Pragmatic Implementation Science Approaches to Assess and Enhance Value of Cancer Prevention and Control in Rural Primary Care

项目概要/摘要-行政核心 我们建议的实施科学中心的主题是“务实的实施科学方法 评估和提高癌症预防和控制在农村初级保健中的价值。”我们会申请， 先进的框架，务实的方法，以及与成本，收益和价值相关的严格的措施， 而且还可以推广到农村初级保健机构，这些机构往往在资源不足的情况下苦苦挣扎， 高需要人口。这些模型和方法将用于指导选择和实施 循证癌症预防和控制计划（CPC）。我们将首先关注肺癌 在农村初级保健机构进行筛查，首先在科罗拉多，然后通过与一个良好的 已建立的初级保健网络（即，国家研究网络）。 我们的总体框架将是我们增强的RE-AIM/PRISM模型，这是广泛的 使用了覆盖范围、有效性、采用、实施和维护框架，并增加了 背景因素（例如，干预措施的特点、实施和可持续性基础设施）。它将 作为开发和测试创新的成本、效益和价值评估的基础， 从不同利益攸关方的角度来理解和指导实施。我们将积极参与 在我们所有的研究中，都要考虑到患者、医疗服务提供者和员工利益相关者的观点。我们的飞行员 实施研究将采用企业负责人参与的方法来调整、实施和评估战略 重视指导实施与肺癌相关的共同决策和戒烟 筛选 我们的方法组将改进和评估我们的实用成本评估方法，以确定 从患者、提供者和交付人员的角度考虑实施/复制成本，然后 制定和试点测试关于不同RE-AIM相对效益的偏好的简要调查措施 成果。然后，我们将评估RE-AIM结果偏好和不同选择之间的关系。 CPC方案。最后，我们的外展和网络股将从事a）针对青少年的外展活动， 以及职业中期的调查人员和从业人员，包括在线专业发展（例如，研究生 证书方案、微型认证）以及量身定制的指导和技术援助办法; B） 开展传播活动，支持研究成果的打包和传播;以及c） 利用多种渠道开展协作活动，促进产品总分类和执行科学方面的伙伴关系 包括制定共享的务实的D&I措施和数据。

Project Summary/Abstract – Administrative Core The theme of our proposed Implementation Science Center is “Pragmatic implementation science approaches to assess and enhance the value of cancer prevention and control in rural primary care.” We will apply and advance frameworks, pragmatic methods, and measures related to cost, benefits, and value that are rigorous, but also generalizable across rural primary care settings that are often struggling with low resources, and a high need population. These models and methods will be used to guide selection and implementation of evidence-based programs for cancer prevention and control (CPC). We will initially focus on lung cancer screening in rural primary care settings, first in Colorado and then nationally through collaboration with a well- established primary care network (i.e., National Research Network). Our overarching framework will be our enhanced RE-AIM/PRISM model, which is an extension of the broadly used Reach, Effectiveness, Adoption, Implementation, and Maintenance framework with the addition of contextual factors (e.g., Intervention characteristics, implementation and sustainability infrastructure). It will serve as the basis to develop and test innovative assessments of costs, benefits, and value from the perspective of different stakeholders to understand and guide implementation. We will meaningfully engage with and include the perspectives of patients, providers, and staff stakeholders in all our studies. Our pilot Implementation Study will adapt, implement, and evaluate strategies using stakeholder-engaged approaches to value to guide the implementation of shared decision-making and smoking cessation related to lung cancer screening. Our Methods Unit will refine and evaluate our pragmatic cost assessment methods to determine implementation/replication costs from the perspective(s) of patients, providers, and delivery staff and then develop and pilot test brief survey measures of preferences regarding the relative benefit of different RE-AIM outcomes. We will then assess relationships among RE-AIM outcomes preferences and selection of different CPC programs. Finally, our Outreach and Network Unit will engage in a) outreach activities targeted at junior and mid-career investigators and practitioners including online professional development (e.g., graduate certificate program, micro-certification) and tailored mentoring and technical assistance approaches; b) dissemination activities to support the packaging and communication of research findings; and c) collaboration activities to facilitate partnerships on CPC and implementation science using multiple channels and including development of shared pragmatic D&I measures and data.