The Primary Care Medical Home and Preventive Service Use in Latino Immigrants

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DESCRIPTION (provided by applicant): CANDIDATE: I am proposing to study how certain features of the Primary Care Medical Home (PCMH) impact the utilization of recommended preventive health services by Latino Immigrants. I will build upon my broad clinical and health policy background, using expert mentors and local research training opportunities to develop into an independent health services researcher. RESEARCH FOCUS: Latino immigrants, a rapidly growing segment of our population, underutilize routine preventive health care. Some features of the PCMH have been associated with increased utilization in some vulnerable populations, but little objective, multi-facility data exists to address the effects of these changs on Latino immigrants. The Oregon Community Health Information Network (OCHIN) is a multiple-facility linked electronic medical record that contains data capable of filling this knowledge gap. This proposal expands on existing PCMH research, and proposes to use the OCHIN Electronic Health Record (EHR) data to evaluate the association between certain PCMH principles and preventive service use in Latino immigrants. TRAINING GOALS: My training goals include (1) developing his skills in research design, analysis, and interpretation with a focus on the use of large databases to study vulnerable populations and 2) expanding my knowledge and experience in the strategies for and practice of health disparities research. ENVIRONMENT: I will undergo his career development in the Department of Family Medicine at Oregon Health Science University and through the Oregon Clinical and Translational Research Institute, two organizations with significant and longstanding resources for early-career researchers. METHODS: (1) Cross-sectional analysis of Latino immigrants in the OCHIN EHR data and their rates of utilization of lipid screening, cervical cancer screening, and pneumococcal vaccination. (2) Retrospective cohort analysis of the association between certain features of the PCMH and these preventive services in Latino immigrants. OUTCOMES: I will measure the rates of preventive service use in Latino immigrants cared for in OCHIN clinics and compare these to rates of other populations in OCHIN. I will test how select features of the PCMH will affect the rate of utilization of lipid screening, cervical cancer screening, and pneumococcal vaccination in Latino immigrants.