Improved Health Outcomes Program (IHOP)

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As a community-based, provider-sponsored plan, Passport Health Plan has invested in the community in which we provide services, especially related to programs that serve our membership.

For the past ten years, Passport Health Plan worked with organizations and individuals within the community to support projects with quantifiable outcomes that impact the Medicaid population through the Improved Health Outcomes Program (iHOP).  Passport Health Plan is proud of the work that has been done through the iHOP.

After proudly supporting 41 projects in its ten-year history, the iHOP has been retired.  The newly formed Passport Foundation will manage Passport grant programs in 2019.

The Foundation will support meaningful programs and services in our community and throughout the Commonwealth that improve social determinants of health for people in under-served and low-income communities.

Please visit the Passport Foundation for future grant funding opportunities.

Click on the link below for a list of the projects funded through the iHOP.

Funded Grant Projects

Cycle X iHOP Grant Summaries

  1. Speech-Language Therapy through Telepractice.
    Many rural, low-income families don’t have access to the speech-language therapies their children need. Telepractice, a two-way interaction between a person and a provider via technology, has the potential to bridge the gap between children who need speech-language therapy and the expert therapists who can provide it. The objective of this project is to demonstrate the viability of delivering home-based speech-language therapy via telepractice to children by leveraging parental support. We hypothesize that parents, regardless of income or education, can effectively facilitate productive speech-language therapy sessions within the home or another familiar environment. The aims of this project are to 1) Design and implement a culturally-appropriate telepractice health literacy protocol for low-income, rural parents of preschool children with speech and language disorders; and 2) Evaluate the efficacy of the telepractice health literacy protocol by implementing speech-language therapy via telepractice with 10 low-income families in rural Kentucky whose child qualifies for a state insurance program, such as the Kentucky Children’s Health Insurance Program. This project is the initial step towards a broader campaign to address the lack of health literacy materials and best practice guidelines for increasing rural families’ trust, acceptance, adoption and success with telepractice in rehabilitative fields.
  2. Role of Family Health Brokers (FHBs) in Managing Chronic Disease Conditions and Serious Mental Health Issues of Refugees: A Pilot Study.
    The overall purpose of this pilot study is to test the benefits of utilizing Family Health Brokers (FHBs) (i.e., a safe and trusted intermediary family member between one’s family and health care providers) as part of a care team to improve refugee access and utilization of health and mental health services.   A comparison of two types of interventions is proposed: 1) treatment as usual vs. 2) treatment as usual + Family Health Broker (FHB).  We hypothesize that utilizing FHBs as part of the care team will significantly 1) increase utilization of medical and mental health services, 2) increase adherence to medication regimens, 3) improve management of chronic disease management and mental health issues, 4) decrease in emergency room visits and, 5) improve overall quality of life for refugees with chronic disease conditions and serious mental health issues. Findings from this study may help to inform the development of further interventions for improving access and utilization for all persons experiencing both chronic health and mental health difficulties.

