The newsletter provides you with an update on NorTex projects and members. It is published twice a year.  Please let us know if you have any feedback, questions, or suggestions. Thank you again for your contribution to NorTex! We look forward to collaborating with you in the future.

An interdisciplinary approach is required to address and improve population health by providing innovative as well as relevant information for public health and clinical interventions. In doing so, population needs are met through multi-perspective lenses by understanding that health concerns are multifaceted and complex. Our vision at NorTex is to create solutions toward a healthier community through interdisciplinary primary care, public health service, research and education. What we do at NorTex cannot be done in silos. It requires an interdisciplinary approach to ensure we are improving the health of the overall community. In response to this, NorTex created two advisory boards, community and clinical, that work together to advise NorTex as new projects, events or engagement opportunities come up. These two advisory boards meet twice a year – one joint meeting in the spring and separate meetings in the fall. The Community Advisory Board has seven members and serves NorTex by providing expertise from a wide array of community organizations. The purpose of the Community Advisory Board is to review and analyze initiatives in NorTex to ensure we are meeting the needs of the community, all while providing culturally sensitive materials that are appropriate. Its guidance helps determine the implications of our projects in the community. Members of the board include nonprofit organizations; a county public health department; and health systems, such as a hospital organization, home health and hospice care, a minister, community health care, an entrepreneur, pharmaceutical and a family medicine clinic.

The Clinical Advisory Board has eight members. The purpose of the Clinical Advisory Board is for members to collaborate and provide clinical advice on conducting innovative, meaningful research. This is an opportunity for clinicians to give input and break down barriers so we can work together across the metroplex as well as collaborate with other primary care researchers in our community. One example is our current project with the primary objective to reduce health care disparities by using a data-driven research approach between family medicine clinics of The University of North Texas Health Science Center at Fort Worth, John Peter Smith Health Network and UT Southwestern. The board is made up of providers and researchers from diverse organizations that include hospital networks, such as JPS Health Network, Cook Children’s and UT Southwestern, a federally qualified health center and academic clinic practice.

NORTEX RESEARCH PROJECTS

FEATURED CURRENT NORTEX PROJECT

HPV CHAT: Implementation of education training in clinical and community settings

The HPV CHAT project seeks to increase HPV vaccinations in Tarrant County within the community and clinical settings by sharing communication tools with health care providers, clinical staff and volunteers to support HPV vaccination recommendations and respond to patient concerns.

Since launching in May 2022, HPV CHAT has been implemented in 15 clinics, and a total of 309 clinical personnel completed the brief, asynchronous training. In addition to clinical settings, 76 volunteers were trained in preparation for community vaccine outreach events. After the training, more than 70% of participants were knowledgeable about HPV vaccination guidelines. In addition, nearly 70% of participants reported feeling confident in their ability to talk to patients about the HPV vaccination.

Across these community and clinical settings, roughly 2,500 education handouts were distributed to community members to facilitate educational awareness of the HPV vaccine. In addition, nearly 6,000 vaccination reminder messages were disseminated to promote HPV vaccination series completion across Tarrant County. Throughout this entire initiative, more than 600 vaccine administration fees were covered at back-to school immunization and school-based immunization events.

This initiative is led by Dr. Erika Thompson at HSC and includes partnership with Dr. Sarah Matches (HSC), Dr. Kimberly Fulda
(NorTex, HSC), Dr. Rachel Meadows (JPS Health Network), Dr. Divya Patel (UT System), Ann Salyer-Caldwell (ICTC) and Grace Maynard (HSC). This project was supported by The University of Texas MD Anderson Cancer Center. Moving forward, the training will be adapted for continuing education credits. For additional information about the HPV CHAT program, please visit: www.unthsc.edu/school-of-public-health/hpv-chat/

FEATURED COMPLETED NORTEX PROJECT

Primary care interventions to improve medication safety- a qualitative study 

Background: Many sources state that patients are frequently harmed by lapses in primary care medication safety. We investigated beliefs and actions taken by primary care physicians and their teams to improve medication safety.

Results: We identified 132 distinct primary care work system strategies to improve medication safety. PCPs and their teams believe that medication safety is an important responsibility of all team members and is expressed through patient-shared decision making, medical decision making independent of patient input, educating patients and their caregivers, providing clinical infrastructure, and providing asynchronous care separate from an office visit. Major actions taken by PCP teams reflected many key principles of high reliability organizations, such as sensitivity to operations, reluctance
to simplify and commitment to resilience. PCP teams interact with many other agents in the complex health care system that they cannot control but they must respond to using logic of anticipation and logic of resilience. Medication safety in primary care is realized through actions taken by front-line caregivers with customized processes and resources, such as adjusting medications in response to insurance company formulary changes, writing out instructions in non-English languages, and deviating from simplistic single-disease guidelines in response to patient-specific co-morbidities or preferences, rather than a top-down command-control algorithm-driven approach to care. PCP teams work within open or distributed work systems rather than the closed systems of previous health care safety exemplars, such as hospital surgical or inpatient environments. Compared to closed systems, many of the root causes of safety events are not within the primary care work system’s control.

