Newsletter








April 2016 Newsletter Article

Dear CORNET Members,

We wanted to share with you what is new within CORNET. 

Project Updates

In Progress: National Immunization Partnership with the APA (NIPA)
This large-scale quality improvement project coaches clinical sites through practice changes so as to increase adolescent HPV vaccination rates and limit missed opportunities for HPV vaccination at every clinic visit. 

Faculty who meet minimum participation requirements will receive MOC 4 credit.  Moreover we are excited that we will be able to offer banked MOC credit for residents as well.

We are nearing completion of the data collection process with our sites participating in Wave 1 and expect to initiate Wave 2 of this project with May orientation calls and data collection.  We have not yet completed recruitment of practices for Wave 2.  If your site is interested in joining, please contact Holly Tyrrell at Hollyce@academicpeds.org for details.

In Progress: Preventive Services Improvement Project - State Spread (PreSIPS2)
A quality improvement initiative based on Bright Futures to improve the preventive health outcomes of young children is underway.  Four Continuity Clinics have been recruited by CORNET to participate in this collaborative project with AAP State Chapters.  Measurement-based preventive services, implemented by faculty and residents in continuity clinics, are the key to the "future" of Bright Futures and incorporation in community practices as our residents transition into their professional careers.

Completed Project: The National Partnership for Adolescent Immunization (NPAI) project has been completed.   Data from this study will be presented at PAS (See below).  We anticipate 3 manuscripts from this project and they are in preparation.

Thanks to participating sites and faculty:

  • University of Utah - Joni Hemond
  • University of South Florida - Tracy Burton, Sharon Dabrow
  • New York Medical College - Terry Hetzler, Vicki Iannoti
  • Baylor College of Medicine - Jan Drutz, Teresa Duryea
  • Dartmouth Hitchcock Medical Center - Kim Gifford, Sam Martin
  • Medical University of South Carolina - Kristina Gustafson, James Roberts
  • University of Oklahoma - Monique Naifeh, Mark Pogemiller
  • University of Southern California - Rukmani Vasan, Jennifer Saenz
  • University of Louisville - Melissa Hancock, Jeff Meyer
  • Helen DeVos Children's Hospital - William Stratbucker
  • Dayton Children's Medical Center - Maria Nanagas, Melissa King, Ilona Albrecht
  • University of Toledo - Mary Beth Wroblewski, Joyce Bevington
  • Duke University Medical Center - Melissa Deimling, Richard Chung

New Publication:
A new manuscript, based on the Secondary Sexual Characteristics in Boys (SSCIB) study, entitled Timing of Puberty in Overweight Versus Obese Boys, was published in Pediatrics and an accompanying article was posted in AAP News.

Both can be viewed here:

If your site participated in this project, please be sure to put the following on your CV:

Lee, J.M., Wasserman, R., Kaciroti, N., Gebremariam, A., Steffes, J., Dowshen, S., Harris, D., Serwint, J., Abney, D., Smitherman, L., Reiter, E., Herman-Giddens, M.E. Timing of Puberty in Overweight Versus Obese Boys. Pediatrics. 2016; 127:320150164.

You can list this on your CV under a heading that includes multi-site studies.  Thank you to all who contributed!

PAS Events
Please join CORNET at PAS in Baltimore, Maryland
CORNET Members Meeting - Sunday, May 1 - 9:00-11:00am
Hilton Baltimore Hotel, Holiday Ballroom 5.
We will be updating our members (and new interested programs) on our current and future studies.  We will also be updating members on some changes in CORNET this year and are always eager to hear new ideas. Please come by and say hello.

We are excited to share that CORNET is part of 2 platform presentations, 2 poster presentations, and 2 workshops this year!  Please join us!

