Research Projects

Engaging in research provides health centers the opportunity to generate evidence and integrate findings into practice to further improve health care delivery, quality of services, and public policy.

We encourage health centers to engage in research and we are here to help them be successful. Beyond health centers, AllianceChicago collaborates in research with academic institutions, research institutions, foundations, other non-profits, and government agencies

capacity building

Active Projects

Capacity Building

The gaps in translating research to practice are well-known and may be more pronounced in Community Health Center (CHCs), where opportunities for clinicians to benefit from access to and learning about contemporary evidence, research findings, and practice guidelines are fewer than in academic settings. The primary objective of E-REACH is to improve organizational capacity to disseminate PCORI-funded Patient-Centered Outcomes Research and Comparative Effectiveness Research findings to support CHC clinicians in understanding and responding to the chronic health needs of their patients. Funder: This project was funded thorugh a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (EADI-30482).

The main goals of the project are to strategically align Northwestern’s organizational entities and to add robust support to technical toolkits for one common mission: accelerate effective implementation science to support evidence-based patient care in a growing academic health system and the communities that they serve. The main goals and activities include: Conducting organizational readiness assessments and developing or enhancing teams and processes to support the principal investigator (PI) or Co-PI overall management of HSII activities; enhancing data structure for evaluation; and identifying, developing and optimizing implementation strategies and approaches. Funder: Northwestern Memorial HealthCare

NP3 and AllianceChicago are partnering together to foster a shared vision of enhancing research relationships between academic researchers and health centers within the AllianceChicago network and promoting practice-based research in health centers. This partnership makes it possible for AllianceChicago to dedicate resources towards prep-to-research and capacity building activities.

Chronic Disease
Chronic Disease Management

The purpose of the project is to expand a central repository of data available to diabetes researchers and collaborators in order to improve diabetes for adult patients in CHCs and to engage CHC clinicians and staff in training and other activities to catalyze diabetes research in their settings. Funder: NIH/NIDDKD

Cardiovascular health (CVH) starts very early in life and worsens with age. The overarching goal of this study is to identify CVH trajectories from birth through age 20 from 7,000 parents and their children in the Chicago area. Patients of Community Health Centers (CHCs) will be invited to participate in this study via text and email. Follow up surveys will be used to help define CVH metrics and create a tool to promote cardiovascular health. Funder: National Institutes of Health (NIH)

This project was initiated by Alivio Medical Center as a community-driven research question. The study developed from the initial question aims to understand the trajectory of patients who screened at high risk of cancer during the COVID pandemic at an AllianceChicago network Community Health Center (CHC), who subsequently received care at a CAPriCORN data contributing site. The results will be critical in understanding what, if any, care the cohort of patients received post-abnormal screening result at the community health center. Funder: NHLBI

This study will use data-driven methods and a community-based participatory approach to identify contextual factors and implementation strategies for improving the management of blood pressure. Funder: Northwestern Primary Care Practice-Based Research Program (NP3)

Multi-state EHR-based Network for Disease Surveillance (MENDS) is an EHR-based pilot chronic disease surveillance system led by the National Association of Chronic Disease Directors (NACDD) and funded by CDC Division for Heart Disease and Stroke Prevention, this project takes chronic disease data and uses weighting and modeling to display and analyze it via two software tools, RiskScape and PopMedNet. Riskscape visualizes the data into charts, figures, and maps to provide quality visuals that help inform work around chronic diseases. The key to this project is its usefulness in analyzing and transforming any healthcare data into visualizations that allow for comprehensive and meaningful views. Any data available in EHRs has the potential to be leveraged via the two tools in use by this project. At AllianceChicago, we have 18 health centers contributing data to this effort, with 6 from Illinois. This project has local partnerships with the Chicago Department of Public Health (CDPH) and with the Cook County Department of Public Health (CCDPH). Funder: CDC

The “Tipping Points” project studies how health coaches may affect the health and wellness of patients with multiple chronic diseases. The new health coaching program will augment regular medical care, including positive affect interventions designed to help patients set their own life goals. Funder: Patient-Centered Outcomes Research Institute (PCORI)

This project seeks to better characterize underrepresented populations living with type 1 diabetes and insulin-requiring diabetes seen for care at Federally Qualified Health Centers (FQHCs) and to identify barriers for Primary Care Providers delivering diabetes care to underserved communities within FQHCs. Funder: Helmsley Charitable Trust

