HOUSTON MEDICAL MONITORING PROJECT (HMMP)

Facility Recruitment

Morbidity Monitoring ProjectPrincipal Investigator/Project

Coordinator MeetingAtlanta, Georgia

November 2 - 4, 2005

Bureau of EpidemiologyOffice of Surveillance and Public Health Preparedness

Houston Department of Health and Human Services

Contacting Facilities

• August 2005: sent letters to all 107 providers on the Houston sampling frame (Announced project is starting)

• September 2005: sent letters to the 25 randomly selected providers (Informed providers their facility was randomly selected)

• October 2005: phone calls to the randomly selected providers to setup a time to meet and discuss the project (duplicate letters faxed to providers as requested)

• October 2005: began meeting with providers (made arrangements to obtain patient line list)

Facility Contact

• Staff Epidemiologist • Provider Liaison• Coordinates initial provider meetings and

obtains patient line list • Surveillance Investigators

• Assist with provider meetings• Collect information for patient line list• Compares patient line list against HARS

• Biostatistician• Conducts descriptive analyses of patient line

lists

Patient Line List VariablesPDP = May, June, July, 2005

• First Name• Last Name• Middle Name or Middle Initial• Race/Ethnicity• Gender at Birth• Social Security Number• Contact Information (Street Address, City, State,

Zip Code, Phone Number)• Date Patient was last seen in Provider’s Office• Date of HIV Diagnosis

Summary of Facility Recruitment

• All 25 facilities were contacted by mail, phone call, and/or fax

• One facility has merged and another has closed• Average of three calls to setup an appointment• Visited 15 out of 23 facilities = 65%

• Waiting to speak to the provider at four facilities• Four facilities have said no to participating

• Average time of visit with a provider = 45 minutes• 30 minutes with the provider and 15 minutes with

office staff• CAB members are notified when a meeting with a

provider is in their facility• In cases of provider resistance, HMMP will rely on the

principal investigator and the Houston PAB representative for assistance

• The CAB may also be asked to assist with a resistant provider

Summary of Patient Line List

• Requested patient line list from 15 out of 23 providers• Received 3 out of 15 patient line list• Three facilities will not release their line list

until final IRB approval (IRB has not been an issue with any other facilities)

• Average time to receive a requested line list is one week

• One facility generated their own line list • Surveillance staff abstracted information to

develop line list for two facilities• Developing a patient line list is labor intensive

for office staff• Four patients from the patient line list received

were found not to be in HARS (one patient was recently diagnosed)

Analysis of Patient Line List (As of October 2005)

• Total of 139 patients from line list• Race/Ethnicity

• 93 whites; 16 blacks; 13 Hispanics; 1 Asian; 1 other; and 15 unknown

• Gender at Birth• 123 males; 15 females; and 1 unknown

• Age (years)Mean 46.5

Facility Contact Strategies

• Community Outreach• Visit various community-based organizations (CBOs) that

provide services to PLWHA• Participation in HIV/AIDS related events• Communication with HIV/AIDS community (developing

quarterly newsletter, plans to develop a website)

• Providers enjoy receiving their mug and pen• Houston’s aim is to form partnerships or

collaborations with the HIV/AIDS community. This way, HMMP is working with the community and not just taking from the community.

Examples of HMMP Outreach Efforts

To HMMP,

It was our pleasure to have you visit The Lazarus House.  I enjoyed meeting each of you and look forward to working with you in the future.  Thank you for the kind words, Michele!  The Lazarus House is a reflection of what can happen if people care.  God blessed us with a houseful of people willing to care for and serve a community in need.  This is definitely a group effort.

Thank you for your time and talent.  Your investigation can provide hope for many nonprofit organizations in the future.  Your energies are truly appreciated.

I will put your names on our invitation list.  We host several fun events, like the upcoming Halloween Party.  Please do not hesitate to call me if you have any future questions, concerns, or suggestions.  You can reach me at 713.526.5071.  And please come back and visit us anytime!

God bless,

Danielle Sampey, Executive Director

Examples of HMMP Outreach Efforts

Hello HMMP,

I just wanted to send a BIG THANKS to all of you for coming out to support C2EA!  I believe our first gathering was a great success!  As I said last night I hope we can continue to network with one another and begin working on solutions for the problems we face individually and collectively. 

Sincerely,

Ms. Nike LukanEducation CoordinatorAIDS Foundation of Houston3202 Weslayan AnnexHouston, Texas 77027

Examples of HMMP Outreach Efforts

Mr. Snare,

Please accept our heartfelt thanks for today’s tour of Bering Omega and the Omega House.  My co-workers and I were enlightened and impressed by the site of your beautiful facility and encouraged by your steadfastness!   We have heard so much about Bering Omega and the Omega House, but never had the opportunity to see for ourselves. Your reputation precedes you.    

Your organization positively touches the lives of so many every year.  Surely, you are the last resort for many and the first choice for most with various physical, mental, and spiritual needs.  We were honored and humbled by this experience and look forward for the next opportunity to visit with you.  

Sincerely,

Taiwo O. Fasoranti MD

Examples of HMMP Outreach Efforts

October 25, 2005 

Dear Dr. Fasoranti:

Thank you for the submission of your scholarship application for The North American Conference on AIDS Treatment Action Forum (NATAF).  

On behalf of the AIDS Treatment Activist Coalition (ATAC), The Center for AIDS Information & Advocacy would like to congratulate you on being selected to receive the 2005 scholarship. NATAF will be held in Oaxaca,Mexico from Sunday, November 27 to Wednesday, November 30, 2005. You must have a valid passport to attend the conference. You will be contacted regarding the details of your award.  

Again, congratulations, and if you have any questions, please feel free to contact me at (713) 527-8219 or Bernie@centerforaids.org. 

Sincerely,

Bernie Vazquez

Education and Outreach Manager

IRB Process

• U. T. Health Science Center at Houston• Initiated May 2005• Changed from hardcopy to electronic• 3 of 25 facilities require an IRB

• These 3 facilities also require a separate research services contract (after IRB approval)

• Assigned Expedited Review• Pending review November 2005

Conclusion

• Majority of providers are interested in participating; setting up meetings with providers is a slow process

• Keep provider correspondence to one page only

• Developing a patient line list is labor intensive for the provider’s office staff (offer staff assistance if possible)

• IRB can be slow and time consuming; only a few facilities require an IRB and/or other documentation before participating

• Developing a relationship with the HIV/AIDS community is important to participation