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

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PROJECT SUMMARY This supplement is a collaborative effort across all seven ISC3 Centers in which we will conduct an environmental scan of social determinants of health (SDH), “the conditions in which people are born, grow, live, work, and age,” within site-specific geographic areas. The Centers will select a set of outer context common data elements (OC-CDE) and build a repository with these data. Measures of interest to include in the OC-CDE repository represent seven domains to capture the following environments: food, physical, economic, social, health care, cancer behavioral and screening, and cancer-related polices. As we plan and implement interventions for the prevention, early detection, and treatment of cancer, we must take the outer context into account. Indeed, SDH are key influencers of health inequality and contribute to health disparities between populations and communities. The BRIDGE-C2 Center Implementation Laboratory is a network of community health centers (CHCs). CHCs face some of the most difficult implementation challenges, as they primarily serve patients with low-income, without health insurance, and living in rural areas. As the BRIDGE-C2 Center targets implementation strategies aimed at improving the adoption of evidence-based cancer screening and prevention interventions, it is clear that we cannot ignore the outer context that the CHCs deliver care in as well as the contextual conditions that patients' experience. As such, collecting outer context measures is essential to provide a robust and complete environmental scan of the clinics. In addition, the BRIDGE-C2 Center is uniquely positioned to assess the independent or combined effect of SDH at the clinic- versus the patient-level. Therefore, the BRIDGE-C2 Center has two main aims for this supplement, first to contribute to the collection of outer context measures and conduct an environmental scan of SDH within the BRIDGE-C2 Center Implementation Laboratory of CHCs in OR, WA, and CA; and second to assess the independent or combined effect of contextual SDH at the clinic- and patient-level on adoption of evidence-based cancer screening and prevention. This will be the first study to assess the impact of practice outer context on cancer screening and prevention interventions while accounting for the patient-level SDH. Findings from this study will provide valuable learnings for all ISC3 Centers and inform cross-Center collaboration in Phase II of the supplement.