Platform Presentations

Pediatric Resident Involvement in a National Quality Improvement (QI) Project in their Continuity Site: A CORNET Study
General Pediatrics & Preventive Pediatrics: Immunizations - Monday, May 2 - 3:30-5:30pm
J R Serwint, C Albertin, P M Darden, N Dhepyasuwan, S G Humiston, K Mann, C M Rand, S J Schaffer, W Stratbucker, P G Szilagyi

National Multisite Quality Improvement (QI) of HPV Vaccination Opportunities Through Standing Order (SO) Implementation: A CORNET (Continuity Research Network) Study
General Pediatrics & Preventive Pediatrics: Immunizations - Monday, May 2 - 3:30-5:30pm
W Stratbucker, J Serwint, P Darden, N Dhepyasuwan, C Albertin, A Blumkin, C Rand, S Schaffer, K Mann, S Humiston, P Szilagyi

Poster Presentations

Provider Prompts to Improve HPV Vaccination Rates within the Continuity Research Network (CORNET)
Immunization Delivery - Sunday, May 1 - 10:30am-12:30pm
C M Rand, S J Schaffer, N Dhepyasuwan, A Blumkin, C Albertin, J R Serwint, P Darden, S G Humiston, K Mann, W Stratbucker, P G Szilagyi

Perceived Benefits of Resident Involvement in a National Quality Improvement (QI) Initiative on Improving HPV Vaccine: The Faculty (Site Director) Perspective, a CORNET Study
General Pediatrics & Preventive Pediatrics: Immunizations II - Monday, May 2 - 5:45-7:30pm
J R Serwint, C Albertin, N Dhepyasuwan, P M Darden, W Stratbucker, A Blumkin, S G Humiston, K J Mann, C M Rand, S J Schaffer, P G Szilagyi

Workshops

ACEing ACES in Continuity Clinic: How to Identify and Address Social Determinants of Health and Adverse Childhood Experiences
Saturday, April 30 - 8:30-11:30am
M J Steiner, S Schilling, J R Serwint, M Morreale, R C Samuels, L Garfunkel, S Dabrow, J Kaczorowski

Teaching the Change You Want to See: Involving Pediatric Residents in QI in Continuity Clinic Using Adolescent Immunization as a Template
Sunday, May 1 - 12:00-3:00pm
S Humiston, P M Darden, J Shaw, P Szilagyi, C M Rand, S Schaffer, J R Serwint, W Stratbucker

CORNET Transitions

Region Research Chair Recruitment
We are seeking APA CORNET members from Region I and Region X to serve as members of the CORNET Executive Committee in the role as Region Research Chairs.  As a member of this Committee, you will benefit by learning from others, improved networking while making new friends and professional contacts, and developing opportunities for collaborative research.  This is a great way to add "national contributions" to your CV.

The CORNET Executive Committee will consider the materials from all interested applicants for this position.

The Role of a CORNET Regional Research Chair is to:

  • Facilitate communication among the Region's CORNET member sites and direct information to and from the Executive Committee.
    • Set up a regional email listserv and/or make periodic phone calls to regional training programs.
    • Provide communication at least quarterly with regional sites.
    • Represent and present updates about CORNET at Regional APA meetings.  Materials can be obtained from the Network Director or Coordinator.
  • Solicit additional institutions/practices within their region to participate in CORNET.
  • Solicit and help generate research study ideas from regional practices.
  • Communication with regional practices about upcoming research studies and recruit interested practice sites.
  • Assist participating practices whenever possible in the implementation of research studies through mentoring.
  • Help maintain regional lists of programs.
  • Advise on possible funding opportunities.
  • Attend the annual 1½ day national CORNET planning meeting following the PAS meeting.  We have been able to provide 1 night's hotel accommodation for this purpose; however, transportation must be available through the member's own institution.

To apply, please submit your name, CV, and a brief summary describing your interest in serving on the CORNET Executive Committee as a Regional Research Chair to hollyce@academicpeds.org.

Do you know your Regional Research Chair?
Here is the current list of CORNET chairs by APA region.  Please reach out to your local contact for any questions or research ideas.  They would be happy to provide you with guidance and suggestions.

