Funding: Zsolt Nagykáldi, PhD

Ongoing Research Support

Tribally Engaged Approaches to Lung Screening (TEALS Trial)
1R01CA225439-01A1, Nagykaldi (PI)  04/01/2019 – 03/31/2024
National Cancer Institute (NCI) $2,361,468
Over the course of 5 years, TEALS will: 1) Conduct focus groups and semi-structured interviews with CNHSA patients, clinicians, and health administrators to elucidate individual- and system-level barriers and facilitators that affect the implementation of LCS; 2) Develop, and iteratively refine an LCS care coordination intervention that will identify eligible persons for LCS, help these patients navigate the screening process, and link them with smoking cessation services, when applicable; 3) Measure the impact of the TEALS intervention on the receipt of screening and a set of patient- and practice-level outcomes by conducting a cluster-randomized clinical trial of LCS implementation; and 4) Disseminate the TEALS program to other researchers and healthcare systems that serve AI/AN patients.

Integrating Behavioral Health and Primary Care for Comorbid Problems – Econometric Study
PCS-1409-24372, Nagykaldi (PI)   07/01/2018 – 12/31/2020
Patient-Centered Outcomes Research Institute (PCORI) $51,984
The purpose of this project is to assist an ongoing PCORI-funded study entitled Integrating Behavioral Health and Primary Care (IBH-PC) that aims at the implementation and testing of a systematic process to move behavioral health services in primary care practices from co-location to full integration within the practice. We will work with UVM researchers to design and implement an econometric evaluation approach, which will measure the cost of implementing the comprehensive behavioral health integration program in primary care settings.

Development of a Patient-Directed Queries Network to Engage Patients and Prioritize Their Questions to Inform the PCORI Research Agenda
ME-1403-11937, Nagykaldi (PI)   01/01/2015 – 6/30/2020
Patient-Centered Outcomes Research Institute (PCORI) $867,325
In collaboration with a patient advisory board, a patient advocacy group, a community coalition, and three practice-based research networks, we will address gaps in patient-centered outcomes research (PCOR) methods in the areas of engagement and prioritization, focusing on longitudinal engagement between researchers and existing patient- and community-based organizations and use of value of information calculations. We will learn how these successful groups have achieved engagement and prioritized opportunities. We will then develop recommendations for enhancements.

Reducing Opioid Prescribing through Education and Support (ROPES-3)    
C1079906, Nagykaldi (PI)  8/1/2018 – 12/30/2020
NIH/OSCTR
This study will help practices and healthcare systems deploy a Safer and Better Opioid Therapy toolkit and scalable care delivery approaches that may optimize the use of opioid medications within primary care settings for non-cancer chronic pain and also decrease the undesired clinical outflow of narcotic drugs into the community.

Expansion and Enhancement of Medical School Curriculum to Increase Physician Workforce in Underserved Oklahoma Communities
1 T99HP335580100, Herman/Crawford (PIs)  09/01/2019 - 08/31/2023
Health Resources and Services Administration (HRSA) $4,704,476
The University of Oklahoma College of Medicine (OU) is submitting an “Expansion and Enhancement of Medical School Curriculum to Increase Physicians in Underserved Oklahoma Sites” to create the Primary Care Pathways to Sustainable Health and Healthcare Network. OU aims to develop this Primary Care Pathways Network to identify and mentor students from tribal, rural, and medically underserved communities in Oklahoma (TRU-OK) beginning K-12 through medical school.
Role: Co-Investigator

Building Rural Stakeholder Engagement in Patient-Centered Type 1 Diabetes Research
10443-CU, Vanessa Jewell (PI/Creighton)  11/01/2018 – 10/31/2020
Patient-Centered Outcomes Research Institute (PCORI) $11,953
Dr. Nagykaldi will support this PCORI award as a consultant with expertise in the areas of comparative effectiveness research methodology, community-engagement, and patient-centered outcomes research specifically in rural and other underserved communities. In addition to ongoing consultations, Dr. Nagykaldi will meet with key personnel 2-3 times to share his CER expertise in the form of interactive learning and workshops.
Role: Consultant

