Special Emphasis Notice (SEN): AHRQ Announces Interest in Grants focused on Health Risk Assessment in Primary Care Settings

Notice Number: NOT-HS-10-018

Key Dates
Release Date: June 22, 2010

Issued by
Agency for Healthcare Research and Quality www.ahrq.gov

Background

The Agency for Healthcare Research and Quality’s (AHRQ) Prevention/Care Management portfolio is interested in the application of health risk assessments (HA) in primary care. HAs have the potential to improve the delivery of preventive care and care management services resulting in safer, more effective healthcare. Specifically, HAs could generate data to identify individual and population health needs, improve communication between patients and clinicians, and help clinicians and patients prioritize care to improve health outcomes.

To date, research on the use and application of HAs has focused primarily on work site settings. The Guide to Community Preventive Services has recommended the use of assessments of health risks with feedback in worksite settings when they are combined with health education programs. (http://www.thecommunityguide.org/worksite/ahrf.html) Research on the use of HAs in worksite settings cannot be assumed to be directly transferable, however, to the primary care setting.

In 2008 AHRQ commissioned an environmental scan and an expert panel meeting to learn more about how HAs are being used in primary care and to identify the research gaps related to HA utilization and outcomes. The environmental scan indicated that only 20% of large medical groups and independent practice associations were routinely using HAs. In reviewing the environmental scan, the expert panel noted that even when HAs are used the results are not always communicated in a usable format to clinicians and/or to patients. The environmental scan also indicated that HA usage has not been assessed in smaller practices and that little is known about the optimal content and format of HAs for use in primary care. Confidentiality and workload were identified as barriers to the integrated use of HAs across worksite, health plan, and primary care settings.

AHRQ has funded research that examines the potential value of HAs in guiding the appropriate delivery of preventive health services. However, additional research is needed to understand the use of HAs in primary care more broadly; the integration of the information derived from HAs with the provision of preventive services and care for patients with chronic illnesses; and the ability of standardized instruments and protocols to prompt effective HA use in primary care.

Research Areas of Interest: AHRQ encourages grant applications that propose research in two priority areas related to the use of HAs in primary care:

  • The prediction of risk using HAs in the general adult, adolescent, and pediatric primary care populations. This includes the development, testing, and implementation of algorithms or other models for health risk assessment in primary care settings.
  • The use of health risk assessments in primary care settings to improve individual and population health outcomes. This includes methods for using HA information to guide the provision of evidence-based preventive services and effective care for persons with chronic illnesses; support of patient engagement and joint decision making; and methods for effectively eliciting HA information and communicating HA results. AHRQ encourages consideration of how meaningful use criteria in health information technology could be applied to improving the use of HAs in primary care settings. AHRQ also encourages consideration of how the needs of special populations (defined, for example, by level of risk, age group, or literacy level) could necessitate different methods or solutions in the application of HAs in primary care settings.

Settings: The focus of this special emphasis notice is the use of health risk assessments in primary care settings. For the purpose of this SEN, primary care settings include: health care clinician offices; outpatient clinics; and Federally Qualified Health Centers and other primary care safety net clinics. Research projects conducted in non-ambulatory settings, and in non-primary care ambulatory settings including Emergency Departments, are not the focus of this special emphasis notice.

Further guidance:

Use of Funding Mechanisms: AHRQ will use its current R01, R18, and R03 mechanisms for applications in this area of interest.

Application Submission: With this notice, AHRQ is providing information about one of the highest research priorities for the prevention and care management portfolio. AHRQ will continue to provide regular updates of research priorities as research budget information becomes available. Applications focused on areas identified in this SEN should be submitted on regular R01, R18, and R03 grant application receipt dates. We encourage applicants to indicate in their applications that they are responding to this notice by including the Special Emphasis Notice title and number. We also encourage applicants to include a cover letter in their application package stating their interest in this SEN. Applications will be reviewed by AHRQ’s standing study sections. Information about the grant application process, including e-grant applications and the funding mechanisms noted above, can be found at http://www.ahrq.gov/fund/.

Inquiries

The AHRQ designated contacts for this SEN are:

Janice Genevro, PhD
Center for Primary Care, Prevention & Clinical Partnerships
Phone: 301-427-1627
E-mail: janice.genevro@ahrq.hhs.gov

Claire Weschler, MEd, CHES
Center for Primary Care, Prevention & Clinical Partnerships
Phone: 301-427-1577
E-mail: claire.weschler@ahrq.hhs.gov