Conclusion: PCP teams improve medication safety through anticipatory and resilient responses to many external forces coming from open systems they cannot control.

Project Investigators: Richard Young, MD; Katheryn Daniel, PhD;Kimberly Fulda, DrPH; Anna Espinoza, MD; Yan Xiao, PhD

Texas Advocates is a statewide nonprofit organization that provides a range of services across the state to adults with intellectual and developmental disabilities and their family members. TA is the Lone Star State’s only organization governed entirely by individuals with intellectual and developmental disabilities. With 20 chapters across the state, it is a busy, productive organization dedicated to ensuring Texas adults with IDD are prepared to speak up and advocate for themselves in their communities and before policymakers at every level.

PROGRAMS

Next Chapter Book Clubs
• Now in its fifth year, the NCBC program is available in 1 1 communities statewide with new chapters in the planning stage, engaging more than 150 individuals in recreational reading
experiences. Meeting in-person, online or in hybrid sessions, club members select their own books, read them aloud to each other in English or Spanish, and then have spirited discussions.

Self-Advocacy Conference
• An annual conference focused on self-advocacy, rights, voting, alternatives to guardianship, healthy relationships, self-determination, peer support, employment, finances and many more relevant topics. It will even include great social events such as Fun Night and the Awards Banquet & Dance.

LEAD Project: Leadership, Empowerment, Advocacy & Self-Determination
• A new program that is poised to select its first cohort of 10 trainees from Travis/Williamson County in early fall 2023, designed to prepare them for and connect them to leadership opportunities in local and statewide nonprofit and governmental organizations. This program will engage, train and support 10 leaders a year in varied locations with McLennan County selected as its training site for 2024-2025. It is funded by Texas Council on Developmental Disabilities.

For more information, go to www.texadvocates.org or email deborah.wallace@texadvocates.org

The Texas Primary Care Consortium is a statewide collaborative initiative led by the Texas Medical Home Initiative in partnership with Texas Health Institute. TPCC is the only multisectoral network focused on primary care in Texas. Its mission is to advance equitable, comprehensive and sustainable primary care for all Texans.

11th Annual Texas Primary Care Consortium Summit: Creating Stronger Primary Care Together for a Healthier Texas
NOV. 2-3, 2023
Participants from broad and diverse backgrounds across the public health and health care spectrum will gather to address the challenges of putting primary care front and center in our health care system. You will leave the summit with a more comprehensive understanding of today’s health care challenges, best practices, lessons learned and available resources — feeling supported and more equipped than ever to improve the health of Texans.

To register: tinyurl.com/yxa9jacm

Dr. Maria Crompton is dual board-certified in family medicine and lifestyle medicine and currently serves as the new director of rural medical education. Among other things, the Office of Rural Medical Education is known for offering the ROME programs, most notably the Rural Scholar’s program – an innovative educational curriculum designed to prepare students for life and practice in rural and underserved communities. She is also a recipient of the 2023 Gold Humanism Honor Society, a nationally recognized organization that embodies the spirit of empathetic, patient-centered care and humanism in medicine.

Crompton received her Bachelor of Science from the University of North Texas and was a rural track graduate in 2008 from the Texas College of Osteopathic Medicine, she then completed residency training in Waco at the MCMERF Family Residency Program. After residency, Crompton practiced outpatient and inpatient family medicine in East Texas at a rural health clinic and critical access hospital. She also served as medical director for its cardiac and pulmonary rehabilitation program. She discovered a passion for teaching after becoming faculty for the UTHSCT Rural Family Medicine Residency program and working with the family medicine residents. She and her family relocated back to Fort Worth and returned home to TCOM in December 2019 as an assistant professor in the Department of Family Medicine and OMM.

In practice, Crompton emphasizes whole-person, holistic care as a cornerstone of osteopathic medicine with a special interest in the needs of rural and underserved communities. Her scholarly activity has predominantly involved social determinants of health and health disparities with the aim of bridging primary care and public health in order to improve health outcomes. Outside of work, Crompton loves nature, sports, music and spending time with her spouse, children and three dogs. As a seasoned ultra-runner, you will find her out on the trails or leading the monthly Walk With A Doc. She welcomes you to join along! She might also be found coaching youth sports in the community or enjoying a game.