Disseminating and Implementing PCOR through the Oklahoma Primary Healthcare Extension System (H2O)
1R18HS023919, Daniel Duffy (PI/OUHSC)  05/01/2015 – 4/30/2020
Agency for Healthcare Research and Quality (AHRQ)  $14,988,420
The goal of this project is to create a Primary Healthcare Improvement Center to support the continuous quality improvement in primary care practices in Oklahoma. This project will accomplish three important tasks: 1) construct an effective and sustainable primary healthcare extension system to disseminate and implement the results of patient-centered outcomes research; 2) to help 300 small to medium-sized primary care practices improve management of four cardiovascular disease risk factors, smoking, blood pressure, cholesterol, and use of low-dose aspirin; and 3) to evaluate the effectiveness of the chosen implementation strategies.
Role: Co-Investigator

Institutional Development Award (IDeA) Program Infrastructure for Clinical and Translational Research
1U54RR033563, James (PI/OUHSC)  08/01/2018 – 07/31/2023
NIH $1,496,350
We propose to strengthen productive bidirectional relationships between researchers and communities in Oklahoma with an emphasis on primary care clinicians, pharmacists, and American Indian communities, expand community test sites by enhancing three practice-based research networks and build a system-wide dissemination/implementation/diffusion infrastructure consisting of county health improvement organizations (CHIOs) linked to each other and, through regional coordinating centers, to the academic research partners.
Role: Co-Investigator

Addressing Health Disparities among Oklahoma Minority and Rural Communities through Clinical Research Education and Career Development
1R25MD011564-01, Stoner, Houchen (Co-PI)  9/24/2017 – 5/31/2022
National Institutes of Health (NIH/NIMHD) $499,072
The overall goal of this research education and career development program is to enhance clinical research methods expertise and research careers among underrepresented researchers focused on health disparities and minority health.
Role: Senior Mentor and Course Instructor

Testing the Effectiveness of Individualized Disease Prevention for Middle-Aged Adults
R01AG059979, Taksler (PI/Cleveland Clinic)    04/01/2019-03/31/2024
National Institute on Aging (NIA)     $497,878
This project will help middle-aged adults to make an informed decision about the health care services that are most likely to promote a longer, healthier life.  We will adapt a previously-published analytic model to incorporate quality of life and integrate a previously-developed decision aid into electronic health records.  Then, in a randomized trial at diverse primary care clinics, we will test of effectiveness of the decision aid on preventive care utilization for middle-aged patients.
Role: Co-Investigator

Building the Heartland Regional Genetics Network
UH7MC30777,  Dean, L (PI)   06/2017-05/2020
Health Resources and Services Administration (HRSA) $1,800,000
The purpose of the Heartland Regional Collaborative is to improve access to quality genetics services to vulnerable populations.
Role: Co-Investigator

CCSG – supplemental #2 – Building Cancer Survivorship Research Capacity in Rural Oklahoma
3P30CA225520-01S1, Mannel, Robert (PI)  05/01/2019 – 04/30/2020
National Cancer Institute (NCI) $96,469
Use community-engagement processes to co-design a tailored cancer care coordination system featuring nurse rural cancer care coordinators (RC3s) embedded within rural healthcare delivery systems who will help improve ONC-PCP communications. Test preliminary effectiveness of the RC3 implementation by examining processes and outcomes using a quasi-experimental design with patient- and system-level care coordination measures collected before and after implementation in at least 30 CNHSA and 30 WCWI patients. Identify factors that facilitate or hinder RC3 effectiveness.
Role: Co-Investigator

