• AAFP National Research Network Newsletter – Winter 2019

    In This Issue

    AAFP NRN News

    Member Highlight: Ed Bujold, MD, FAAFP

    I became part of the Ambulatory Sentinel Practice Network (ASPN) more than 25 years ago. This organization eventually morphed into the AAFP NRN. I spent two wonderful afternoons with Dr. Curtis Hames in Claxton, Georgia, interviewing him for a book I was writing. He suggested I consider joining the ASPN. He was a member of their advisory board. Being a practicing clinician, I was a bit reluctant to step into this arena. Looking back now, I am so glad he pushed me in this direction. I was immediately struck by the collegiality of the physicians and researchers there and immediately felt these people were kindred spirits interested in practice improvement and research bubbling up from practices like mine. I finished writing my book the following year, and Dr. John Hickner was the president of ASPN. John read my book and offered to buy copies of my book for each member of ASPN attending the conference that year. This cemented my relationship with the organization.

    Ed Bujold, MD, FAAFP

    Since then I have been involved in several collaborative projects and have had the opportunity to write my own papers with help from the outstanding team the AAFP NRN provides to help get some of our members’ work into appropriate medical journals. I now feel I have closed a loop. I have been on the AAFP NRN's advisory board just as Dr. Curtis Hames was more than 30 years ago.

    One of the greatest benefits the AAFP NRN has offered me personally is the ability to connect with university professors, thought leaders, policymakers, and other likeminded professionals. I have been able to give back to my community by practicing cutting-edge ideas in medicine. This has allowed my practice to be at least 10 years ahead of an ever-changing curve in medicine.

    What I have been able to offer the network, the AAFP NRN has given back to me and my community tenfold. Along the way, I have made wonderful friends and look forward to seeing them each year as we continue to collaborate on projects that have made a difference to me and many likeminded physicians.

    Living in the ‘trenches of medicine’ where I do, I have always felt voices like mine have contributed to the body of research the AAFP NRN produces. This means a lot to me and others in my position. It has also prevented me from ever being burned out. I firmly believe physicians who meaningfully engage in practice-based research networks don't get burned out, and I am now collaborating with colleagues to prove that researchable idea. I am now 67 years old and have no intention of retiring. My professional life is really too interesting to stop right now.

    For further details about practice-based research, I’d like to refer you to the North American Primary Care Research Group (NAPCRG) website. The video at the top of the page describes primary care research and physicians like myself and others working in in the trenches of primary care. The interviews half way down the page shows myself and my Canadian colleagues discussing the work we have done.  At the bottom of the page, there is a book section. A link to my book, "An odyssey of primary care research, historical perspectives," can be found there. It is now free on Kindle through Amazon.

    In closing, I would like to say that I have had a very interesting career which never would have been possible without my involvement in the AAFP NRN. Thanks for the ride!

    Meet the AAFP NRN Staff

    In 2019, the AAFP NRN celebrates its 20th anniversary. On November 1, 1999, the network was established. Our mission is to cultivate, conduct, and disseminate primary care research that improves health care and benefits the health of patients, families, and their communities. Our staff help us accomplish this mission every day. The AAFP NRN staff consists of: (2nd row) Jennifer Carroll, MD, MPH; Keron Hopkins, MA, MPA, CRA; Cory Lutgen; Brian Manning, MPH, CHES; Joel Shields, MA; Angela Lanigan, MA, RD; (1st row) Kaari Van Auken; Christina Hester, PhD, MPH; Elisabeth Callen, PhD, GStat; Ashley Grill, MPH, RDH; Natalia Loskutova, MD, PhD; Ileana Cepeda, MPH.

    Featured Staff Member

    Keron Hopkins, MA, MPA, CRA, is the research and operations administrator for the AAFP NRN. She has worked in research administration for 20 years. She was first introduced to the field while working as a James E. Webb Fellow at the Smithsonian Institution. During that time, she was principal in the drafting of its misconduct in science policy. In addition to the AAFP NRN, Hopkins sharpened her skills working at American University, the Smithsonian Institution, George Washington University, Kansas University Medical Center, the University of Kansas, and the University of Missouri-Kansas City.

    "Working for the AAFP NRN has been an amazing opportunity," Hopkins said. "I love its dynamic nature. It has afforded me the opportunity to use my current skill set. Because of its dynamic nature, I continue to learn new things and news ways of doing things."