Cycle IX iHOP Grant Summaries

  1. Norton Healthcare Yellow Community Paramedicine Program.
    Hospital readmissions are a major contributor to U. S. healthcare costs.  The Yellow Paramedicine program will discover whether home visit interventions made by a community paramedic can improve health outcomes and also lower overall healthcare spending for a target population of Passport and Humana patients discharged from the hospital with chronic conditions.  The program aims to test a novel partnership model of care management intended to reduce both 30-day hospital readmissions and unnecessary emergency department visits.  Norton Healthcare & Yellow Ambulance will support better patient self-management and care in the home, offering a unique partnership model for healthcare organizations to improve patient care.  We hope findings will incentivize the state to develop formal statutes to reduce the legal uncertainty currently hindering implementation of such programs.  We hypothesize that a paramedicine intervention will decrease both readmission after an index stay (Specific Aim 1) and avoidable ED visits (Specific Aim 2) for the target population.  The proposed project is a quasi-experimental design with selection criteria for participation that will seek participants both proactively, identifying high utilizers within the electronic medical record (EMR), and reactively, contacting appropriate patients admitted to the hospital during the study.
  2. The Pediatric Primary Care Project: Breaking the Cycle of Toxic Stress. Grant awarded to University of Louisville Division of General Pediatrics.
    Evidence shows when caregivers have experienced childhood trauma without positive interventions to help buffer the effects, their child will be at a high risk of having the same experience. Primary care clinics have a unique advantage and responsibility to break the cycle of toxic stress and support resiliency, the act of adapting and recovering in the face of adversity. Our aims include: 1) Implement a new screening tool to measure toxic stress and social/legal needs for all children as well as their caregivers in our urban pediatric primary care teaching clinic. 2) Provide multi-disciplinary interventions and link caregivers with high toxic stress scores to a resiliency partner. 3) Collect all data from screening tools and interventions, analyze data, and measure effects on wellness checkup and immunization compliance for 0-15 month olds, a Child Health Insurance Program Reauthorization Act (CHIPRA) core health outcome measure. 4)Create a community asset map and build broad-based, innovative partnerships with community organizations that strengthen families and promote resilience.

Cycle VIII (2015-2016) iHOP Grant Summaries

  1. Using brief Cognitive Behavioral Therapy to Improve Outcomes of Children with Special Needs and Their Female Caregivers.  Grant awarded to the University of Louisville School of Nursing.
    A cross-sectional prevalence study will be conducted with approximately 150 adult female caregivers of children with special health care needs to identify 50 caregivers with elevated depressive symptoms who meet the inclusion criteria and agree to participate in the randomized controlled trial with repeated measures.  The purpose is to evaluate the effects of brief Cognitive Behavior Therapy on outcomes for Medicaid enrolled children and their caregivers
  2. Improving the Wellness and Immunization Rates for Pediatrics Utilizing Pre-Visit Planning and Proactive Office Encounters.  Grant awarded to the White House Clinics.
    Design, implementation and evaluation of a proactive office encounter (POE) pediatric intervention, a systematic approach to offering preventive health screening, addressing well child visit measures and immunizations at every office encounter for every eligible patient.  The purpose is to implement a systemic in-reach intervention program to address the preventive care needs of pediatric patients, utilizing pre-visit planning and proactive office encounters in the Centers’ largest location in Richmond, Madison County, Kentucky.
  3. Enhancing Self-Management of Chronic Disease in Refugee Communities.  Grant awarded to the Kentucky Office of Refugees and Catholic Charities.
    To expand the refugee community health workers program and implement and evidence-based curriculum (Stanford Chronic Disease Self-Management Program) for chronic disease management for individuals with limited English proficiency (LEP), utilizing the Program and trained community health volunteers).  Pre and post testing survey for workshop participants which assesses their health literacy, knowledge of their health condition and perceived quality of life will be conducted.  The purpose is to improve healthcare access and health outcomes for the refugee population.
  4. Peer Counseling Intervention to Enhance Breastfeeding in Low-Income Infant/Mother Dyads in Kentucky.  Grant awarded to University of Kentucky’s College of Nursing.
    A two-group, randomized and controlled trail design will be used to assess the efficacy of a community-based peer counselor intervention to increase breastfeeding initiation, duration and exclusivity in low-income infant/moth dyads in Kentucky.  The purpose is to:
    a) Determine the efficacy of a tailored intervention on the initiation, duration and exclusivity of breastfeeding for four months.
    b) Document infant growth and health outcome trajectories during the four month postnatal period in the intervention and usual care groups.
    c) Conduct qualitative assessment of factors associated with degree of adherence and acceptability of the intervention.

