The Precision Health Research Program, led by Drs. Caitlin G. Allen and Lori Orlando, applies implementation science methods to develop, deliver, and evaluate precision health and genomic interventions alongside our community partners in the following areas:
- Implementation of genomic medicine
- Population-based genomic screening
- Communication of genomic information
- Workforce development
Projects
- Genomic medicine Risk Assessment Care for Everyone (GRACE): Family health history (FHH), a critical component of genomic medicine that is essential for both identifying individuals at risk for hereditary conditions and for contextualizing results of genetic testing, continues to be broadly underutilized and underappreciated in clinical care. GRACE is designed to: 1) develop and deploy a FHH collection model using pre-implementation assessments at clinical sites with highly diverse patient populations to select the most appropriate integration options and pathways for both patients and providers; and 2) perform a randomized implementation-effectiveness pragmatic hybrid trial to assess implementation and effectiveness outcomes relevant to these diverse populations. Outcomes will include reach, uptake, clinical utility, accessibility, genetic testing frequency, genetic testing results, and cost-effectiveness.
- The VA Genomics Learning Health System: Implementing genomic medicine across diverse veteran communities: In this project, the VA will bring its national learning health system (LHS) infrastructure and genomic medicine implementation strategies to a network of other genomics-enabled LHS. The network will conduct implementation projects centered on a mainstream model for delivery of genomic medicine that promotes the use of evidence-based, guideline-concordant genetic testing by frontline clinicians (U01HG013781).
- Advancing Translational Science Through the Implementation of Population Based Genomic Screening (ASPIRE): We are building and testing innovative, technology-enhanced approaches to make population-based genomic screening (PGS) more efficient at Atrium Health. By co-designing recruitment and results-return strategies with patients and community partners, and piloting tools such as automated e-consent, portal outreach, educational videos, and a chatbot, this project aims to reduce barriers, streamline participation, and generate real-world evidence to scale genomic medicine programs for public health impact.
- Facilitating the Implementation of Population-based Genomic Screening Across Diverse Populations and Settings (FOCUS): We apply implementation mapping to conduct a needs assessment of population-based genomic screening programs, create an implementation guide (FOCUS toolkit), and evaluate the utility of the implementation guide using a stepped wedge cluster randomized trial design (R01HG013851).
- Scalable Clinical Decision Support for Individualized Cancer Risk Management (GARDE): Evidence supports individualizing cancer screening based on each person’s risk. We propose to enhance and disseminate software that scans electronic health records of target patient populations to: 1) automatically identify those at high risk to develop hereditary cancers according to national cancer guidelines, and 2) reach out to patients via automated “chatbots” offering patient education and the opportunity to receive at home genetic testing for hereditary cancers. Through wide dissemination, the GARDE platform has the potential to enable evidence-based, individualized cancer screening to reduce cancer burden (5U24CA274582-02).
- PaRtnEring to build understanding oF gEnomics Responsibly (PREFER) CHW Genomics Research Education Program (PREFER CHW): The PREFER CHW program is designed to fill the gap in available resources to train CHWs in basic competencies related to genomics. We are working with CHW training programs in North Carolina, South Carolina, Tennessee, and Mississippi to develop and implement the program (1R25HG013479-01).
- Precision Public Health Network: Established in 2019, the Precision Public Health Network is made of hundreds of early-stage investigators focused on precision health research. We provide training from leaders in the field and develop collaborations to advance precision health research. We host conferences as part of this network (R13CA261073).