Partnership for Implementation of Evidence-Based Practices in Rural Primary Care

我们建议发展和维持一个实施伙伴关系，重点是通过农村社区卫生中心的循证实践。我们将使用循证质量改进（EBQI）的方法，以促进参与性的研究伙伴关系（社区卫生中心的病人和供应商）致力于适应，采用和基于证据的做法的评估。社区卫生中心合作伙伴的能力建设目标是：1）与大学研究人员合作，培养EBQI能力并使其制度化; 2）评估和发展评价循证实践实施情况的内部能力; 3）发展成功申请外部资金的内部能力，为持续实施循证实践提供资金。该伙伴关系的临床目标是在农村初级保健诊所对双相情感障碍和酒精使用障碍实施循证实践。该合作伙伴关系的科学目标是：1）识别、理解和克服障碍，发展和维护致力于在农村社区卫生中心实施循证实践的合作伙伴关系; 2）制定、完善和手册化农村社区卫生中心EBQI指南。方法-在我们的退伍军人事务部心理健康质量增强研究计划的实施研究经验的基础上，我们将与社区卫生中心的患者和提供者合作，以适应双相情感障碍和酒精使用障碍的循证实践。使用RE-AIM评估框架，我们将评估实施对患者水平和组织水平结果的影响。还将对执行伙伴关系和环境质量基准指数进程进行形成性评价，以改进执行伙伴关系的结构/进程，并真实的改进环境质量基准指数方法。总结性评价将评估循证实践的可持续性。

We propose to develop and sustain an Implementation Partnership that will focus on the adoption of evidence based practices by rural Community Health Centers. We will use Evidence Based Quality Improvement (EBQI) methods to foster a participatory research partnership with (Community Health Center patients and providers) devoted to the adaption, adoption, and evaluation of evidence based practices. The capacity building goals of the Community Health Center partners are to: 1) cultivate and institutionalize a capacity for EBQI in partnership with university research faculty; 2) assess and develop an internal capacity for evaluating the implementation of evidence based practices; 3) develop an internal capacity to successfully apply for external funding to finance the sustained implementation of evidence based practices. The clinical goals of the partnership are to implement evidence based practices for bipolar disorder and alcohol use disorders in rural primary care clinics. The scientific goals of the partnership are to: 1) identify, understand, and overcome barriers to developing and maintaining a partnership devoted to the implementation of evidence based practices in rural Community Health Centers; and 2) develop, refine, and manualize an EBQI Guide for rural Community Health Centers. METHODS - Building on our implementation research experience in the Department of Veterans Affairs Mental Health Quality Enhancement Research Initiative, we will collaborate with Community Health Center patients and providers to adapt evidence based practices for bipolar disorder and alcohol use disorders. Using the RE-AIM evaluation framework, we will evaluate the impact of implementation on patient level and organizational level outcomes. A formative evaluation of the Implementation Partnership and the EQBI process will also be conducted in order to improve the structure/process of the Implementation Partnership and to refine EBQI methods in real time. A summative evaluation will assess the sustainability of the evidence based practices.