Infectious Diseases
Infectious Disease/COVID

With the profound disparities uncovered by the COVID-19 pandemic, compounded by the longstanding disparities in rheumatic disease outcomes, our overarching goal is to better understand and address low vaccine uptake and hesitancy among communities of Black individuals with these conditions. Framed by awareness of the role of structural racism, we will build upon our existing community-academic partnerships across two cities to develop and test a scalable intervention comparing two strategies to educate community leaders to change vaccine-related norms. Funder: National Institutes of Health (NIH)

The objective of this study is to implement strategies to increase uptake and support PrEP persistence among Black cisgender women in community health center (CHC) settings. AllianceChicago and Health Choice Network will partner with University of Chicago for this 5-year NIH-funded project. This study will take place at 12 locations of care within 3 CHCs, including 4 sites in the Midwest and 8 in the Southern U.S. Funder: NIH

The overarching goal of this project is to identify and apply best practices for strengthening childhood vaccination rates toward improving Human Papillomavirus (HPV) uptake for children and adolescents seen in Community Health Centers (CHCs) through implementation of a quality improvement-focused learning collaborative for CHC immunization champions. Funder: Merck Sharp & Dohme LLC

Communities served by FQHCs are more likely to be under-vaccinated and have poor health outcomes associated with vaccine preventable diseases. Multiple factors contribute to low vaccination rates in medically underserved populations including equitable vaccine distribution, provider behaviors, clinic workflow, and lack of vaccine confidence among patients. The goal of this observational cohort study is to address knowledge gaps in factors associated with vaccination completion and refusal of vaccines against human papillomavirus, influenza, COVID-19, and pneumococcus among patients served by FQHCs. Funder: Merck Sharp & Dohme LLC

maternal child health
Maternal Child Health

The Community Health Center-Reproductive Life Plan (CHC-RLP) Project will assess the impact of One Key Question® implementation on reproductive health metrics in the community health, primary care setting. Funder: Agency for Healthcare Research and Quality (AHRQ)

The goal of the project is to develop a digital decision tool to facilitate developmentally appropriate contraceptive counseling for adolescents seeking care in primary care settings. We will recruit adolescents and primary care providers to participate in interviews, focus groups, and design sessions to help create the tool. Funder: National Institute of Child Health and Human Development (NICHD)

The HBCD study will examine healthy brain and behavioral development across the critical first years of life with a national, diverse sample of 7,500 women and children. The study will also monitor the development of children who have been exposed to substance use and other adversities during pregnancy across a 10-year period. Mothers and babies will complete several research visits each year that include surveys, infant developmental and behavioral assessments, neuroimaging, and biospecimen collection. Funder: National Institutes of Health (NIH)

Using an implementation science framework, we aim to understand how a two-generation model of postpartum care could be implemented in diverse clinical settings. To do this we propose to conduct qualitative interviews with clinicians and administrators from 10 clinical sites across the country. Funder: National Institute of Child Health and Human Development (NICHD)

iREACH aims to reduce peanut allergy risk through a clinical decision support (CDS) tool incorporated into participating health centers’ electronic health record. The CDS iREACH tool, developed and tested by pediatricians, is designed to support providers in identifying infants at high-risk for peanut allergy, testing or allergist referrals for infants, assessing risk of the results, and counseling parents of infants on introduction of peanut products. Funder: National Institutes of Health (NIH)

The overarching aim of this study is to determine the optimal patient-centered strategy to improve care for children with acute otitis media and reduce unnecessary antibiotic use to mitigate antibiotic-associated harms. Funder: Patient-Centered Outcomes Research Institute (PCORI)

The LINCC Trial is a co-scheduling intervention that links well-baby visits with postpartum contraceptive care in order to reduce rates of short interval pregnancy. Funder: National Institutes of Health (NIH)

OPTIMIZE aims to address inequity perinatal healthcare, particularly for African American women. The OPTIMIZE checklist is a strategy to facilitate coordination and integration of efforts to improve perinatal care for AA women. Aims 1. Develop the OPTIMIZE checklist with interviews and/or focus groups with AllianceChicago CHCs staff and patients 2. Conduct pragmatic, randomized trials in CHCs to evaluate the effectiveness and implementation of the OPTIMIZE checklist strategy 3. Conduct process evaluation, including conducting organizational surveys and interviews with clinic staff and patients. Funder: NIH

This study will test a technology-based strategy to promote preconception care and diabetes self-management among English and Spanish-speaking women with type 2 diabetes in primary care. Aims 1. Test the medication reconciliation (MedRec) tool and deliver low literacy print tools to support diabetes self-care as well as post-visit text messaging to encourage healthy lifestyle behaviors to eligible patients 2. Analyze EHR data (e.g., HbA1c, blood pressure) on enrolled participants 3. Request feedback (via brief electronic survey) from 10 CHC personnel on their experience with the project. Funder: NIH