Region I: To be filled
Region II: Allison Gorman, agg9003@med.cornell.edu
Region III: Lynn Garfunkel, lynn.garfunkel@viahealth.org
Region IV: Mike Steiner, msteiner@med.unc.edu
Region V: Heather Burrows, armadillo@med.umich.edu
Region VI: Sue Heaney, Heaney@slu.edu
Region VII: Teresa Duryea, teresad@bcm.edu
Region VIII: Sharon Dabrow, sdabrow@health.usf.edu
Region IX: Wendy Hobson-Rohrer, wendy.hobson@hsc.utah.edu
Region X: To be filled

A Letter from our CORNET Research Coordinator, Nui Dhepyasuwan

Hi Everyone,

I wish I could do this in person, but this is the best way to reach all of you. I wanted to let you all know that I am leaving APA CORNET. I'm excited to pursue an opportunity where I will take on an advanced role as a Director of Research and Quality Programs at The Uro-Gynecologic Society. I am so grateful that I can utilize my years of experience in research in working with you within CORNET and grow my expertise in another capacity. Please know that this was NOT an easy decision to make as I have enjoyed my time with CORNET and I treasure having had the opportunity to work with all of you.

Without such a positive group of people behind me (all of you), I wouldn't be where I am today. All of your passion and volunteerism in 'continuity' became my passion for the last 10 years. Thank you all for your support and encouragement that you have provided me during my time with CORNET. I may not work in the same office as all of you, but I truly appreciated and enjoyed all the correspondences from afar. I enjoyed the time on conference calls, working with all of you on various tasks, and accomplishing the important research projects, workshops and manuscripts that we produced as a team. Seeing the camaraderie in CORNET and how it all comes together is truly something that has inspired me.

My last day was March 10th. If possible, I do plan on attending PAS to say goodbye as you all mean a lot to me and I hope we can keep in touch. Again, thanks so much for everything. It has been a pleasure working with all of you.

Sincerely,
Nui

A Letter from our outgoing Network Director, Janet Serwint
Dear Colleagues,

As I step down as the Network Director of CORNET, I wanted to take this opportunity to offer some reflections and also much deserved thanks to you, our CORNET members.   To be able to help to develop CORNET was a dream come true for me.   From the beginning of my career I have been dedicated to the care of poor, underserved children and ensuring high quality of care through clinical research and educational opportunities to learners.  What a privilege to be able to design a practice based research network that addressed these goals!  CORNET evolved through the APA Continuity SIG whose members have similar goals.  We first presented a SIG workshop on conducting research in continuity sites during a 1995 PAS meeting .  During the workshop we identified over 70 research studies conducted in 70 individual  continuity practices. This workshop was a call to many of us in the Continuity SIG for future research opportunities.   I developed a survey of pediatric residents to assess their learning goals and experiences at various continuity clinical sites.  While I had distributed the survey to the residents in my program at Hopkins, the results from 76 residents from a single training program didn't seem too compelling.  So I went to the Continuity SIG meeting and asked for 3-4 additional programs to participate.  Imagine my surprise, and joy, when 42 continuity directors expressed interest in participating and 36 programs completed participation, leading to responses from > 1100 residents.  What a powerful example of the potential of collaboration and also the passion that many of us have about our work and the need to disseminate and share results.   The results of this survey were published and influenced future RRC guidelines on the continuity experience.

