Roberto Cardarelli, DO, MHA, MPH, is Professor and Chair for the Department of Family & Community Medicine for the University of Kentucky College of Medicine. He also currently directs the Kentucky Ambulatory Practice-based Research Network that helps primary care clinics implement quality improvement models to improve the care they deliver to their populations.
Dr. Cardarelli is a recipient of the AAMC/Donaghue Foundation award and serves as the Principal Investigator of the Reducing the Lung Cancer Burden in Northeast Kentucky through an Academic Community Partnership: A Terminate Lunch Cancer (TLC) Study.
To learn more, download Dr. Cardarelli's ROCC Star Profile (PDF).
Describe the overall aim for the Terminate Lung Cancer (TLC) Study?
The Terminate Lung Cancer study is a partnership with a community rural hospital and the region’s Area Health Education Center (AHEC) to disseminate lung cancer screening and tobacco cessation guidelines to a spectrum of learners and providers in Northeast Appalachia Kentucky, a region that suffers one of the highest rates of lung cancer and smoking. We are also testing the impact of practice facilitation through continuous quality improvement (CQI) tools and methods on lung cancer screening and tobacco cessation in 5 primary care clinics affiliated with the region’s community hospital.
We are basing our implementation strategy using the Promoting Action On Research Implementation on Health Services (PARIHS) framework. Here, we collaborate with our community partners (St. Claire Regional Medical Center and Northeast AHEC) which includes system and clinic leaders, providers, and staff to identify levers and barriers to the successful implementation of the guidelines in practice. We develop team-based (clinic-led) approaches that identify processes to best guide the implementation of the guidelines, and use CQI tools to conduct iterative small-scale process testing to further refine pragmatic approaches as we implement guidelines into practice. We even involve patients and their experiences in the process so that we can disseminate successful implementation approaches to other clinics across the state and nation.
How are you applying the lessons learned from this project as you approach other evidence-based implementation studies?
We are scaling this study in a pending NIH R01 application to involve over 5,000 patients and 14 clinics. In addition, we are applying this approach in studies related to opioid prescribing and the appropriate management of chronic pain in primary care settings.
What recommendations do you have for other researchers interested in including community partners in their research studies?
In order to make meaningful and sustaining change in a community, it is vital to not only collaborate with community organizations, but to truly partner with them from the conception of the study idea to the dissemination of project findings. As we say in community medicine, “The solution is found in the community, not in our academic medical centers.”