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

项目总结--总体 阿拉斯加原住民和美国印第安人(Anai)的平均预期寿命比非阿拉斯加印第安人短10岁 西班牙裔白人和Anais人死于糖尿病、心脏病和 癌症。然而，Anai社区的医疗服务资金严重不足。部落与健康 为ANAI患者服务的组织需要证据证明成功实施了有效的 改善ANAI健康结果的干预措施。中南部基金会(SCF)，部落拥有和运营的 医疗保健组织拥有屡获殊荣的医疗保健提供和重新设计模式，因此提出了一套 该中心应用中的五项独立但相关的努力，“建设传播能力和 在部落医疗系统中的实施研究。SCF是主要申请者，并将牵头 这些与阿拉斯加原住民部落健康联盟和阿拉斯加大学的当地合作伙伴的努力， 以及华盛顿大学、梅奥诊所和阿肯色大学的国家合作伙伴 医学系。阿拉斯加内外的其他专家将提供额外的支持。 实施为牙科诊所开发的糖尿病筛查和转诊服务 阿拉斯加城市土著卫生保健环境(RP1)将研究实施一项循证 干预以确定有糖尿病风险的Anais；新陈代谢-知情护理以帮助阿拉斯加原住民 戒烟(RP2)将评估使用尼古丁代谢物比率测试来 选择戒烟治疗；并通过以下方式启动文化知情的高级护理计划 ANAI初级保健人员(RP3)将评估证据的有效性和实施情况- 在患有严重疾病的ANAIS患者中进行基于文化的、量身定制的姑息治疗干预。二是能力建设 努力将使RPS和中心作为一个整体取得成功。研究人员的职业提升 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 在D&I研究方面。行政核心将支持沟通和协调，执行统一的 评估策略，并为Anai Research管理人员创造一条新的职业道路。所有中心 将使用两个公认的D&I研究框架对组件进行评估：REACH、有效性、 采用、实施和维护(RE-AIM)和 实施研究(CFIR)。 拟议的中心将在一个由ANAI领导和运营的现有中心内扩大研究能力 研究部。具体目标的实现将提高部落医疗保健的能力 组织和ANAI研究人员领导未来专注于改善ANAIS健康的研究。

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.