling Referrals for Early Onset Colorectal Cancer

Sarah Knerr
Sarah Knerr

Topic Area: Cancer Prevention and Control

Principal Investigator: Sarah Knerr, UW HPRC core investigator from UW Department of Health Services* within the School of Public Health

Duration: 3 years, $650,000

Overview: The project goal is to pair the increased focus on universal tumor screening with increased attention to improving post-screening genetic counseling referral and attendance.

To address this issue, the research team will explore using health care system strategies to increase appropriate referrals to genetic counseling for early onset colorectal cancer patients. The team will study how to use patient navigation to increase access to guideline-recommended services in diverse health care settings by improving referral and attendance rates for genetic counseling and testing.

Further, researchers will study how to implement patient navigation interventions within multi-institution health systems, as well as in rural and under-resourced environments.

Project findings have the potential to improve population health by increasing early detection and timely treatment of colorectal cancer and other hereditary cancers, reducing morbidity and mortality.

Validity & Reliability of the Redesigned National Health Interview Survey

Larry Kessler
Larry Kessler

Topic Area: Cancer Prevention and Control

Principal Investigator: Larry Kessler, UW HPRC affiliate investigator from UW Department of Health Services* within the School of Public Health

Duration & Funding: 4 years, $1.8 million

Overview: Researchers intend to support cancer screening efforts by testing the validity and reliability of cancer screening questions that allow the U.S. Department of Health and Human Services to measure the nation’s progress toward screening goals for breast, cervical, colorectal, and lung cancers. While several national surveys ask about screening, there is no standard, validated, national set of questions.

During this study, researchers will evaluate current cancer screening history questions in the U.S. Centers for Disease Control and Prevention’s National Health Interview Survey. To do this, they will interview a diverse sample of screening-eligible adults and develop a refined set of cancer screening questions.

To test the validity of the newly developed questions, researchers will select a diverse sample of more than 1,500 adults with known screening histories to complete the questionnaire. Participants will receive web-based or phone questionnaires assigned randomly; a sub-sample of 240 people will be randomly selected for in-person interviews.

The team will then be able to calculate the reliability of each cancer site screening questionnaire by repeating the questionnaires one to three months after the initial survey.

Because there is a high level of evidence that timely and appropriate cancer screening reduces morbidity and mortality from some cancers, knowing whether national screening goals are being met could help save lives by helping the government redirect resources that would increase screening in promising populations.

* The Department of Health Services is now the Department of Health Systems and Population Health. This name change took place July 1, 2021.

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