Building Research in Implementation and Dissemination to close Gaps and achieve Equity in Cancer Control (BRIDGE-C2) Administrative Supplement

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This supplement will explore how the COVID-19 pandemic is impacting cancer screening and prevention (i.e., cancer preventive care) among patients receiving care in community health centers (CHCs) by leveraging the The Building Research in Implementation and Dissemination to close Gaps and achieve Equity in Cancer Control (BRIDGE-C2 ) Center Implementation Laboratory infrastructure. CHCs adapted and changed the way they deliver care during the current pandemic. For example, our Laboratory CHCs showed an 80% decline of in-person office visits, March to April 2020, in which cancer preventive care is typically delivered. This supplement will allow our team to collect the data needed to inform and align the research of our BRIDGE-C2 Center Parent Grant with the new realities of providing healthcare during the COVID-19 pandemic. We will track and understand the implementation strategies made by CHCs to change healthcare delivery processes and priorities, especially cancer preventive care, and share these critical lessons with a variety of stakeholders including the Implementation Science Centers in Cancer Control Program (ISC3 ) and CHCs across the US. With this supplement we will extend the work of our Parent Grant to answer the following questions: (1) What impact has COVID-19 had on the delivery of cancer preventive care; (2) What are the within and across state variations in CHC response to local levels of the COVID-19 outbreak and state / county actions; (3) What processes did CHCs use to adapt existing or adopt new strategies and implement operational changes to realign care with cancer preventive care guidelines in the COVID-19 context; and, (4) How do these findings inform BRIDGE-C2 Center’s future work? Once answered, more questions will become apparent leading to larger scale investigations and additional requests for grant funding. The BRIDGE-C2 Center with its national Implementation Laboratory of geographically diverse CHCs caring for over 1.9 million patients impacted by health disparities is uniquely positioned to extend its Parent Grant to quickly answer these important questions. The Aims of this supplement are: Aim 1: Identify and monitor the impact of the COVID-19 pandemic on delivery and receipt of cancer preventive care over a 12-month period; Aim 2: Identify the processes CHCs used, the external support and assistance they received to implement and adapt cancer preventive care to the COVID19 pandemic context, and operational changes employed to realign care with cancer prevention guidelines; and, Aim 3: Rapidly disseminate findings to a variety of relevant stakeholders. This supplemental work will: (1) advance implementation science by understanding how local adaptations were rapidly implemented or deimplemented in a crisis; (2) guide cancer prevention recommendations on identifying new or adapted ways to deliver cancer preventive care; and (3) rapidly distill and widely disseminate critical implementation findings to NCI laboratories and centers, CHCs and other primary care settings.