Cycle VII (2014-2015) iHOP Grant Summaries

1. Despensa de alimentos y hogar de assistencia médica preventiva: The Food Pantry Preventative Medical Home Without Walls
The goal of this project is to implement a nonequivalent comparison groups multiple time-series design in Shelby County for recipients of food pantry products from two Dare-to-Care food pantries. The focus of this project is to enhance the Aposento Alto food pantry (AAFP) as follows: a) Create a culturally sensitive preventative medical home without walls providing preventative care and a culturally sensitive medical referral system; b) Create a chronic disease friendly environment; c) Train Latino promotores to provide preventative screenings, health education and facilitate improved health behaviors for AAFP clients; d) Conduct healthy food trainings/ demonstrations at the AAFP; e) Get community partners involved to provide fresh or frozen fruits and vegetables to the AAFP.  It is hypothesized that after intervention implementation at the AAFP, the following will be true for AAFP customers but not for Serenity food pantry customers (traditional comparison food pantry): 1) Reduction of 10% in the consumption of fat; 2) Increase of 10% in the consumption of fruits/vegetables; 3) Decrease of 5% in overall BMI; 4) Decrease in blood glucose levels, A1c levels (diabetes customers), blood pressure and cholesterol to be closer to recommended levels; and 5) Increase of 10% in self-efficacy to manage health.   This is the second grant approved for this program (see Cycle V).

2. Accountable Care Teams
Increasing numbers of children are being prescribed psychotropic medications (PM), including anti-psychotics, anti-depressants, and stimulants.  In Kentucky almost 600,000 children receive Medicaid. One-in-seven of these children has been prescribed a PM. Almost half of all children in the Kentucky foster care system have been prescribed a PM. This rate of PM prescribing to Kentucky’s children is double the national average.  With Passport support, a team of health care providers and research personnel will examine patterns of PM prescribing to identify appropriate and inappropriate prescribing practices and solutions for improving the care of children who have mental health needs.   We will focus on: 1) children younger than 5 years of age; 2) children receiving multiple PMs, 3) children not receiving recommended behavioral health services; 4) children not receiving recommended laboratory monitoring and/or 5) children who do not have a behavioral health diagnosis that substantiates PM.   This project will lead to a better understanding of the mental health needs, access issues, and quality of care in the Passport population. We will not only deliver crucial evidence, but also create partnerships necessary to improve the quality of care and constrain the costs of inappropriate practices.

3. Navigating high-risk in-client clients using a lay-health worker model in Eastern Kentucky: The Bridges to Home Program
St. Claire Regional Medical Center in Morehead, KY and the University of Kentucky College of Medicine, Division of Community Medicine, and Kentucky HomePlace are working together to reduce 30-day readmission rates using a lay-health worker (LHW) model. The aims of the study are to identify and assist in addressing the psychosocial and health determinants of high-risk clients, as determined by the LACE-index, before, during, and after the time of hospital discharge using LHWs. The study will assess its impact by measuring compliance of discharge orders and appointments, client satisfaction, and 30-day readmission rates. The LHW will provide community resources and education to clients that are identified during the hospital stay.  The LHW will also navigate clients after hospital discharge to ensure barriers to improved wellness, such as transportation, housing and safety, and cost factors, are being addressed. The LHW will coach clients and encourage them to attend post-hospital appointments and engage in the identified resources by conducting a 24-72 hour “check-up” call and subsequent reminder calls for each appointment. Outcomes will be measured 30 days after discharge from the hospital.

4. Improving Care through Pre-Visit Planning and Pro-Active Office Encounters
Patients in rural Kentucky are accustomed to visiting the doctor on a reactive basis—for sick visits or immediate needs.  Through this study, White House Clinics will utilize evidence based guidelines to conduct pre-visit planning and Proactive Office Encounters to address preventive health measures at each scheduled appointment—regardless of the reason for the appointment.  Proactive Office Encounters utilize pre-visit planning and chart prep to proactively identify and close gaps in preventive care provision, including cancer screening utilization and chronic disease management.  Through the strategic use of information technology (e.g., electronic health records) and the use of a Care Coordinator, White House Clinics will improve the rates of cancer screenings, chronic care measures and specific immunization measures for White House Clinic patients.

