TY - JOUR T1 - Moving Upstream—Health Extension and Primary Care JF - The Journal of the American Board of Family Medicine JO - J Am Board Fam Med SP - 10 LP - 12 DO - 10.3122/jabfm.2017.01.160355 VL - 30 IS - 1 AU - Lyle J. Fagnan Y1 - 2017/01/01 UR - http://www.jabfm.org/content/30/1/10.abstract N2 - 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. ER -