Bronx BREATHES

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					                                              NYCRING NEWS
                                        V O L U M E   1 I ,   I S S U E   1                     S P R I N G   2 0 0 7
       NYC RING Network
Institute for Urban Family Health
(Manhattan & Bronx)
                                                          Bronx BREATHES
Beth Israel Department of Family         In this newsletter we take the opportunity to highlight an important project
Medicine
                                     taking place in the NYC RING network, Bronx BREATHES – Bronx Einstein
Beth Israel Residency in Urban
Family Practice                      Alliance for Tobacco-free Health. Bronx BREATHES is funded by the New
                                     York State Department of Health Bureau of Tobacco Use, Prevention, and
Bronx-Lebanon Hospital Center
(Bronx)                              Control. The Principal Investigator of the project is Steven Bernstein, MD
Fulton Park Family Practice          (sbernste@montefiore.org) and project manager is Saba Jearld, MPH
Ogden Family Medical & Dental        (sjearld@montefiore.org).
Center                                   The State’s comprehensive tobacco control program aims to prevent initia-
Montefiore Medical Center            tion of tobacco use, reduce use of tobacco products through promotion of ces-
(Bronx)                              sation, reduce the social acceptability of tobacco products through promotion
Montefiore Medical Group             of cessation, and eliminate exposure to secondhand smoke through a three-
 -Castle Hill
 -Comprehensive Family Care
                                     pronged strategy: community mobilization, media and counter-marketing, and
  Center (CFCC)                      cessation. Bronx BREATHES is one of 19 Tobacco Cessation Centers in the
 -Comprehensive Health Care          state that are charged with the overall mission to promote that providers advise
  Center (CHCC)                      their patients to quit smoking. Bronx BREATHES has three main goals:
 -Family Health Center                                                                                  (Continued on page 4)
 -Fordham Family Practice
 -Marble Hill Family Practice
 -University Ave. Family Practice
 -West Farms Family Practice
 -Williamsbridge Family Practice
South Bronx Health Center for
                                      Call to join NYC RING Task Force Committees
Children and Families                     In an effort to increase collaboration among NYC RING sites and create a
(Bronx)                              mechanism for initiating small projects, we are forming task force committees
North Bronx Healthcare Network       for the following three core areas of focus within NYC RING: 1) diabetes and
(Bronx)                              metabolic syndrome, 2) behavior change and 3) depression. We are looking
Health Care Center at Gun Hill
                                     for clinicians, educators and researchers from within the NYC RING commu-
Healthcare Center at Tremont
                                     nity to participate as members on these task force committees. There will be an
Saint Joseph's Medical Center        initial face to face organizational meeting and then most subsequent meetings
Family Health Center (Yonkers)
                                     will be conducted through conference calls and emails on a regular basis. The
Private Practice (Bronx)             groups will receive administrative support from network coordinator Stacia
Riverdale Family Practice (Morrow)
                                     Maher.
Staff                                     The tasks force committees would have the following goals for their area
Diane McKee, MD, MS
Program Director
                                     of focus: 1) identify existing measurement tools that are in use, 2) create a list
Paul Meissner, MSPH                  of measurable outcomes, 3) identify pilot studies that would be initiated, 4)
Network Coordinator                  and suggest ways to build on these activities to include network wide collabo-
Stacia Maher, MPH                    ration. While we would like these pilot studies to result in grant submissions, it
                                     is important that NYC RING stimulate the sharing of information to improve
NYC RING Website
http://www.nycring.org
                                     practice. If you are interested in joining one of these tasks forces please contact
                                     Stacia Maher at 718-430-2749 or at smaher@aecom.yu.edu.
       P AGE      2