Cycle VI (2013) iHOP Grant Summaries

1. Hardin County HONORS Program
Lincoln Trail District Health Department (LTDHD) and Hardin Memorial Hospital (HMH) are implementing the Hardin County HONORS (Hands-On Nutrition, Outreach, & Recreation for Students) Program. Hardin County HONORS is designed to be a demonstration project focusing on at-risk students and utilizing CATCH (Coordinated Approach to Child Health), an evidence based program. We believe our community’s health status can be improved through convenient and structured opportunities for physical activity and health/nutrition education. The specific aims of the Hardin County HONORS program are to increase knowledge of health and healthy choices and also motivate participants to make improvements in health indicators and health habits. Components of the program include nutritional health, fitness and exercise, tobacco abstinence, and avoidance of substance abuse. HONORS will focus on at-risk students and their families and will be piloted at Panther Place.

2. Assessing Impacts of Supportive Housing for Adults with Severe/Persistent Mental Illness
Wellspring’s Permanent Supportive Housing services facilitate exit from homelessness, increase use of community mental health services and other community supports, and reduce demand on more costly systems services. Objective: Develop and implement a tracking and reporting system to assess the impact of supportive housing for adults with severe/persistent mental illness on the traditional health care and criminal justice systems, as well as utilization of other social services, and overall client life satisfaction.

3. Bridges to Care
The primary aim of this study is to seed a community programming effort called “Bridges to Care” that will address the challenging effort to bring pregnant women who are struggling with mental illness and co-occurring substance abuse or addiction into clinically appropriate services. The “Bridges to Care” program seeks to eliminate the perceived and real barriers to care experienced by this fragile client population when referred to professional services. Bridges to Care will coordinate with the existing program called Kids Now Plus, which is an effort to identify pregnant mothers with mental illness, domestic violence and substance abuse/dependency issues in primary care settings and make referral to community based clinical services. The Bridges to Care program aims to develop a wellness focused incentive program for the identified population. The Bridge to Care program seeks to help these young women come to trust “helping agencies” by rewarding their positive efforts towards treatment outcomes by offering wellness benefits in their plan of care that are consistent with their holistic needs. The bridges to Care program will seek to develop a network of wellness programming providers (natural supports) that are already present in the community.

4. Fit 4 Fun
The aim of our study “Fit 4 Fun” is to improve the overall health and quality of life of the children of Grayson County via regular exercise, dietary changes, mental health counseling and family education. We predict that participation in this multi-disciplinary approach to combating the childhood obesity epidemic will directly improve lipid levels, cardiovascular endurance, self image, quality of life and raise family awareness of healthy lifestyle changes. Not only are we hoping to positively affect the participants in this study but we also anticipate an overflow into the habits of their families and friends. This overflow of lifestyle changes and increased activity levels will ultimately improve the lives of numerous individuals in Grayson County.

Cycle V (2012) iHOP Grant Summaries

1. Proyecto de Alimentacion Sana Sin Perder El Buen Savor (Healthier food without losing the good flavor project).
This study addresses 4 critical needs in diabetes management for Latino diabetics: 1) The high prevalence and disproportionate impact of Type 2 diabetes on Latinos; 2) The need to address Latino cultural traditions and values that create barriers in creating lifestyle changes; 3) The lack of multilevel nutrition programs addressing cultural influences of eating healthy in a community with inadequate resources to access healthy and affordable food; and 4) The lack of nutrition focused randomized controlled trials (RCT’s) within the Latino diabetic population. The goal of this project is to implement a pilot RCT in Shelby County (SC) for Latino families with no insurance affected by diabetes. The project focuses on a family focused multilevel lifestyle intervention vs. an individual level control intervention. The multilevel family intervention will address both individual/family behaviors as well as the social context in which the family functions. The intervention recognizes the social determinants of health affecting disparities and the need to move beyond clinical interventions in high-risk groups in order to advance health. The individual level control intervention provides only nutritional information.

