RT Journal Article SR Electronic T1 Moving Upstream—Health Extension and Primary Care JF The Journal of the American Board of Family Medicine JO J Am Board Fam Med FD American Board of Family Medicine SP 10 OP 12 DO 10.3122/jabfm.2017.01.160355 VO 30 IS 1 A1 Fagnan, Lyle J. YR 2017 UL http://www.jabfm.org/content/30/1/10.abstract AB Health extension programs represent an opportunity for practice-based research networks (PBRNs) and primary care practices to develop collaborations reaching beyond the clinic walls to address the upstream social determinants of health and engage in community-based research. The Health Extension Regional Officers (HEROs) program at the University of New Mexico described in this issue of the JABFM is an innovative model with a bidirectional approach to linking academic health centers to community-based practices and organizations. Health extension programs are local, influenced by history, relationships, and support. Oregon's health extension workforce represents a diverse group that includes practice facilitators, community health workers, and Cooperative Extension agents. PBRNs are measuring success in terms of collaboration across a spectrum of health activities. The Oregon Rural Practice-based Research Network uses a “Four Pillars” model of community engagement, practice transformation, research, and education to involve researchers, health policy experts, educators, and health extension workers to improve community health.