BRACE 3.0: Building Capacity of Health Department and Their Partners to Address Climate and Health

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ABSTRACT We seek continued support for the UMass Worcester Prevention Research Center (PRC), located at the University of Massachusetts Worcester. The UMass Worcester PRC serves as 1) The hub of applied public health research at UMass Worcester; 2) An integral part of the fabric of Greater Worcester's collaborative public health system; 3) A research partner that addresses real-world challenges across Worcester, MA, the Commonwealth and beyond; and 4) A national leader in applied prevention research and translation activities conducted in collaboration with public health, community and health care sectors. Under the guidance of a multi-sector, highly engaged community advisory board, we seek to grow and enhance a comprehensive center infrastructure and research portfolio that is responsive to local, state and Healthy People 2020 priorities. These include promoting healthy eating, physical activity, tobacco cessation and management of common conditions such as obesity, hypertension, diabetes, asthma and certain cancers. Our interventions and tools are intended to be implementable in real world settings that serve diverse populations, including: 1) interventions that build clinical capacity for implementing prevention programs, 2) interventions that build clinical-community linkages, 3) community-based (e.g., home, schools, community organizations) interventions, and 4) evaluations of policy, systems and built environmental approaches and approaches to improve their adoption. Guided by an expanded version of the CDC's Knowledge to Action Framework, we will amplify our research portfolio and establish the business case for prevention interventions through innovative activities that support dissemination, translation, stakeholder training and communication. We also will continue to inform local and state public health practice, train the next generation of public health researchers, and contribute to the national PRC network. The applied research project is an implementation study of the evidence-based Approach for Lowering blood pressure through Medication Adherence (ALMA) intervention, which was developed by members of our team. ALMA is a systems-based intervention that alerts medical assistants to identify patients with uncontrolled hypertension and facilitates referrals to a community health worker-delivered coaching intervention that promotes medication adherence. Implementation will be facilitated by leadership support and CHC-based medical and operations champions. Using a quasi-experimental design, we will conduct the study in partnership with federally-qualified community health centers (CHCs) that are members of an Accountable Care Organization (ACO) in Massachusetts. The intervention sites will be the Edward M. Kennedy Community Health Center and Family Health Center of Worcester, long-standing partners of our PRC. Five CHCs with similar patient profiles will serve as a comparison condition. Outcomes will include return on investment and cost-effectiveness, blood pressure control among sub-populations and implementation process outcomes. Findings will be used to promote the translation of ALMA into practice.