                             Highlights from Current NYC RING Site Visits
                              This year Paul Meissner and I have          list. If this were done it could 1) encour-
                         been visiting NYC RING member sites to           age all providers to list smoking status
                         learn about current quality improvement          in CareCast for all their patients over a
                         projects and research initiatives. We typi-      certain age, 2) monitor compliance and
                         cally attend a provider meeting and talk         generate lists of patients without smok-
                         informally with the staff. It is the best way    ing status on their problem lists, and 3)
                         for us to stay informed of the wide array        encourage providers to list smoking
                         of projects and interests that exist within      status for those who appear on the list as
                         our network. It also allows us to consider       "smoking status unknown", and con-
                         ways to build on these activities to include     tinue to monitor progress in this effort
                         network wide collaboration.                      on an iterative basis. An initial project
                              The sites we have visited so far in-        may be to have smoking status listed on
                         clude the Family Health Center, Fordham          the problem lists of a majority of pa-
                         Family Practice, the Health Center at Tre-       tients in each practice. At a later stage,
                         mont, South Bronx Family Health Center,          we could monitor changes in smoking
                         West Farms Family Practice, Institute for        status using this tool.
                         Urban Family Health and Bronx Lebanon.                Paul and I plan to keep visiting sites
                         Some common themes that providers                on a regular basis. If you have any spe-
                         would like to explore, or are currently ad-      cific topics that you would like to see
                         dressing in quality improvement projects,        addressed at your site please let me
                         include improving delivery of service to         know. Also let us know if you would
                         patients, obesity, depression, diabetes,         like to have us at one of your upcoming
                         borderline hyperlipodemic and hyperten-          provider meetings. I can be reached at
                         sive, and HIV.                                   718-430-2749 or at
                              A specific result of one of our site vis-   smaher@aecom.yu.edu.
                         its was a discussion about building a regis-
                         try of smokers at the Family Health Cen-         Stacia Maher, MPH
                         ter. It was suggested that smoking status        NYC RING Coordinator
                         could be placed on the CareCast problem



 We’re on the web at
                                                                   Ideas?
http://www.nycring.org
                              As always we hope to achieve a balance of projects within NYC RING- some
                          more focused on quality improvement, some on “research”, some externally funded,
                          some pilot-scale projects without funding, some led by researchers, others led by our
                          clinician colleagues. Opportunities for clinicians who have a specific interest or
                          "burning question" exist to take advantage of the resources of NYC RING. We would
                          love to hear from you!
                              Please contact Stacia Maher, the NYC RING Program Coordinator at
                          smaher@aecom.yu.edu or 718-430-2749 if you have any ideas or need assistance with
                          getting a project started.




            NYCRING        NEW S
V OLUME    1I,   ISSUE    1                                                                        P AGE    3


                    Featured Collaborators-
            Steve Bernstein, MD & Saba Jearld, MPH
     Steven Bernstein, MD, with funding from the New York State Department of Health to the Albert
Einstein College of Medicine, has been the principal investigator for Bronx BREATHES, a Tobacco
Cessation Center since 2004. Dr. Bernstein is Associate Professor of Clinical Emergency Medicine at
the Albert Einstein College of Medicine. He also holds appointments in the Albert Einstein Cancer
Center and the Bronx Center to Reduce and Eliminate Ethnic and Racial Health Disparities, a Project
EXPORT center funded by the NIH’s National Center for Minority Health and Health Disparities. Dr.
Bernstein is residency-trained and board-certified in internal medicine and emergency medicine, with
additional fellowship training in hematology-oncology, and a postdoctoral fellowship at the Robert
Wood Johnson Clinical Scholars Program at Yale University, where he trained in clinical epidemiol-
ogy, study design and biostatistics. Dr. Bernstein has been interested in emergent presentations of to-
bacco-related illness for over 15 years. With an initial Priority Populations grant from Legacy in 2001,
he was one of the first investigators in emergency medicine to work in this area. Currently, Dr. Bern-
stein oversees additional tobacco-related projects with funding from NIH/National Institute on Drug
Abuse and the Robert Wood Johnson Foundation.
     Saba Jearld, MPH. Ms. Jearld holds a Master of Public Health degree from Columbia University ,
Mailman School of Public Health. Ms. Jearld is responsible for the day to-day management of Bronx
BREATHES and provides coordination support for Dr. Bernstein's other tobacco-related projects. She
has multiple years of experience coordinating programmatic, administrative, evaluation, and research
operations for public health research & service projects in the area of HIV/AIDS and work-site health
initiatives. Prior to working with Bronx BREATHES Ms. Jearld was a Project Coordinator within the
Department of Sociomedical Sciences at Columbia University * Mailman School of Public
Health. During her tenure at Columbia University she coordinated the efforts of two HIV/AIDS,
HRSA Ryan White-funded, research/service projects - Partnership for Family Health, a consortium
providing comprehensive, multidisciplinary, medical, dental, mental health care and social services to
HIV infected and affected families; and - Northern Manhattan Pediatric and Perinatal Adherence Ini-
tiative, a multi-site, theory-based intervention aimed at improving adherence to antiretroviral therapy
among HIV positive pregnant women, adolescents, children and their caregivers. In addition, Ms.
Jearld was involved from inception with the Harlem Business Wellness Initiative - a health promotion
partnership, between Harlem businesses, health care organizations, and Columbia University focusing
on identification and referral for quality, low-cost health care and preventive services for employees of
small businesses in Harlem - funded through a CDC/ Health Protection Research Initiative grant.