2. Parenting Skills Training in a Primary Care Setting
For many parents, the primary care provider is the first point of contact for child behavior concerns. It has been estimated that approximately one in four outpatient pediatric visits are for behavioral, developmental, or psychosocial concerns. Yet behavioral and counseling skills have been relatively neglected in medical training, and most practitioners are not delivering evidence-based interventions for behavioral concerns. In a sample of Kentucky pediatricians, two-thirds identified lack of appropriate training as a barrier to providing behavioral health services in their practice. Parenting effectiveness is a critical factor in numerous child developmental outcomes and parent training has been identified as an effective approach for reducing and preventing child behavior difficulties. Providing parent training in a primary care setting improves access to care, reduces stigma, and allows for intervention at an early point of contact. Specific aims of this project are:
– To evaluate the feasibility and acceptability of a parent training intervention designed to address and prevent emotional, behavioral, and developmental difficulties in youth
– To evaluate the efficacy of this intervention in changing parent behavior, child behavior, and parental self-efficacy.
– To identify and address barriers to successful implementation.

3. Assessing Refugee Community Health in Louisville, KY.
The aim of this study is to perform research to identify a culturally appropriate model for a community health worker program within refugee communities resettled in Louisville, Kentucky. The study will provide qualitative data on the health-related needs of refugees, specifically: Health needs perceived by refugees Perceived quality of healthcare received by refugees, Barriers to accessing health care encountered by refugees, and Community assets that can be utilized in the development of a community health worker program. The results of the study will be used to develop a community health worker (CHW) program. CHWs will be selected from the various communities to assist their peers by delivering culturally and linguistically appropriate health education and health system navigation assistance, as well as serving as liaisons with health care providers to educate them on community needs. Thus, the program is intended to empower refugees to play a more active role in their health, and the health of their families and community. The series of conversations proposed in this research will build on existing partnerships between refugee communities, the Kentucky Office of Refugees (KOR), resettlement agencies in Louisville, and health care providers. It will formalize conversations on health needs that have occurred over the last two years, and will identify individuals motivated to ultimately participate in the program as CHWs.

4. The New Directions Quality of Life Campaign: Improving Health Outcomes and Access to Services Among Medicaid Patients and the Uninsured Served by New Directions Housing Corporation
Health inequities among Louisville’s residents of low income have ignited the creation of public and private efforts to increase awareness and access to health interventions. Resilient neighborhood leaders and agency stakeholders are increasingly moving to collaboration and resident engagement to frame prevention strategies, bridge gaps and more closely draw together the weave of the community’s health safety net. By leveraging its affordable housing platform, New Directions Housing Corporation, will assess advances in increased community level outcomes in health access in two self-aware community areas, the Smoketown and Shelby Park neighborhoods east of downtown and the California Neighborhood west of downtown. In 2012, this Louisville agency and its partners will implement a measurable strategy of engagement, information sharing, encouragement and collaboration to respond to already vivid resident dialogues addressing nutrition and expanding urban gardening. Our goals are to increase participation in existing health programming, decrease the number of uninsured seniors, identify current obstacles for access to health services, determine what residents identify as most needed health services or programs currently lacking. We hope to observe an overall improvement in self-reported health. Baseline measurements will be determined using survey and key informant interviews. A final deliverable will be a case study produced for the NeighborWorks America Community Building and Organizing Initiative and the national Resident Services Consortium.

5. Multidisciplinary Smoking Cessation Interventions for Primary Care Patients
The purposes of this interdisciplinary program are to increase the beneficial effects of smoking cessation counseling received by low-income patients in the ambulatory care setting. Two novel counseling approaches to promote smoking cessation behaviors will be compared to the current standard of care counseling. The specific aims are to: 1. Compare the effects of resident physician motivational interviewing (MI), resident physician MI plus nurse telephone follow up using MI approach, and the current counseling approach (brief counseling) on smoking behaviors (readiness to quit, quit attempts, cigarettes smoked per day, current smoking rates) among current smokers. 2. Identify factors that predict smoking behavioral change. 3. Evaluate patient satisfaction with each of the three smoking cessation counseling approaches.