Due to underlying differences in infrastructure and operations, FQHCs are often outpaced in research productivity and participation by academic medical settings, both in maternal health and other topics. The Research Engagement and Partnerships in Reproductive and maternal health Outcomes (REPRO) Project will center the growing momentum on maternal health equity to optimize research engagement in CHCs in two HRSA-funded Health Center Controlled Networks (HCCNs), AC and HCN, which together, serve over five million patients. Funder: Patient Centered Outcomes Research Center (PCORI)

STEP-UP aims to test the effectiveness and fidelity of a technology enabled, ‘stepped care’ strategy to connect high-risk, postpartum patients to primary care within community health care settings. Interventions will include the use of Clinical Decision Support that prompts counseling and referral of high-risk patients to primary care, the inclusion of health-literacy educational materials as part of after-visit summary and text message reminders to motivate patients to schedule and attend primary care visits. Funder: National Institutes of Health (NIH)

Partnership with the National Association of Community Health Centers (NACHC) to optimize postpartum care provision, including addressing high-risk pregnancies in the postpartum period and improved care coordination and developing a quality measure for postpartum care. Funder: NACHC


The goal of this study is to better understand the landscape of pediatric overweight and obesity in populations served by Community Health Centers. The initiative will use quantitative data and a comprehensive, stakeholder driven approach to inform the development of new Clinical Quality Measures (CQMs) for use in clinical settings. Funder: NACHC

practice optimization
Practice Optimization

A patient’s relationship with their primary care physician (PCP) or advanced practice provider (APP) is an instrumental asset and is associated with improved health outcomes, increased patient satisfaction, and lower utilization costs. Relational continuity between physicians and care teams and the patients they serve is one of the core defining elements of primary care. The goal of the Continuity and Relationships Among Patients, Physicians, and Care Teams (CARE PACT)  study is to better understand Physician/APP relationships with patients by evaluating the number of different providers and care team members involved in each patient’s care and PCP relationship continuity in a network of FQHCs, most of which are accredited Patient-Centered Medical Homes (PCMHs). Funder: American Medical Associate (AMA)

The goal of this mixed methods study is to assess issues with patient problem and medication lists and their impact on providers and efficiency in the community health center (CHC) setting. We are specifically interested in understanding the burden placed on providers by lengthy and out of date lists. Using Electronic Health Record data, we will evaluate the length and relevance of problem and medication lists within participating CHCs. Funder: American Medical Association (AMA)

This study proposes to evaluate an advanced rooming process implemented at a Federally Qualified Health Center (FQHC), with the goal of better understanding the impact on visit efficiency and satisfaction of patient needs. Funder: American Medical Association

In primary care, time should be optimized for activities that add value and make progress toward the quadruple aim. It is essential for healthcare organizations to avoid misinterpretation of regulatory requirements, which can lead to unnecessary expenditure of clinical and operational resources and waste. Misperceptions of regulations and prioritization of risk avoidance/compliance citations by individuals who hold roles as gatekeepers can result in care team burnout. Federally Qualified Health Centers must comply with additional federal regulations and care for populations with many social needs, thus efficient and effective use of time in these settings is even more critical. Funder: American Medical Association (AMA)

social determinants of health
Social Determinants of Health

This study aims to examine the association between social needs and preventive health services, including screening and diagnostic mammography and the association between social needs and chronic disease such as diabetes control and hypertension control. Funder: Northwestern University, Feinberg School of Medicine

Since the passage of the Affordable Care Act, many states, including Illinois, have expanded Medicaid eligibility to include adults without dependents, significantly increasing Medicaid coverage. However, a persistent challenge is Medicaid “churn” when Medicaid-eligible individuals are removed from the Medicaid program and are then required to re-apply. Funder: Robert Wood Johnson Foundation

Smoking cessation
Substance Use

The IMPACT project aims to support the implementation of a bidirectional eReferral tool to the Illinois Tobacco Quitline (ITQL) at one Community Health Center in Chicago. The eReferral system will target all smokers who have a primary care visit during the grant period who are deemed by the provider to be ready to make a quit attempt. The goal of the project is to increase the number of referrals to the ITQL, increase smoking cessation counseling, and ultimately increase smoking cessation rates. A secondary aim is to increase reach to patients with housing insecurity.

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