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Background Hepatitis B virus (HBV) infection is a major health disparity between Asian Americans, Native Hawaiians, and Pacific Islanders compared with other racial/ethnic groups in the U.S. Aims Our aims were to determine the effectiveness of an electronic health record (EHR) data-driven clinical intervention to improve HBV screening and vaccination rates at a community health center primarily serving Asian American patients. Methods Using a community-engaged approach, we conducted a study to compare the differences in screening and vaccination rates for 6,429 patient encounters before and after implementation of the EHR intervention. A multivariable logistic regression analysis was conducted to estimate the effect of the intervention. Results Analyses indicated that patients who visited the clinic after implementing the EHR intervention were more likely to be screened (OR=1.8, pl.001) and vaccinated (OR=2.8, pl.001) for hepatitis B. Conclusions Electronic health record interventions implemented using a community-engaged approach may improve delivery of appropriate care to patients at risk for hepatitis B in a community health setting.

Research conducted to benefit communities is often done without community involvement, threatening its relevance for the groups the studies purport to serve. A great need exists for education of both researchers and community members on how research can be more appropriately conducted in partnership with community members. This paper presents Community Criteria for Research Participation developed by community health centers (CHCs) with input from academic partners to support CHCs' capacity to conduct research of community significance.

In 2010, the Health Resources and Services Administration (HRSA) established the Community Health Applied Research Net- work (CHARN) to build research infrastructure and capacity at community health centers (CHCs) and to promote comparative effectiveness research in these safety-net settings. A data warehouse with standardized data was created to capture, manage, and share patient-level data with all eighteen participating CHCs, including four CHCs primarily serving Asian American, Native Hawaiian, and Other Pacific Islanders (AANHOPI). AANHOPI patients face unique health risks, yet these large and diverse populations are historically understudied. The CHARN data warehouse provides important opportunities for understanding the health needs of this heterogeneous population.

Background: Understanding and enhancing change capabilities, including Practice Adaptive Reserve (PAR), of Community Health Centers (CHCs) may mitigate cancer-related health disparities. Materials and Methods: Using stratified random sampling, we recruited 232 staff from seven CHCs serving Asian Pacific Islander communities to complete a self-administered survey. We performed multilevel regression analyses to examine PAR composite scores by CHC, position type, and number of years worked at their clinic. Results: The mean PAR score was 0.7 (s.d. 0.14). Higher scores were associated with a greater perceived likelihood that clinic staff would participate in an evidence-based intervention (EBI). Constructs such as communication, clinic flow, sensemaking, change valence, and resource availability were positively associated with EBI implementation or trended toward significance. Conclusions: PAR scores are positively associated with perceived likelihood of clinic staff participation in cancer screening EBI. Future research is needed to determine PAR levels most conducive to implementing change and to developing interventions that enhance Adaptive Reserve.

Introduction. A needs assessment was conducted of hepatitis B education, screening, vaccination, and care within community health centers (CHCs) serving Asian Americans, Native Hawaiians, and Pacific Islanders. Methods . Written surveys were administered to health education directors from 13 CHCs and 75 medical providers from 14 CHCs in the U.S. and affiliated Pacific Islands. Results . Although hepatitis B is within the mission of CHCs and clients are screened regardless of insurance status, little financial or staffing resources are dedicated to hepatitis B services. Lack of funding is considered the greatest barrier. Better coordination between HBV prevention and primary and specialty medical services is needed. Discussion . HBV cross-training for providers and allied staff, particularly around identification and screening of high risk groups and case management, would greatly enhance services along with additional funding. Findings support national hepatitis B strategy recommendations made by the Institute of Medicine and Office of Minority Health.

Objectives. We sought to examine the utilization and impact of enabling services, such as interpretation and eligibility assistance, among underserved Asian American, Native Hawaiian, and other Pacific Islander (AANHOPI) patients served at 4 community health centers. Methods. For this project, we developed a uniform model for collecting data on enabling services and implemented it across 4 health centers that served primarily AANHOPI patients. We also examined differences in patient characteristics between users and nonusers of enabling services. Results. Health center patients used many enabling services, with eligibility assistance being the most used service. In addition, compared with nonusers, users of enabling services were more likely to be older, female, AANHOPI, and uninsured (P < .05). Conclusions. For underserved AANHOPI patients at community health centers, enabling services are critical for access to appropriate care. We were the first to examine uniform data on enabling services across multiple health centers serving underserved AANHOPI patients. More data on enabling services and evaluation are needed to develop interventions to improve the quality of care for underserved AANHOPI patients.

Background : The mission of the Community Health Applied Research Network (CHARN) is to build capacity to carry out Patient-Centered Outcomes Research at community health centers (CHCs), with the ultimate goal to improve health care for vulnerable populations. Objectives : The CHARN Needs Assessment Staff Survey investigates CHCs’ involvement in research, as well as their need for research training and resources. Results will be used to guide future training. Methods : The survey was developed and implemented in partnership with CHARN CHCs. Data were collected across CHARN CHCs. Data analysis and reports were conducted by the CHARN data coordinating center (DCC). Results : Survey results highlighted gaps in staff research training, and these gaps varied by staff role. Conclusions : There is considerable variation in research involvement, partnerships, and focus both within and across CHCs. Development of training programs to increase research capacity should be tailored to address the specific needs and roles of staff involved in research.

Background: The Community Health Applied Research Network, funded by the Health Resources and Services Administration, is a research network comprising 18 Community Health Centers organized into four Research Nodes (each including an academic partner) and a data coordinating center. The network represents more than 500,000 diverse safety net patients across 11 states.Objective: The primary objective of this paper is to describe the development and implementation process of the CHARN data warehouse.Methods: The methods involved regulatory and governance development and approval, development of content and structure of the warehouse and processes for extracting the data locally, performing validation, and finally submitting data to the data coordinating center.Progress to Date: Version 1 of the warehouse has been developed. Tables have been added, the population and the years of electronic health records (EHR) have been expanded for Version 2.Conclusions: It is feasible to create a national, centralized data warehouse with multiple Community Health Center partners using different EHR systems. It is essential to allow sufficient time: (1) to develop collaborative, trusting relationships among new partners with varied technology, backgrounds, expertise, and interests; (2) to complete institutional, business, and regulatory review processes; (3) to identify and address technical challenges associated with diverse data environments, practices, and resources; and (4) to provide continuing data quality assessments to ensure data accuracy.