Practice Engagement Methods. We use several strategies to engage practices in the Black Belt with sufficient numbers in the sampling frame to assure feasibility (Table 9). Xx. Xxxxxxxxxx, a respected leader in primary care in the state of AL and leader of a PBRN leads the AL team’s practice engagement, and Drs. Xxxxxxxx and Xxxxxxxx lead the NC team’s practice engagement efforts. Xx. Xxxxxxxx leads a PBRN in NC. During the proposal development phase, we secured letters of interest from over 100 practices or practice organizations. Xx. Xxxxxxx’x team engaged over 600 patients from 130 mostly single physician practices in the Black Belt in their work to date, and these practices will be engaged to participate by direct invitation from Xx. Xxxxxxx. Xx. Xxxxxxxxxx will not only approach the AL PBRN practices in the Black Belt, but will also make presentations at local meetings of the Medical Association of the State of AL (see letter of support) and the local chapter of the American Association of Family Physicians. Our and the NC AHEC work extensively with primary care practices in their regions to place medical students in these practices for their ambulatory medicine training, thus they are familiar with many of our targeted practices. They will assist with recruitment as well as providing their qualitative assessment which will inform decision-making on individual practice readiness as part of the Recruitment and Retention Workgroup deliberations. Of note, demand for assistance with practice transformation in both AL and NC is high, as meaningful use criteria are fully implemented and as CMS moves rapidly to value-based reimbursement. The process of practice engagement is sketched out in Figure 6 and Appendix 1. The process begins with a lead letter and an informational sheet providing an overview of the study (see Appendix 1). Within 2 weeks, a telephone call takes place between a study investigator and the practice physician. The feedback from the Community Advisory Boards and NC AHECs was used to develop talking points for how to respond to potential resistance. The telephone call is followed by additional calls and/or an in-person visit. Once a practice agrees to participate, a Letter of Agreement is obtained from the practice physician or other authorized official, and the practice’s Champion is identified (see 4.1.d below). Once the Letter of Agreement is signed, the study team assists the practice with obtaining a Federal Wide Assurance number if the practice does not already h...
