Building Capacity for Dissemination and Implementation Research in a Tribal Healthcare System

项目概要-总体 阿拉斯加原住民和美洲印第安人（ANAI）的平均预期寿命比非阿拉斯加人短10年。 西班牙裔白人和ANAIs有较高的死亡率，如糖尿病，心脏病， 癌然而，ANAI社区的医疗保健服务资金严重不足。部落与健康 为ANAI患者服务的组织需要关于成功实施有效的 干预措施，以改善ANAI的健康结果。中南部基金会，一个部落拥有和经营的 一家医疗保健组织，拥有屡获殊荣的医疗保健交付和重新设计模式，因此提出了一套 在本中心的申请中，五项独立但相关的工作，“建立传播和 在一个部落医疗保健系统的实施研究”。SCF是主要申请人， 这些努力与阿拉斯加土著部落健康联盟和阿拉斯加大学的当地合作伙伴， 以及华盛顿大学、马约诊所和阿肯色州大学的国家合作伙伴 医学科学。阿拉斯加内外的其他专家将提供额外的支持。 实施糖尿病筛查和转介服务开发的牙科诊所内 城市阿拉斯加土著卫生保健设置（RP 1）将研究实施一项基于证据的 干预，以确定ANAIs在糖尿病的风险;代谢知情的护理，以帮助阿拉斯加原住民 戒烟（RP 2）将评估使用尼古丁代谢物比率测试的可接受性和可行性， 选择戒烟治疗;和启动文化知情的提前护理计划， ANAI初级保健人员（RP 3）将评估证据的有效性和实施情况- 在患有严重疾病的ANAIs中进行基于文化的姑息治疗干预。二是能力建设 这些努力将优化RP和整个中心的成功。研究人员的职业发展 该项目将提供基础研究技能方面的持续培训和指导，并建立新的能力 D&I研究行政核心将支持沟通和协调， 评估战略，并为ANAI研究管理员创造一个新的职业途径。都是坚持 将使用两个公认的D&I研究框架对这些组成部分进行评估：覆盖范围，有效性， 采用、实施和维护（RE-AIM）以及 实施研究（CFIR）。 拟议中的中心将扩大研究能力内建立的ANAI领导和运营 研究部。具体目标的实现将提高部落保健的能力 该组织和ANAI研究人员领导未来的研究，重点是改善ANAI的健康。

PROJECT SUMMARY - Overall Average life expectancy for Alaska Native and American Indian (ANAI) people is 10 years shorter than non- Hispanic Whites, and ANAIs have higher death rates from conditions such as diabetes, heart disease, and cancer. Yet, healthcare services in ANAI communities are significantly underfunded. Tribes and health organizations serving ANAI patients need evidence about the successful implementation of effective interventions to improve ANAI health outcomes. Southcentral Foundation (SCF), a tribally-owned and operated healthcare organization with an award-winning model of healthcare delivery and redesign, thus proposes a set of five independent yet related efforts in this Center application, “Building Capacity for Dissemination and Implementation Research in a Tribal Healthcare System.” SCF is the primary applicant and will lead these efforts with local partners at the Alaska Native Tribal Health Consortium and University of Alaska, as well as national partners at the University of Washington, Mayo Clinic, and University of Arkansas Medical Sciences. Other experts within and outside of Alaska will provide additional support. Implementing a Diabetes Screening and Referral Services Developed for Dental Clinics Within an Urban Alaska Native Health Care Setting (RP1) will study the implementation of an evidence-based intervention to identify ANAIs at risk for diabetes; Metabolism-Informed Care to Aid Alaska Native People to Quit Smoking (RP2) will assess the acceptability and feasibility of using a nicotine metabolite ratio test to select smoking cessation treatment; and Jumpstarting Culturally-informed Advance Care Planning with ANAI People in Primary Care (RP3) will evaluate the effectiveness and implementation of an evidence- based, culturally-tailored palliative care intervention in ANAIs with serious illness. Two capacity building efforts will optimize success of the RPs and Center as a whole. The Researcher Career Enhancement Project will provide ongoing training and mentoring in foundational research skills and build new capacity in D&I research. The Administrative Core will support communication and coordination, implement a unified evaluation strategy, and create a new career pathway for ANAI Research Administrators. All Center components will be evaluated using two well-recognized D&I research frameworks: Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) and the Consolidated Framework for Implementation Research (CFIR). The proposed Center will expand research capacity within an established ANAI-led and -operated Research Department. Fulfillment of the specific aims will advance the capacity the tribal healthcare organization and ANAI researchers to lead future research focused on improving the health of ANAIs.