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

我们建议发展和维持一种执行伙伴关系，重点是农村社区保健中心采用循证做法。我们将使用基于证据的质量改进（EBQI）方法来促进与（社区卫生中心患者和提供者）的参与性研究伙伴关系，致力于适应、采用和评估基于证据的实践。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，培养和制度化EBQI能力；2)评估和发展评估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，以资助基于证据的实践的持续实施。该伙伴关系的临床目标是在农村初级保健诊所实施双相情感障碍和酒精使用障碍的循证做法。该伙伴关系的科学目标是：1)确定、了解并克服发展和维持致力于在农村社区卫生中心实施循证实践的伙伴关系的障碍；2)为农村社区卫生中心制定、完善和手工编制EBQI指南。方法：基于我们在退伍军人事务部心理健康质量提升研究计划中的实施研究经验，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。还将对实施伙伴关系和EQBI过程进行形成性评估，以改进实施伙伴关系的结构/过程，并实时改进EBQI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.