Bridging the evidence-to-practice gap: Evaluating practice facilitation as a strategy to accelerate translation of a systems-level adherence intervention into safety net practices

资助父母奖摘要 EVIDENCE项目（新冠病毒检测和疫苗的概念）由社会、伦理和 行为影响（SEBI）研究COVID-19检测在服务不足和/或弱势群体 人口倡议。项目证据利用了NIMHD资助的家庭项目的基础设施 纽约大学Langone Health的健康中心（FHC）是一个由联邦合格的健康中心（NHC）组成的网络， 纽约市为超过125，000名低收入和种族和民族多样化的患者提供服务。项目证据是 一项三阶段社区参与的研究，采用多管齐下的顺序混合方法设计， 全面了解推动COVID检测和疫苗接种的多层次因素， 19例黑人和拉丁裔患者（主要结局），以及参与安全网提供的随访护理 卫生系统。第一阶段是利用FHC电子健康记录（EHR）数据库， 与接受PCR相关的个人层面社会人口统计学、临床和医疗保健利用因素 对400名在FHC接受治疗的黑人和拉丁裔患者进行COVID-19检测。这一阶段还将 使用经验证的自我报告措施，捕获测试的社区和结构层面的决定因素 (NIH PhenX工具包）在相同的患者（目的1）。在第2阶段，来自第1阶段的数据源正在 结合定性数据（例如，焦点小组、人种学观察、文件分析）， 组织和道德问题，以阐明重要的社会，文化和背景因素相关 接受COVID-19检测和潜在疫苗（目标2）。与我们的社区监督合作 在第三阶段，我们将整合第一阶段和第二阶段的数据，以改进、测试和传播定制的 工具包和伦理治理指南（例如，临床试验透明度和数据隐私）（目标3）。这些 将设计工具包，以提高对COVID-19检测和疫苗研究的知识和认识， 将在FHC、当地社区、NYULH和RADx UP协调机构之间广泛传播， 数据收集中心。

Summary of the Funded Parent Award Project EVIDENCE (pErception of coVID tEsting aNd vaccine) was funded through the Social, Ethical, and Behavioral Implications (SEBI) Research on COVID-19 Testing among Underserved and/or Vulnerable Populations initiative. Project EVIDENCE leverages the infrastructure of a NIMHD-funded project in the Family Health Centers (FHCs) of NYU Langone Health, a network of federally qualified health centers (FQHC) in NYC that serves over 125,000 low-income and racially and ethnically diverse patients. Project EVIDENCE is a three-phase community-engaged study that uses a multipronged, sequential mixed methods design to gain a comprehensive understanding of the multilevel factors that drive uptake of testing and vaccination for COVID- 19 of Black and Latinx patients (primary outcome), and participation in follow-up care offered by safety-net health systems. Phase 1 is utilizing the FHC electronic health record (EHR) database to quantitatively examine individual-level sociodemographic, clinical, and healthcare utilization factors associated with receiving a PCR test for COVID-19 among 400 Black and Latinx patients who receive care at the FHCs. This phase will also capture the community- and structural-level determinants of testing using validated self-report measures (NIH PhenX Toolkit) among the same patients (Aim 1). In Phase 2 the data sources from Phase 1 are being coupled with qualitative data (e.g., focus groups, ethnographic observation, document analysis) to capture organizational and ethical issues to shed light on important social, cultural, and contextual factors associated with uptake of COVID-19 testing and potential vaccine (Aim 2). In partnership with our Community Oversight Task Force (COTF), in Phase 3, we will integrate Phase 1 and 2 data to refine, test, and disseminate tailored toolkits and ethical governance guidelines (e.g. clinical trials transparency and data privacy) (Aim 3). These toolkits will be designed to increase knowledge and awareness of COVID-19 testing and vaccine research and will be widely disseminated among the FHCs, local community, NYULH, and the RADx UP Coordination and Data Collection Center.