community health center, disparities, quality improvement, quality of care, vulnerable populations



  1. Chin, Marshall H. MD, MPH
  2. Kirchhoff, Anne C. MPH
  3. Schlotthauer, Amy E. MPH
  4. Graber, Jessica E. PhD
  5. Brown, Sydney E.S. BA
  6. Rimington, Ann MPH
  7. Drum, Melinda L. PhD
  8. Schaefer, Cynthia T. RN, CS
  9. Heuer, Loretta J. PhD, RN, FAAN
  10. Huang, Elbert S. MD, MPH
  11. Shook, Morgan E. MUP
  12. Tang, Hui MS, MS
  13. Casalino, Lawrence P. MD, PhD


The Health Disparities Collaboratives are the largest national quality improvement (QI) initiatives in community health centers. This article identifies the incentives and assistance personnel believe are necessary to sustain QI. In 2004, 1006 survey respondents (response rate 67%) at 165 centers cited lack of resources, time, and staff burnout as common barriers. Release time was the most desired personal incentive. The highest funding priorities were direct patient care services (44% ranked no. 1), data entry (34%), and staff time for QI (26%). Participants also needed help with patient self-management (73%), information systems (77%), and getting providers to follow guidelines (64%).