    In 2015, she became a certified research administrator (CRA). She is currently a member of the Society of Research Administrators International (SRAI). During her membership with the National Council of University Research Administrators (NCURA), she presented at its 2016 regional meeting and its 2017 Annual Financial Research Administration conference.

    In her private business, she provides accounting and grant administration consultation to small businesses. She holds bachelor’s degrees in psychology and accounting, and master’s degrees in public administration and economics. While working on her degree in economics, she studied abroad in Brazil for one year.

    Advancing Research Through Family Medicine Discovers Program

    The AAFP Foundation’s board of trustees recently approved a plan for the AAFP Foundation to partner with the AAFP NRN on its new Signature Scientific Program, Family Medicine Discovers. This partnership and program will help advance the vision of building research capacity in family medicine in an exciting new way. The vision for the Family Medicine Discovers program is to cultivate scholarship and engagement among community family physicians to conduct rapid, feasible projects with innovative, high-impact ideas that provide great potential for advancing new evidence and knowledge generation for family medicine.
    The AAFP NRN extends its appreciation to the AAFP Foundation leadership and board of trustees for their enthusiastic support of this partnership. We are very excited about this partnership and will keep members posted as more details become available.

    AAFP NRN Activities

    Celebrating the Past and Building the Future

    Practice-based research ensures generalizability of results and makes sure that researchers develop knowledge and test innovative ideas about what works in family medicine. This is done to advance health and deliver on the Quadruple Aim of health care:

    • Enhancing patient experience
    • Improving population health
    • Reducing cost
    • Improving the work life of health care clinicians and staff

    Conducting research in practice takes building relationships and sharing information as part of a robust bidirectional engagement strategy. The AAFP NRN strives to coordinate in a way that values relationships and builds opportunities for members to engage with each other and share with fellow physicians and researchers.

    There is a changing landscape in practice-based research and finding ways to connect and grow relationships in the AAFP NRN is essential to growing the network’s opportunities and building the future of clinical practice-based research in primary care.

    As the AAFP NRN prepares to celebrate its 20th anniversary on November 1, 2019, the network is building for the future by updating its digital infrastructure with a rebuild of the AAFP NRN member database. The database will house all the intellectual assets the network has created over the years. The rebuild began more than a year ago, and the final connections in the system were put in place on October 4, 2018.

    You can help us with our rebuild and database management by keeping our membership records current. Update your information, which consists of contact information, information about your practice, personal demographic information and affiliations, and practice ownership. So far, 150 AAFP NRN members have updated their information. Staff are working to reach all AAFP NRN members. As part of the effort to engage at multiple levels of organizations, practices, and institutions, please share this link to update AAFP NRN membership records with your health care team, colleagues, practice staff, or administrators. Are you not an NRN member yet? New members can sign up through the same link.

    When you update your information in the AAFP NRN membership records, we’ll send you a choice of a coffee mug, water bottle, blanket, or tool keychain that displays the AAFP NRN logo.

    The AAFP NRN team works to recruit interested primary care physicians and health care providers to participate in studies. Some of the ways we are working to engage and grow the network include connecting members through study activities; having a presence at conferences (such as the North American Primary Care Research Group (NAPCRG) annual meeting); providing continuing medical education at Family Medicine Experience (FMX); and finding new ways to build lasting practice-based research relationships.

    Participation with the AAFP NRN can include a variety of levels of involvement, depending on the project. You can become involved with a short, one-time commitment, such as sending a letter of support for a grant proposal or taking a brief survey. More involvement might entail participating in a study or training and recruiting patients into studies. Sustaining relationships that define the network at the AAFP NRN is a top priority. For more information about us, please visit www.aafp.org/nrn.


    Elisabeth Callen and Natalia Loskutova presented, "Individuals over age 65 with chronic conditions affected by changes in weather – an early warning system for individuals and health care providers." The poster was presented at the 10th Conference on Environment and Health held January 6-10, 2019, in Phoenix, AZ.

    Callen and Loskutova presented, "The impact of extreme heat events on individuals over age 65 and the mitigation of lives lost and affected." They presented at the 24th Conference on Applied Climatology held January 6-10, 2019, in Phoenix, AZ.

    Funded Projects

    The NRN is collaborating with colleagues and NRN members at the University of Rochester (Kevin Fiscella, MD, MPH, is the principal investigator) on a recently awarded project. Christina Hester, PhD, MPH, will lead the NRN team on this Essential Hospitals Institute (Robert Wood Johnson) minigrant for the collaboration. The project is titled, "Advancing cost conversation tools, resources, and lessons."