CCSG – supplemental #2 – Colorectal Cancer Screening Implementation in Partnership with Native American Communities
3P30CA225520-01S2, Mannel, Robert (PI)   05/01/2019 – 04/30/2020
National Cancer Institute (NCI) $224,082
The overall objective of the two-phased project is to increase CRC screening uptake in AIs aged 50 to 75 years who are at average risk for CRC. For this purpose, we will test the effectiveness of a comprehensive, multilevel (i.e., individual, community, and systems/ organizational), and multi-component (i.e., small media, navigation services) intervention with AI populations (on and off tribal lands) across the three states. We will focus on culturally appropriate evidence-based strategies that promote any guideline approved CRC screening (i.e., fecal immunochemical test, colonoscopy, computed tomographic colonography). During the planning phase (Year 1, eight months), we will build community-academic partnerships between I/T/U healthcare facilities, tribal entities, and university-based cancer centers; and secure tribal authorizations, IRB approvals and data sharing agreements. We will also adapt and pilot test the intervention processes and strategies. During the implementation phase (Years 2-5), we will test dissemination and implementation of multilevel and multi-component evidence-based strategies for enhancing screening. We will finalize these strategies after participatory input from our three state-specific Community Advisory Committees. Findings from this research could lead to an immediate increase in CRC screening and ultimately enhance cancer health equity by reducing the preventable CRC disease burden among AIs.
Role: Co-Investigator

Completed Research Support

Promoting the Development and Dissemination of Practice Facilitation in North America
1R13HS025315-01, Nagykaldi (PI)   07/01/2017 – 06/30/2019
Agency for Healthcare Research and Quality (AHRQ) $105,000
The Steering Committee of the Coordinated Coalition of Primary Care Research Networks (CoCoNet2), working with the North American Primacy Care Research Group (NAPCRG) and other collaborators will develop and organize National Practice Facilitation Conferences to be held in 2017, 2018, and 2019 in conjunction with the PBRN Annual Meetings with an overlapping plenary session relevant to both audiences. The PF conference will: 1) Provide a novel venue for PFs that will be extended and reinforced through an ongoing, national learning community; 2) Support the diffusion and sustainability of practice facilitation by disseminating innovations, knowledge, best practices, and useful resources; and 3) Promote the evolving science of practice facilitation through research presentations, forums, workshops, and continuous professional networking.

Individualizing Disease Prevention for Middle-Aged Adults
1R21AG052849-01A1, Taksler (PI/Cleveland Clinic)  12/01/2017 – 3/31/2019
National Institute on Aging (NIA)     $290,178
Individualizing Disease Prevention for Middle-Aged Adults” will help middle-aged adults to make an informed decision about the handful of health care services that are most likely to promote longevity.  We will employ a previously-published analytic model to learn how to communicate the net benefits of all major preventive care services, individualized for a patient’s age and risk factors, and build a web-based portal. We will pilot test the framework with middle-aged adults.
Role: Co-Investigator

Disseminating Patient Centered Outcomes Research to Improve Healthcare Delivery
1R18HS023237-01, Nagykaldi (PI)   07/01/2014 – 12/31/2018
Agency for Healthcare Research and Quality (AHRQ) $1,340,397
We propose to implement a sustainable, county-based preventive services delivery model that aligns incentives for primary care practices (PCPs), county health departments (CHDs), and hospitals in 3 rural counties.  Wellness coordinators will remind patients of recommended primary (immunizations), secondary (screening), and tertiary (chronic disease management) services and direct them to the most appropriate services and resources. Primary care practices will implement systematic screening for tobacco use and physical inactivity and provide brief counseling and referrals. The model will be supported by a comprehensive, web-based Preventive Services Registry and Wellness Portal/Health Risk Assessment tool interfaced to PCPs’ electronic health record systems (EHRs). We expect to reach about 70,000 patients cared for by 59 clinicians in 20 primary care practices (PCPs), increasing delivery of preventive services and average estimated life expectancies, while producing financial and other benefits (e.g. improved health care quality metrics, a better community-level coordination of care, etc) to local hospitals, PCPs, and county health departments (CHDs).

Rebuilding the SoonerSuccess Tiered Care Navigation System
OUHSC#950130, Nagykaldi (PI)  01/01/2014 – 12/31/2018
Oklahoma SoonerSuccess Program $4,000
A step-wise assessment and rebuilding of the Oklahoma SoonerSucess Program’s care navigation and tracking system for children and adults with special care and developmental services needs.

