Translating research into practice: Protocol for a community-engaged, stepped wedge randomized trial to reduce disparities in breast cancer treatment through a regional patient navigation collaborative.
Translating research into practice: Protocol for a community-engaged, stepped wedge randomized trial to reduce disparities in breast cancer treatment through a regional patient navigation collaborative.
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将研究转化为实践：社区参与的阶梯式楔形随机试验方案，旨在通过区域患者导航协作减少乳腺癌治疗的差异。
DOI：
10.1016/j.cct.2020.106007
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发表时间：
2020-06
影响因子：
2.2
通讯作者：
TRIP Consortium
中科院分区：
文献类型：
--
作者：
Battaglia TA;Freund KM;Haas JS;Casanova N;Bak S;Cabral H;Freedman RA;White KB;Lemon SC;TRIP Consortium
乳腺癌死亡率的种族和社会经济差异仍然存在。在马萨诸塞州的波士顿，黑人、非西班牙裔妇女和医疗补助保险的个人与白色或私人保险的妇女相比，延误治疗的可能性高出2-3倍。虽然存在减少延误的循证护理协调战略，但它们并没有在医疗机构中系统地实施。将研究转化为实践（TRIP）利用社区参与的研究方法来解决乳腺癌护理提供的差异。四个马萨诸塞州临床和转化科学研究所（CTSI）中心与波士顿乳腺癌公平联盟（The Coalition）合作，为波士顿居民实施基于证据的护理协调干预措施，以应对乳腺癌护理延迟的风险。该联盟采用社区驱动的进程来界定护理提供差距的问题，确定目标人群，并制定严格的务实办法。我们选择了一个群集随机化，步进楔形混合I型有效性实施研究设计。该干预措施实施了三项循证策略：患者导航服务，供学术医疗中心使用的共享患者登记册，以及基于网络的健康社会决定因素平台，以识别和解决护理障碍。主要临床结局包括至首次治疗的时间和接受指南一致性治疗的时间，这些通过电子健康记录摘要获取。我们将使用混合方法来收集可接受性、采用/渗透、忠诚度、可持续性和成本等次要实施结果。TRIP利用创新的社区驱动的研究策略，专注于跨学科合作，设计和实施转化科学研究，旨在更有效地将经过验证的卫生服务干预措施融入临床实践。
Racial and socioeconomic disparities in breast cancer mortality persist. In Boston, MA, Black, Non-Hispanic women and Medicaid-insured individuals are 2–3 times more likely to have delays in treatment compared to White or privately insured women. While evidence-based care coordination strategies for reducing delays exist, they are not systematically implemented across healthcare settings. Translating Research Into Practice (TRIP) utilizes community engaged research methods to address breast cancer care delivery disparities. Four Massachusetts Clinical and Translational Science Institute (CTSI) hubs collaborated with the Boston Breast Cancer Equity Coalition (The Coalition) to implement an evidence-based care coordination intervention for Boston residents at risk for delays in breast cancer care. The Coalition used a community-driven process to define the problem of care delivery disparities, identify the target population, and develop a rigorous pragmatic approach. We chose a cluster-randomized, stepped-wedge hybrid type I effectiveness-implementation study design. The intervention implements three evidence-based strategies: patient navigation services, a shared patient registry for use across academic medical centers, and a web-based social determinants of health platform to identify and address barriers to care. Primary clinical outcomes include time to first treatment and receipt of guideline-concordant treatment, which are captured through electronic health records abstraction. We will use mixed methods to collect the secondary implementation outcomes of acceptability, adoption/penetration, fidelity, sustainability and cost. TRIP utilizes an innovative community-driven research strategy, focused on interdisciplinary collaborations, to design and implement a translational science study that aims to more efficiently integrate proven health services interventions into clinical practice.
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影响因子：
3.9
作者：
Abdel-Rahman, Omar
通讯作者：
Abdel-Rahman, Omar
DOI：
10.1158/1055-9965.epi-12-0532
发表时间：
2012-10
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Battaglia TA;Bak SM;Heeren T;Chen CA;Kalish R;Tringale S;Taylor JO;Lottero B;Egan AP;Thakrar N;Freund KM
通讯作者：
Freund KM
影响因子：
6.2
作者：
Ko, Naomi Y.;Snyder, Frederick R.;Freund, Karen M.
通讯作者：
Freund, Karen M.
影响因子：
45.3
作者：
McLaughlin, John M.;Anderson, Roger T.;Paskett, Electra D.
通讯作者：
Paskett, Electra D.
影响因子：
3.4
作者：
Lake, Eileen T.;Staiger, Douglas;Rogowski, Jeannette A.
通讯作者：
Rogowski, Jeannette A.