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

本增刊将探讨COVID-19大流行如何影响在社区卫生中心（CHCs）接受治疗的患者的癌症筛查和预防（即癌症预防护理），利用实施和传播建设研究来缩小差距并实现癌症控制（BRIDGE-C2）中心实施实验室基础设施的公平性。在当前大流行期间，卫生保健中心适应并改变了提供护理的方式。例如，我们的实验室chc显示，2020年3月至4月，通常提供癌症预防保健的亲自办公室就诊减少了80%。这一补充将使我们的团队能够收集所需的数据，为BRIDGE-C2中心家长资助的研究提供信息，并使其与COVID-19大流行期间提供医疗保健的新现实保持一致。我们将跟踪和了解CHCs制定的实施策略，以改变医疗保健服务流程和优先事项，特别是癌症预防保健，并与各种利益相关者分享这些关键经验，包括癌症控制计划实施科学中心（ISC3）和美国各地的CHCs。通过这一补充，我们将扩展父母赠款的工作，以回答以下问题：(1)COVID-19对癌症预防护理的提供产生了什么影响；(2) CHC应对当地COVID-19疫情水平和州/县行动的州内和州间差异是什么；(3)在COVID-19背景下，CHCs采用哪些流程来调整现有或采用新的战略，并实施业务变革，以使护理与癌症预防护理指南重新调整；(4)这些发现对BRIDGE-C2中心未来的工作有何启示？一旦得到答案，更多的问题将变得明显，从而导致更大规模的调查和额外的拨款申请。BRIDGE-C2中心及其地理位置不同的CHCs国家实施实验室照顾着190多万受健康差异影响的患者，具有独特的优势，可以延长其父母补助金，以迅速回答这些重要问题。目标1：确定和监测2019冠状病毒病大流行在12个月内对提供和接受癌症预防护理的影响；目标2：确定卫生保健中心使用的流程，他们在实施和调整癌症预防护理以适应covid - 19大流行背景时获得的外部支持和援助，以及为使护理与癌症预防指南重新调整而采用的操作变化；目标3：迅速将调查结果传播给各种相关利益攸关方。这项补充工作将：(1)通过了解在危机中如何迅速实施或取消当地适应措施来推进实施科学；(2)指导癌症预防建议，确定新的或适应的方式来提供癌症预防保健；(3)迅速提取关键的实施结果，并将其广泛传播给NCI实验室和中心、CHCs和其他初级保健机构。

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.