CORNET was officially launched in 2002 when my colleague and friend, Sue Feigelman, joined me in writing an infrastructure grant to the Agency for Healthcare Research and Quality.   Who would have believed they would fund us?  It was fairly amazing since to that point in time we had little pilot data to support our ability to form a network.  Yet, this was truly a launching point for CORNET.
Since that time CORNET has thrived, mainly due to the interest, passion and dedication of our Steering Committee, Executive Committee and our members.  Our studies have bridged critical health care issues of underserved populations with important research and educational goals.   We have received funding from national funders including AHRQ, HRSA/ MCHB, CDC and NIH and also foundational grants from individual institutions that have supported our work.   The current enrollment in CORNET includes 125 clinical practice sites, which are affiliated with 105 pediatric training programs (52% of all pediatric training programs nationally). These sites provide primary health care to more than 851,800 patients and include the training of over 5,500 categorical pediatric and medicine-pediatric residents nationally, with an average of 52 residents per site (16-150). Two-thirds of sites are located at hospital-based clinics with the remainder at hospital-affiliated buildings, United Stated military clinics, community health centers, private practices and health maintenance organizations.
Our research network has contributed 18 peer reviewed manuscripts, 25 presentations at national meetings and 9 workshops at PAS meetings (including presentations at the 2016 PAS meeting this year.  See other portions of newsletter for 2016 PAS events).  This productivity represents input from more than 60 discrete co- authors on manuscripts and greater than 200 site co-investigators, a wonderful example of the mentoring that takes place through CORNET.   It has been inspiring to work with colleagues who have had limited past research experience and through their involvement in protocol reviews have developed into colleagues who can critically propose important and well-designed research studies.   CORNET studies have been published in high impact journals and spanned many topics including parental perception of high quality health care in continuity practices, a randomized controlled trial of an educational intervention on oral health, addressing health care disparities in Spanish speaking patients, adherence to asthma guidelines, the importance of mental health counseling,  and most recently, quality improvement projects to enhance adolescent HPV vaccine administration.  Throughout, our work has focused on the detrimental health effects of growing up in poverty and eliminating  health care disparities.  
I am so proud of the work we have accomplished.  It demonstrates what can be achieved when a group of motivated and talented colleagues contribute to something larger than any one individual can achieve.   Again a demonstration of the power of collaboration. 

I have many thanks to offer because the strength of CORNET is due to its members and mentors.   Mort Wasserman and Eric Slora from the PROS network were instrumental in mentoring us in the initial phases of our development, inviting a CORNET member to sit on the PROS Steering Committee and forming collaborative studies between PROS and CORNET.  I would like to thank the APA Board for supporting CORNET to become the first APA endorsed practice based research network.  Also thanks to Peter Szilagyi who assisted us during lean times in incorporating CORNET as a research platform for interesting immunization related studies that have been incredibly successful. 

Members of the Steering Committee make up the backbone of our network.   I would like to thank Sue Feigelman for her dedication and support in the initial development of CORNET.  Sue served as a co-director during my APA presidency and has remained an active member of the CORNET Steering Committee.  Thanks to Paul Darden, who as APA President, had the vision to support practice based research networks in his APA  presidential address and also worked out a business plan for success.   Paul remains as a critical member of the Steering Committee and has led our most recent successful studies on immunization delivery.   Marilyn Dumont-Driscoll has served as the membership chair of CORNET and has been essential in the recruitment of members and also writing  the newsletter.  And finally, I wish to acknowledge Bill Stratbucker who contributes his expertise in educational research and quality improvement.  Bill has also served as our workshop guru and led CORNET in the successful implementation of our first five CORNET workshops! 

Our Executive Committee is also critical to the functioning of our network and serves as our compass in determining  which studies to pursue and future goals.   Thanks to the members of our Executive Committee (both past and present).   These members include:  Michelle Barratt, Heather Burrows, Sharon Dabrow, Teresa Duryea, Cindy Ferrell, Lynn Garfunkel, Allison Gorman, Susan Heaney, Terry Hetzler, Wendy Hobson- Rohrer, Ellen Link, John Olsson, Richard Pan, Ron Samuels, Lee Sanders and Mike Steiner.

The CORNET administrative core is incredibly important to mention.  Thanks to Beth King and Holly Tyrell who have made critical contributions in organizing calls, helping with study protocols, assisting with data analysis and dissemination of results.

But my most heartfelt thanks goes to Nui Dhepyasuwan.  (It has taken me all these years to successfully spell your last name Nui J. ) Nui has been the heart of CORNET.  Her dedication, determination, creativity, amazing work ethic, and commitment to producing the most high quality products possible has been inspiring to watch.  I have been incredibly fortunate to be able to interact with her often, and see her as a true partner and life- long friend.    

I am thrilled to be leaving CORNET in the competent hands of Iman Shariff, MD, MPH, who I have had the privilege to work with over the past 12 months.  Her vision, wisdom and dedication is exactly what can take CORNET to the next successful phases.  I leave with the hope and vision that CORNET will continue to address eliminating poverty in children over the next decades.   Thank you for working within CORNET and for providing me such valuable experiences, sharing with me your knowledge, and being wonderful colleagues and friends. 

Sincerely,

Janet Serwint


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