Establishing the Coordinated Consortium of Networks (CoCoNet)
1P30HS021644-01, Nagykaldi (PI)  09/1/2012 – 12/31/2017
Agency for Healthcare Research and Quality (AHRQ) $532,934
This initiative will create a formal, coordinated coalition of regional practice-based research networks called CoCoNet (the Coordinated Coalition of Networks) that will include a broad spectrum of practices, clinicians, and patients from 4 different parts of the country.

A Community e-Health Promotion Program Addressing Oklahoma’s Urban Disparities
PA-14-001, Kathleen Dwyer (PI)   07/01/2015 – 06/30/2017
Agency for Healthcare Research and Quality (AHRQ) $300,000
Health disparities persist in spite of widespread public health efforts. Approaches that can influence health culture in communities, beyond the regular clinical environment are needed. We have partnered with the Faithful, Fit and Strong Health Collaborative to conduct the study in African American churches. The proposed study couples an enhanced web-based HRA, used successfully in the primary care setting, with personalized, goal directed health planning, facilitated by health coaching. An evidence-based and strategic community health improvement approach using systematic health risk assessment has great potential to create healthier communities and will facilitate the translation of evidence-based clinical guidelines into practice and create a roadmap for other organizations to engage their communities in prevention and health promotion.
Role: Co-Investigator

Improving the Adoption of Advance Directives in Ambulatory Care Settings in Oklahoma
OUHSC OSCTR Grant, Wickersham (PI)    07/01/2016 - 06/30/2017
NIH $100,000
We will compare the practice-level adoption rates of the "Five Wishes" Advance Directive (AD) document to those of the current standard Oklahoma AD form in a small, pair-matched, cluster-randomized clinical trial in 6 community primary care practices as our primary outcome measure. We will implement the two ADs in 6 practices (3 practices in each arm) and follow the process of AD adoption and maintenance. We will also determine and compare the experience of patients and clinicians using the two AD forms via semi-structured interviews either over the phone or in person. Clinicians will be similarly interviewed about their experience with AD adoption.
Role: Co-I and Faculty Development Mentor

Mental and Behavioral Health Screening Through a Pediatric Integrated Health Collaborative
5U495M061259-03    Wissow (PI)    09/01/2014 – 09/30/2015
Johns Hopkins University  $21,753
The Pediatric Integrated Care Collaborative (PICC) will be developed to (1) increase the quality of child trauma services by integrating behavioral and physical health services targeting traumatic stress exposure and recovery, (2) extend accessibility of services by integrating trauma-informed behavioral health services with primary care, and (3) promote a sustainable integration.
Role: Co-Investigator

Health Risk Assessment (HRA) Preventive Care Services
PO# 0909009632, Nagykaldi (PI)  01/01/2014 – 12/31/2015
EGID/HealthChoice $43,800
Implementing a customized health risk assessment technology for the Oklahoma State Employees Insurance wellness program.

Using Health Risk Appraisal to Prioritize Primary Care Interventions
PO 1K08HS016470-01A2 Nagykaldi (PI)    09/01/2008 – 08/31/2013        
Agency for Healthcare Research and Quality (AHRQ)
The K08 Proposal has three specific aims: 1) Conduct a systematic review of the existing literature in order to refine a novel implementation model of a clinically integrated Health Risk Appraisal (HRA) implementation that will help clinicians prioritize evidence-based interventions; 2) Refine and pilot test the integrated HRA technology within a primary care practice-based research network to determine the feasibility of implementation and the efficacy of the instrument; 3) Conduct a randomized clinical trial to examine the impact of this integrated HRA approach on important patient outcomes, including estimated life expectancy, patient centeredness of care, and provider and patient satisfaction in primary care practices.