    In collaboration Gary Chovnick, DrPH, MPH, at ICF International, Inc., Hester was awarded a subcontract for the AAFP NRN to partner with ICF to provide family physician input about the development of educational materials for the Centers for Disease Control and Prevention project, "Provider opioid education and training." Please contact Hester for more information.

    Hester and Tracey Allen-Ehrhart, from the AAFP Division of Practice Advancement, developed and were awarded a Eugene Washington PCORI Engagement Dissemination Award for "Building sustainable infrastructure to disseminate PCOR and CER findings to primary care audiences."

    Building upon his work with local refugee communities, long-time NRN investigator and faculty member at the University of Kansas Department of Family Medicine, Joseph LeMaster, MD, MPH, was awarded a Eugene Washington PCORI Engagement Capacity Building Award for "Building PCOR capacity with newcomer patients in practice-based research networks."

    We thank all of our members who have been or will be responsive to our need for help with these projects.


    If you would like a copy of any of the presentations, please contact the AAFP NRN at (800) 376-5463 or nrn@aafp.org.

    The following were presented at the poster session at the University of Colorado Denver Department of Family Medicine meeting held November 14, 2018:

    Elisabeth Callen, Jennifer Carroll, Cheryl Jernigan, Rebecca Mullen, Kim Kimminau presented "Patient-clinician-researcher engagement: steps needed to transform relationships, clinical care and research in family medicine."

    Juan Carlos Cardet, Paula J. Busse, Jennifer K. Carroll, Thomas B. Casale, Tamera Coyne-Beasley, Maureen Fagan, Victoria E. Forth, Anne L. Fuhlbrigge, Michelle L. Hernandez, David Kaelber, Barbara Kaplan, Margarita Lorenzi, Suzanne Madison, Nancy E. Maher, Karen Majewski, Brian Manning, Melissa D. McKee, Sylvette Nazario, Wilson D. Pace, Michael J. Pencina, Cynthia S. Rand, Jacqueline Rodriguez-Louis, Lilin She, Joel Shields, Jessica E. Teng, Michael E. Wechsler, Juan P. Wisnivesky, Barbara P. Yawn, and Elliot Israel, on behalf of the PREPARE investigators, presented "Adherence to adding ICS to rescue therapy in a pragmatic trial with adults with asthma – a pilot study."

    Victoria E. Forth, Juan Carlos Cardet, Paula J. Busse, Jennifer K. Carroll, Thomas B. Casale, Tamera Coyne-Beasley, Maureen Fagan, Anne L. Fuhlbrigge, Michelle L. Hernandez, David Kaelber, Barbara Kaplan, Margarita Lorenzi, Suzanne Madison, Nancy E. Maher, Karen Majewski, Brian Manning, Melissa D. McKee, Sylvette Nazario, Wilson D. Pace, Michael J. Pencina, Cynthia S. Rand, Jacqueline Rodriguez-Louis, Lilin She, Joel Shields, Jessica E. Teng, Michael E. Wechsler, Juan P. Wisnivesky, Barbara P. Yawn, and Elliot Israel, on behalf of the PREPARE investigators, presented "Patients know best – lessons learned from a pilot study to test the study design and materials for a large pragmatic asthma trial."


    Carroll JK, Pulver G, Dickinson LM, Pace WD, Vassalotti JA, Kimminau KS, Manning BK, Staton EW, Fox CH. Effect of 2 clinical decision support strategies on chronic kidney disease outcomes in primary care. A cluster randomized trial. JAMA Netw Open. 2018;1(6):e183377.

    Carroll JK, Fiscella K, Cassells A, Sanders MR, Williams SK, D’Orazio B, Holder T, Farah S, Khalida C, Tobin JN. Theoretical and pragmatic adaptation of the 5As model to patient-centered hypertension counselling. J Health Care Poor Underserved. 2018;29(3):975-983.

    Hester CM, Jiang V, Bartlett-Esquilant G, Bazemore A, Carroll JK, DeVoe JE, Dickinson WP, Krist AH, Liaw W, New RD, Vansaghi T. Mapping research capacity among US family medicine organizations. Fam Med 2019;51(2):120-128.

    Yawn BP, Israel E, Wechsler ME, Pace W, Madison S, Manning B, Doros G, Fuhlbrigge A. The asthma symptom free days questionnaire: how reliable are patient responses? J Asthma. 2018;26:1-9.