Building Capacity for Patient-Centered Outcomes Research in Rural Washington

Background: COVID-19 disproportionately affects rural people and American Indians (AIs). NW HERON, WSU’s practice-based research network, seeks to improve the health and health care of rural, tribal, and medically underserved communities. Results from a NW HERON survey of administrators of affiliated practices conducted in 2020 showed that COVID-19 was the second highest ranked clinical concern. NW HERON lacks patient-informed perspectives to conduct patient-centered outcomes research (PCOR) on COVID-19. Identifying research questions on COVID-19 generated by rural and AI patients is critical to the Network’s mission to enhance the health and health care of Washington State residents.

Proposed Solution to the Problem: The proposed project will collect critical information on COVID-19 research priorities generated by rural and AI patients and providers. To achieve this solution, the project team will use the SEED Method by engaging patients and other stakeholders from five NW HERON primary care practices. The SEED Method convenes participants to focus on a specific disease topic.

Objectives: The primary objective of the proposed project is to utilize the SEED Method with rural and AI patients and providers to identify COVID-19 comparative clinical effectiveness research (CER) and PCOR questions.

Aims: 

1. Convene a COVID-19 topic stakeholder group consisting of rural and AI patients and providers who will engage with the research team
2. Conduct key informant interviews with rural and American Indian patients who have had COVID-19 
3. Interview other stakeholders to inform the development of PCOR/CER research questions on COVID-19
4. Generate and prioritize PCOR/CER questions on COVID-19

Activities: The project team will use the SEED Method to generate rural and American Indian PCOR/CER questions on COVID-19.  They will engage in the following activities:

1. Identify and engage topic stakeholders
2. Conduct key informant interviews
3. Develop conceptual models
4. Generate research questions
5. Prioritize research questions
6. Creation of dissemination plan
7. Creation of a CAB sustainability plan

Projected Outcomes and Outputs:

Short-term outcomes during the project period include: 

1. Participation of five NW HERON-member facilities in SEED 
2. Completion of 20 key informant interviews with patients and other stakeholders 
3. Generation of priority research questions that will motivate PCOR/CER efforts on COVID-19 
4. Creation of a dissemination plan

Medium-term outcomes (0-2 years post-project period) include:

1. Dissemination of results
2. Grant applications submitted 
3. Funded grants

Long-term outcomes (3+ years post-project period) include:

1. Grant applications submitted 
2. Funded grants

Patient and Stakeholder Engagement Plan: The project team will engage patients over 18 years old with a history of COVID-19 and providers from rural and AI-serving primary care practices that are NW HERON-affiliated practices. For the 12-month project period the research team will convene these topic stakeholders on the planning and execution of the proposed project in six sessions on average lasting three hours. For these meetings a cloud-based collaborative communication platform will be used.

Project Collaborators: NW HERON comprises 200+ primary care clinics serving rural, tribal, and urban medically underserved communities through affiliation agreements. This project will engage five primary care practices (three rural and two AI-serving) through SEED.