Cycle IV (2010) iHOP Grant Summaries

1. Effects of Educational Intervention on Long-Term Outcomes of Hospitalized Children with Asthma.
This study will assess the effectiveness of utilizing reinforced asthma education to improve care and reduce the health care costs that result from avoidable morbidity related to asthma in children 5-12 years of age. The main objectives are to: 1) to determine the retention rate of knowledge about asthma and 2) evaluate the clinical status, quality of life and healthcare costs of children with asthma following an educational intervention. A randomized control design will be utilized to assess standardized asthma education versus standard education with an enhanced reinforcement education intervention.

2. Cost Savings and Improved Access to Health Care with Guardianship.
This objective of this study is to understand the extent to which guardianship services achieve cost savings and improved access to health care for Medicaid and uninsured populations in Passport Health Plan’s (PHP) Region 3. Project hypotheses are: 1) state guardianship services provided by the Division of Guardianship, Cabinet for Health and Family Services, achieve cost savings and improved access to health care for Medicaid and uninsured populations in PHP’s 16 Kentucky counties and 2) functionally disabled Medicaid and uninsured populations in PHP’s 16 counties without appropriate guardianship services increase costs and reduce access to care for this population. The study authors will analyze data from the Division of Guardianship to gather in-depth information regarding guardianship services available in PHP’s 16 counties. Additionally, the study team will calculate guardianship and Medicaid costs and cost savings to the state and quality of life improvements for the legally “disabled” persons served by the Division.

3. Disease Management Program for Depression.
This study will pilot a disease management program for Medicaid insured patients with major depressive disorder (MDD) seen in primary care. Specific project aims are: 1) increase the frequency of use of an objective measure for diagnosing and monitoring outcome of patients with MDD treated by primary care clinicians; 2) increase the number of patients with MDD who receive appropriate and adequate treatment for this condition by primary care clinicians; 3) decrease the number of patients who are treated with antidepressants for non-indicated conditions; and 4) pilot use of health care costs as a measure of impact of a disease management program.

4. Improving Health Outcomes Through a Community Care Navigator.
The aim of this project is to improve the health outcomes of residents in Region 3 with Passport, Passport Advantage, Medicaid, or no insurance through a disease management initiative designed to reduce 30-day readmissions to Jewish Hospital by 4% over a 12-month period. The demonstration project is modeled after the Coleman Care Transitions Intervention, an evidence-based four-week coaching process that empowers patients to assume greater responsibility and control over their self-care in the community. Improved adherence with prescribed treatment is expected to stabilize or curtail markers of participants’ disease and to minimize health care utilization. The project will provide a community care navigator to eligible patients who will serve as a health coach for each patient. The navigator, a registered nurse, will monitor the health status of each patient and work as a coach to improve their ability to manage medications, keep their personal health record, understand the indicators suggesting that their condition is worsening and how to respond, and facilitate follow-up care with primary care providers and specialists.

5. FIXIN ADDICTION: Improving the Treatment of Pregnant Opioid Addicts & Their Babies.
The aims of this project are to: 1) educate OB/GYN residents and the community at large about the proper evaluation and treatment of opioid addiction; 2) provide an important alternative to long-term maintenance with Methadone and Suboxone for pregnant women who are addicted to opiates; and 3) reduce the severity and duration of neonatal abstinence syndrome (withdrawal) among infants born to addicted mother. Pregnant narcotic addicts will be indentified as they are referred to the U of L OG/GYN clinic, private practice or labor and delivery triage area. All pregnant narcotic addicts will be offered detoxification, comprehensive prenatal care and counseling via the University of Louisville OB/GYN service. The specific approach to detoxification, weaning or substitution and maintenance will be individualized based on whether or not the patient is already enrolled in a Methadone or Suboxone treatment program.