Bronx Week 2007 is taking place from Saturday, June 16 to Sunday, June 24. If you are interested in
having an event listed on the Bronx Week calendar of events and website please contact Lucille Roldan
at 718-590-3522 for an application. Applications are due March 30th.

New York State Health Foundation (NYSHealth) has announced two new initiatives to support their
objective to expand health care insurance to state residents who cannot afford to purchase their own
coverage or whose coverage is inadequate. For information on request for proposals on these two initia-
tives please visit their website at http://www.nyshealth.org/.


 NYCRING         NEW S
(Continued from page 1)
     1. To provide training, technical assistance, and follow-up to health care institutions in the Bronx regard-
ing the design and implementation of systems to identify tobacco users at each patient encounter and provide
brief cessation counseling.
    2. To identify and promote direct cessation services in the form of intensive behavioral counseling in group
or individual settings in the Bronx.
    3. To increase the number of Bronx residents who use the services of the New York State Smokers'
Quitline.
    While not formally a NYC RING project, Bronx BREATHES is an excellent example of how research can
be used to inform practice based change strategies. The program translates research into practice by educating
and training all Bronx health care provider organizations and clinicians in smoking cessation techniques. Re-
search illustrates that advice from a clinician doubles the quit rates of patients interested in quitting smoking.
Within the last two years, Bronx BREATHES has provided training and technical assistance for over 300 pro-
viders, ancillary staff, and administrators at over a dozen community health centers, ambulatory practices, and
hospitals. As a result, Bronx BREATHES provider partners now make more referrals, utilizing the Fax-to-Quit
referral system, to the NY State Smokers’ Quitline than any other state-funded cessation center provider part-
ners. In 2006 916 referrals were made by Bronx clinicians to the NY State Smokers’ Quiteline.
    The efforts of Bronx BREATHES have been featured in the NY Daily News, the Norwood News, and on
BronxTalk and News12 the Bronx. As a testament to Bronx BREATHE’ commitment to provider and patient
education over 15,000 Bronx BREATHES brochures have been distributed to partners and the community.
These are available in both English and Spanish, and include a list of intensive smoking cessation programs in
the Bronx. The program has also distributed over 15,000 New York State Quitline referral cards, 300 New
York State Smokers Quitline Provider Quit Kits, and 2,000 pocket pharmacotherapy guides.




                                        NYC RING Research Liaisons
                  Institute for Urban Family Health                                      Family Health Center
               Andreas Cohrssen, MD & Wendy Barr, MD                            Zack Rosen, MD & Matt Anderson, MD, MS

                   Bronx-Lebanon Hospital Center                           South Bronx Health Center for Children and Families
               Doug Reich, MD & Tony Lopez, MD, MPH                                        Peter Meacher, MD

                 Montefiore Medical Group Castle Hill                                University Ave. Family Practice
                        Darwin Deen, MD, MS                                                Robert Clarick, MD

            Comprehensive Family Center Practice (CFCC)                                West Farms Family Practice
              Peter Bernstein, MD & Andrew Racine, MD                                   Clement Landanno, MD

             Comprehensive Health Care Center (CHCC)                                 Williamsbridge Family Practice
                  Iman Sharif, MD & Galit Sacajiu                                           Noel Brown, MD

                           Fordham Family Practice                       North Bronx Healthcare Network Health Center Tremont
                            Marianne Dietrich, MD                                           Jean Burg, MD

                          Marble Hill Family Practice                                 Saint Joseph's Medical Center
                             David Savarese, MD

                                                            Our Mission
To define and strengthen the knowledge base and improve the practice of urban primary care by:
1. Identifying and addressing research and quality improvement questions important to primary care providers, patients, families, and
their communities
2. Defining and pursuing a research agenda focused on the specific health, disease, and health services issues of urban underserved
patients and communities, and
3. Providing a research resource for undergraduate and graduate medical education in primary and community health.

				
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