Engaging Family Medicine Residents in the Chronic Care Model

The state of Kentucky leads the nation in many behaviors that result in poor health. Smoking is prevalent in 33% of the adult population and 63% of Kentuckians are overweight. Inactivity is reported by 31%. These statistics are higher in the rural areas of the state, areas where socioeconomic levels suffer and access to care is strained. Not surprisingly, these behaviors are associated with higher levels of diabetes and cardiovascular disease (CVD). In 2000, the American Heart Association ranked Kentucky 4gth in the nation for its a~e-adjusted CVD death rate. Diabetes is the fifth leading cause of death in Kentucky, ranking 71 highest with 8.5% of adults affected. Treating this disease burden requires well equipped family physicians, knowledgeable about the spectrum of resources available and ready to deploy these resources in the most efficient way. FUsing the Chronic Care Model as a guide to medical care delivery has repeatedly been shown to improve outcomes for those with chronic illnesses, yet has had slow uptake by academia. Reasons include ignorance, resistance to change, financial hurdles, and residency accreditation concerns. We propose to overcome these barriers by involving residents in the design and implementation of critical changes in care delivery and to actively pursue faculty development to support such changes. The overall goals of this project are: I) to improve the knowledge, skills, and attitudes of our family medicine residents in primary care of the underserved who have one or more chronic illnesses in both rural and urban settings, and 2) to improve the quality of care for patients with chronic illnesses provided by our residency graduates who are being trained in underserved areas. 9 Specifically, we propose to accomplish these goals via the following major objectives: Objective I: Engage residents in the design, implementation, and assessment of educational experiences to teach the knowledge, skills, and attitudes to use the Chronic Care Model to provide effective care for patients with chronic illness, particularly in underserved and underrepresented populations. Catlett, Sharon F; Allard, Joseph