Cycle III (2009) iHOP Grant Summaries

1. Aqui Es Donde Nos Encontramos (Here is Where We Meet) Project
The goal of this project is to develop, implement, and evaluate a community-focused, digital storytelling tool and method, which will enhance ongoing efforts to engage community members developing plans to eliminate health inequities. The specific aims to achieve this objective for the Latino populations served by two neighborhood community centers are:
– Recruit and train 10 facilitators in using PlaceStories, a digital storytelling methodology, to encourage, support and sustain the Health Equity Dialogue process with these populations;
– Implement and test the effectiveness of using this specific tool and methodology in expanding the engagement of Latino populations in action planning focused on addressing the social determinants currently limiting their access to prevention and clinical services and on decreasing their exposure to negative systemic issues; and
– Collect, analyze and share relevant information about the community’s perception of priority issues regarding health inequities and proposed best practices for addressing these priorities.

2. Kangaroo Care Expanded
This project proposes to increases breastfeeding rates in sixteen Kentucky counties by training healthcare providers to implement Kangaroo Care (KC) at the ten birthing hospitals served by Passport Health Plan. The primary goal is to increase breastfeeding rates in the ten hospitals in the Passport Area from an average of 49% to an average of 55% in 12 months.

3. Wholesale “Central Fill” Pharmacy System
The aim of this study is to determine the effects of a Wholesale “Central Fill” Pharmacy system on the Access to an Indigent Prescription Replenishment Program; Kentucky Physician’s Care (KCP) Program. The related hypothesis is that by implementing a Wholesale “Central Fill” Pharmacy System an increase will be demonstrated in:
– The number of participating pharmacies;
– The speed which participating pharmacies receive their replenished pharmaceuticals; and
– The number of participating pharmaceutical companies.

4. Improve use of health services by teen mothers with symptoms of depression through a public health, social marketing intervention.
The aim of this study is to determine the acceptability, feasibility, and efficacy of a public health, social marketing intervention to improve health care use of teen mothers with symptoms of depression. Exploratory research questions will be utilized to define the market (understand how teen mothers use social media; where they receive health information; who they prefer to receive health information from), in message development (obtain the opinions of teen mothers concerning what the message should be, the image of the message, and how message should be delivered such as Facebook or text message, etc.), and in concept and message testing (pilot testing of the message with teen mothers). Then outcomes related to the public health, social marketing intervention will be measured.

5. E.A.R.S.: Leading to a better understanding of the educational needs, access issues, resources and satisfaction with care for high risk pregnant women who                       participate in the Prenatal Task Force Mother’s Day Out Program.
The aims of the project are to lead to a better understanding of the needs and access issues for pregnant, low income women; examine the Mother’s Day Out Program (MDO) to improve the satisfaction with care; and explore the unique collaboration and community based partnerships that MDO offers to improve the care for this population.

Cycle II (2008) iHOP Grant Summaries

1. Clinical Skills for Early Detection of Oropharyngeal Carcinomas in High-Risk Urban African American Population: Development of a Novel Educational Intervention and Educational Assessment Strategy.
The study objective is to develop and test an educational intervention aimed at oral health practitioners’ ability to improve recognition of early-stage oropharyngeal cancers. Thirty Louisville-based oral health practitioners will be targeted to participate in a continuing education program on oral health utilizing standardized patients. Following this work shop standardized patients will visit the oral health practitioners practice for unannounced new patient visits to determine the effectiveness of the training at fixed intervals (3, 6, and 9 months) post intervention and education session.

2. The Effects of Motivational Interviewing on Type 2 Diabetes Management in African American Adults: A Pilot Study.
The study objective is to determine the effects of a motivational interviewing intervention on adherence to prescribing treatment regimens, diabetes markers, and number of unscheduled health care visits among African Americans with type 2 diabetes mellitus. This study is a randomized, controlled trial with a planned enrollment of 30 participants to the intervention group and 30 participants to a usual care group.