Using Health Information Technology to Improve Healthcare Quality in Primary Care Practices and in Transitions Between Care Settings (AHRQ Task Order #17)
Contract No.: HHSA290200710009I, Mold (PI)   10/1/2009 – 12/31/2012
Agency for Healthcare Research and Quality (AHRQ)
The purpose of this task order is to develop and study the impact of a regional Health Information Exchange (HIE) between a collaboration of primary care providers in Norman, Oklahoma and hospitals in Oklahoma City.
Role: Co-Investigator

Impact of a Wellness Portal on the Delivery of Patient-Centered Prospective Care
PO R18HS017188, Mold (PI)   09/01/2007 – 05/31/2011
Agency for Healthcare Research and Quality (AHRQ)
The goal of this project is to develop and test a patient Wellness Portal that activates and empowers patients to improve their preventive care collaborating with their primary care clinicians.
Role: Co-PI

Expansion of the PBRN 'Stay-at-Home Influenza Toolkit' (AHRQ Task Order #18)
Contract No.: HHSA 29020077100091, Mold (PI)   9/1/2009 – 6/30/2010
Agency for Healthcare Research and Quality (AHRQ)
The purpose of this task order is to redesign and expand an influenza patient self-management web-based toolkit and develop a web package and implementation manual that primary care practices can use to customize and implement the toolkit in their environment.
Role: Co-PI

Collaborative Research: DRU: Hypothesis Generation and Feedback in Dynamic Decision Making
SES-0624136, Hamm (PI)  10/01/06 – 09/30/09
National Science Foundation
The purpose of this project is to validate findings from collaborators who are conducting cogIBLT modeling studies, using stimulus materials that have hight medical fiedelity and using individuals at various levels of medical education. This work will provide insight into the kinds of training needed to prepare clinicians to deal with decision making about dynamic medical situations.
Role: Programmer

AHRQ Task Order #2: The Use of Health Information Technologies by Primary Care Practices to Support Self Care Management during a Pandemic Influenza Event
PO HHSA290 2007 10009, Mold (PI)   09/01/07 – 08/31/08
Agency for Healthcare Research and Quality (AHRQ)
The goal of this project is to improve primary care practice surge capacity by implementing technologies that assist patients in home-based self-management during an influenza epidemic or pandemic.
Role: Co-PI

Increasing EPSDT Completion Rates in Primary Care Practices
PO, Mold (PI)   07/01/07 – 06/30/08
Oklahoma Health Care Authority (Medicaid)
The goal of this project is to improve EPSDT rates and quality using academic detailing, audits with feedback, practice facilitation, and quality circles.
Role: Co-Investigator

Training in Primary Care Medicine & Dentistry: Residency Training in Primary Care
D58 HP05177-03, Reilly (PI)    07/01/05 – 06/30/08                            
Bureau of Health Professions
The major goal of this training grant is to develop, implement, and evaluate a curriculum designed to teach family medicine residents in the three residency programs (OKC, Enid, Lawton) administered by the Department of Family and Preventive Medicine (DFPM) at the University of Oklahoma, to use the Chronic Care (CCM) and Goal-Directed Health Care (GDHC) Models to improve the care provided to patients with chronic illnesses and increase the delivery of preventive services.
Role: Programmer

Enhance the Rate and Quality of EPSDT Examinations
PO# (N/A), Mold (PI)  07/01/06 – 06/30/07
Oklahoma Health Care Authority (Medicaid)
The purpose of this project is to improve both the rate and quality of EPSDT examinations performed in primary care offices in eight Canadian County practices and in other selected practices throughout the state.
Role: Co-Investigator

Creating a New Model of Delivery for Preventive Services
PO#  HR05-083, Mold (PI)    07/01/05 – 06/30/07
Oklahoma Center for the Advancement of Science and Technology (OCAST)
The goal of this project is to establish and then study, within a single primary care practice in Weatherford, Oklahoma , a model, evidence-based preventive services delivery system. The model system, which will substantially separate preventive services from routine office visits, will include brief, periodic “longevity visits” between physician and patient followed by longitudinal interactions   between the patient and a preventive services nurse.  The entire process will be facilitated by a computerized patient registry with decision support, recall and reminder, and audit functions.
Role: Co-Investigator

