Utah Center for Clinical and Translational Science

犹他州临床和转化科学中心

• 批准号: 10363309
• 负责人: WILLARD H. DERE
• 金额: $ 123.11万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-03-30 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10363309
• 关键词: Academic Medical Centers; Achievement; Address; Administrative Efficiency; Advocacy; African; African American; Area; Biomedical Research; Cities; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Collaborations; Colorado; Communities; Community Outreach; Complement; Computer software; Data; Data Collection; Disease; Diverse Workforce; Ecosystem; Education; Ensure; Environment; Ethics; Evaluation; Face; Fostering; Foundations; Funding; Genes; Genetic; Genomics; Goals; Health; Health Care Research; Health Professional; Health system; Healthcare; Healthcare Systems; Idaho; Informatics; Infrastructure; International; Knowledge; Latino; Leadership; Learning; Longevity; Medicare; Methodology; Methods; Mission; Native Americans; Participant; Patients; Positioning Attribute; Principal Investigator; Prize; Process; Public Health; Randomized; Refugees; Reproducibility; Research; Research Infrastructure; Research Methodology; Research Project Grants; Research Training; Resource Sharing; Resources; Rural; Science; Scientific Advances and Accomplishments; Services; Sodium Chloride; Special Population; Statistical Methods; Structure; Surrogate Markers; Time; Training; Training and Infrastructure; Translational Research; Translations; Underrepresented Minority; United States Department of Veterans Affairs; Universities; Utah; Work; Wyoming; base; burden of illness; career; clinical center; community based participatory research; data acquisition; educational atmosphere; experience; frontier; implementation science; improved; innovation; member; multidisciplinary; novel; programs; quality improvement organization; sharing platform; skills; software development; suburb; tool; translational impact; translational pipeline

PROJECT SUMMARY/ABSTRACT Racial/ethnic minority, low socioeconomic status (SES), and rural populations suffer profound health inequities across a wide variety of diseases and conditions, as well as a disproportionate burden of the negative health consequences of the COVID-19 pandemic. Latinos make up ~14% of the Utah population vs. ~40% of Utah's COVID-19 cases, and the case rate is over 3-fold higher in neighborhoods characterized by high vs. low deprivation. The case rate in Utah per 100,000 is 665 among Whites vs. 3,503 among Latinos, 3,470 among Pacific Islanders, 1,727 among African Americans, and 1,569 among Native Americans. Community Health Centers (CHCs) are optimal settings for addressing the screening and uptake of COVID-19 testing among underserved populations. Twelve Utah CHC systems are participating in SCALE-UP Utah. Their 39 primary care clinics serve over 115,000 unique patients annually (37% Latino, 11% Native American, 61% <100% poverty level, 51% uninsured, and 49% of clinics are in rural/frontier areas). SCALE-UP Utah is a state-wide, pragmatic, multilevel intervention study. The long-term objective is to increase the reach, uptake, and sustainability of COVID-19 screening and testing among underserved populations. The team has existing infrastructure and “shovel ready” clinic and population health management (PHM) interventions ready for implementation. SCALE-UP Utah builds on long standing, funded partnerships, and will implement and evaluate three practical, feasible, scalable multi-level interventions to increase COVID-19 screening and uptake in Utah CHCs. Interventions leverage widely adopted Health Information Technology (HIT) at the point of care, text messaging, and patient navigation. SCALE-UP Utah will coordinate and synergize existing infrastructure and resources across the state, as well as strengthen infrastructure and data networks for rapid deployment of new screening and testing protocols, vaccination programs, etc. The project will employ a rapid cycle research approach in which interventions are tested on a small scale, using short time frames (e.g., <1 month) and cyclical evaluation cycles. A critical aspect of these rapid-research cycles is that change can be quickly tested on a small scale, and then disseminated to other clinics/patients. The interventions will be readily available for adoption by other low-resource healthcare settings; and, the data will advance population health and implementation science. The specific aims are to: 1. Implement and evaluate clinic and PHM interventions for increasing the uptake of COVID-19 testing among CHC patients across Utah. 2. Examine implementation effectiveness outcomes, as well as characteristics of both clinics and patients that may influence intervention effects and implementation outcomes.

项目概要/摘要 少数种族/族裔、低社会经济地位 (SES) 和农村人口健康状况不佳 各种疾病和状况的不平等，以及不成比例的负面负担 COVID-19 大流行对健康造成的影响。拉丁裔约占犹他州人口的 14%，而犹他州约占 40% 犹他州的 COVID-19 病例，高社区与低社区的病例发生率高出 3 倍多 剥夺。犹他州每 10 万名白人中的病例率为 665 例，拉丁裔中为 3,503 例，拉丁裔中为 3,470 例。 太平洋岛民、非洲裔美国人 1,727 人、美洲原住民 1,569 人。社区健康 中心 (CHC) 是解决筛查和接受 COVID-19 检测的最佳场所 服务不足的人群。犹他州的 12 个 CHC 系统正在参与犹他州 SCALE-UP 项目。他们的39个小学 护理诊所每年为超过 115,000 名独特患者提供服务（37% 拉丁裔、11% 美洲原住民、61% <100% 贫困水平，51% 没有保险，49% 的诊所位于农村/边境地区）。 SCALE-UP 犹他州是一个全州范围的 务实的、多层次的干预研究。长期目标是扩大覆盖面、采用率和 在服务不足的人群中进行 COVID-19 筛查和检测的可持续性。团队现有 基础设施和“准备就绪”的诊所和人口健康管理（PHM）干预措施已准备就绪 执行。 SCALE-UP 犹他州建立在长期的、资助的合作伙伴关系的基础上，并将实施和 评估三种实用、可行、可扩展的多层次干预措施，以提高 COVID-19 筛查和吸收率 在犹他州的CHC。干预措施利用广泛采用的健康信息技术（HIT） 护理、短信和患者导航。 SCALE-UP 犹他州将协调和协同现有的 加强全州的基础设施和资源，并加强基础设施和数据网络，以实现快速发展 部署新的筛查和测试方案、疫苗接种计划等。该项目将采用快速 循环研究方法，其中使用短时间框架（例如，<1 月）和周期性评估周期。这些快速研究周期的一个关键方面是变革可以 快速进行小规模测试，然后传播给其他诊所/患者。干预措施将是 易于被其他资源匮乏的医疗机构采用；并且，这些数据将促进人口增长 健康和实施科学。 具体目标是： 1. 实施和评估诊所和 PHM 干预措施，以提高 COVID-19 检测的采用率 犹他州各地的 CHC 患者中。 2. 检查实施效果的结果，以及诊所和患者的特征 可能会影响干预效果和实施结果。