3. A Community Coalition to Help Parents Raise Healthy Confident Children.
The study objective is to form a community coalition to fight childhood and adolescent obesity through a year long interdisciplinary program. Three components of the program include: 1) physical activity, 2) dietary management and nutritional education, and 3) confidence and self-esteem boosting counseling sessions. Fifty obese children, ranging 5-12 years of age with a commitment of at least 1 parent, will be selected to participate in the program.

4. Louisville Metro EMS PSIAM Pilot Program.
Study goals are: 1) to implement a pilot program for the alternate triage of patients assessing the 911 emergency medical services system (EMS) for low-acuity medical concerns; and 2) to evaluate the specificity of a 911 call-processing algorithm for indentifying low-priority 911 medical patients, and for the timely and safe referral of these patients to alternative non-acute sources of medical care. 911 emergency calls categorized as “low-priority” by the MetroSafe 911 Communications Center will be secondarily triaged by a trained nurse utilizing the pilot PSIAM call-processing algorithm. The nurse will access a database to determine the appropriate and safe alternative referral to existing community resources rather than the emergency dispatch of a 911 ambulance.

5. Intra-uterine device placement: a randomized, controlled trial.
This study is a randomized, controlled trial comparing typical placement of IUD’s at six week’s postpartum or later and immediate post-placental placement with regards to the rate of success, complications, and patient satisfaction.

Cycle I (2007) iHOP Grant Summaries

1. Health Needs and Experiences of Immigrants and Refugees in South-Central Louisville
Louisville is experiencing a rapid growth in its immigrant and refugee population many of whom are residing in South Central Louisville. Refugees and immigrants often face barriers to accessing health care such as language, culture, fear and confusion about the medical system, past trauma, victimization, poverty, and social isolation that often preclude access and acquisition of care. This study sought to learn the health care needs, experiences with the existing health care system, and determine barriers that prevent health care access for refugee and immigrants, including both personal and environmental challenges faced when attempting to obtain health care and achieve wellness.

2. Improving Access to Mental Health Care in Young Postpartum Women with Symptoms of Depression.
The aims of this project included determining the feasibility, acceptability, and efficacy of New Mother Program, a telephone based depression care management program) in postpartum adolescents 13-18 years of age with symptoms of depression. This program is screening adolescents 13-18 years of age for symptoms of postpartum depression, with those registering a positive depression at baseline being enrolled into the New Mother Program. Potential outcomes include enrolling adolescents in the New Mother Program and entering depression treatment in a timely manner, as well as satisfaction with telephone based depression care management intervention.

3. Access to Early Dental Care – An Initial Step to Dental Health
The objectives of this project were to improve access to preventive dental care in the first two years of life and to reduce the risk of early childhood caries. This project was conducted at the Children and Youth Project of the Department of Pediatrics, University of Louisville. The C&Y Project provides comprehensive health care to children, including medical, dental, nursing, nutrition, speech, and social services. Dental preventive services were scheduled at the same time as medical preventive visits.

4. Chronic Care Coordination Project
The goal of this project was to improve clinical outcomes for Passport Health Plan members and underinsured individuals with chronic illnesses, with a focus on diabetes, through the implementation of an on-site chronic care coordinator at the University of Louisville Family Medicine-Ambulatory Care Building. Potential outcomes included: improving clinical outcomes for patients with chronic illnesses with a focus on diabetes; providing coordination of patient care using a multidisciplinary team approach to include Passport Health Plan Disease Managers and community resources; implementing self-management support strategies to empower patients to become more actively involved in managing their own care, and analyzing outcome data continuously.

5. Kangaroo Care
The goal of this project was to implement a program titled, “Kangaroo Care” in the newborn nursery at University Hospital to positively impact mother-infant outcomes and demonstrate a statistically significant increase in the number of newborn infants’ breastfeed. Kangaroo care, also known as “skin-to-skin” are, is a special way a mother holds her newborn infant with contact starting at birth and continuing after discharge. This method of care, involving placing the infant on a mother’s bare chest immediately after birth or within the first 24-hours of life provides benefits to both the mother and child.