Delivery of Preventive Services in Primary Care
PO# 1 R21 HS014850-01, Mold (PI)   09/30/04 – 09/26/06
Agency for Healthcare Research and Quality
The major goal of this project is to study the effectiveness of a multi-component intervention to translate three office system strategies known to increase delivery of immunizations and other preventive services in a group of primary care practices. This two-year study will contribute to our understanding of multi-component translational interventions within practice-based research networks.
Role: Co-Investigator

Access Grid Node System integral to PBRN Research and the NIH Roadmap Initiative
PO, Mold (PI)     08/15/05 – 08/14/06
Presbyterian Health Foundation
The Access Grid technology is a new way to enhance academic group collaboration in the virtual space. Utilizing the high-speed Internet2 backbone that connects hundreds of academic institutions nationwide, this system increases the ability of researchers in the Department of Family and Preventive Medicine (DFPM) to collaborate with other researchers at the OUHSC, other academic medical centers, and in primary care practices across the state and the entire nation.
Role: System Designer, Clinical IT Specialist

A Project to Increase Delivery of Preventive Services to Medicaid Beneficiaries Phase IV
PO# 20030073R1, Mold (PI)    07/01/04 – 06/30/05
Oklahoma Health Care Authority (Medicaid)
A randomized, controlled trial to examine the clinical effectiveness of the Preventive Services Reminder System (PSRS), a web-based secure immunization and preventive services registry and forecasting system.
Role: Co-PI

Smoke-Free Families / Smoke-Free Beginnings
PO# (N/A), Mold (PI)   01/01/03 – 11/30/05
Robert Wood Johnson Foundation
The University of Oklahoma Health Sciences Center, Oklahoma Physicians Research/ Resource Network, and Oklahoma State Medical Association were collaborating for the implementation of a Smoke Free Families project to assist pregnant women to stop smoking and evaluate the implementation of Smoke Free Families Best Practice Intervention in private physicians’ offices.
Role: Clinical IT Specialist

Development of an Electronic Surveillance and Alert System Linking the Oklahoma State Department of Health with Primary Care Physicians
PO# Z054014, Mold (PI)   07/01/03 – 06/30/04
Oklahoma State Department of Health / CDC            
The goal of the project was the development, testing, and implementation of the OKAlert-ILI System, a bidirectional, dual-use influenza-like illness surveillance and messaging system, during the influenza seasons of 2003–2004 and 2004–2005 in the Oklahoma Physicians Resource/Research Network, a primary care practice-based research network.
Role: Co-Investigator/Clinical IT Specialist

Improving Diabetes Care In Primary Care Practices
PO, Mold (PI)   09/30/02 – 05/30/03
Oklahoma Foundation for Medical Quality (OFMQ)
The Diabetes Patient Tracker (DPT) was developed as a part of an OKPRN best practices research and development project aimed at improving documentation and delivery of medical services for diabetic patients.  Participants were introduced to the principles learned from exemplar physicians and supplied with a Diabetes Toolkit that contained findings and resources for implementation.  Following the chart audits, consultations were held with physicians and the office staff.  They were taught how to use the PDA and DPT handheld application. After and average of 4 months, patient charts in participating physician offices were audited by OFMQ to determine the post-intervention rates of delivering and documenting services.
Role: Co-Investigator

Associations Between Night Sweats and Sleep Disturbances
PO# R21 HS13557-01, Mold (PI)   07/01/01 – 06/30/02
Agency for Healthcare Research and Quality
Cross-sectional study of consecutive adult patients seen in 10 primary care physicians’ offices.  Data collected and transmitted by PDA included demographic variables, height, weight, and blood pressure, occurrence of a variety of sleep-related symptoms, and occurrence and severity of night sweats, day sweats, and hot flashes in the past month.  For women, information about menstrual status was also obtained.  
Role: Clinical IT Specialist