Focusing Implementation to Bring Effective Reminders: FIBER

描述(申请人提供)：聚焦实施带来有效提醒(光纤)混合方法4年研究将评估大规模人群为基础的结直肠癌(CRC)筛查患者提醒计划和协调随访的实施情况。Five将使用研究人员开发的实用稳健实施和可持续发展模型(PRISM)来指导分析。PRISM考虑了干预设计、外部环境、干预实施和维护基础设施中的元素，以及采用组织及其患者的特征，这些特征与计划的覆盖范围、有效性、采用、实施和维护(RE-AIM评估框架)相关。主要目标：在50-80岁应接受结直肠癌筛查的健康计划成员中(n=50,000)；他们的初级保健提供者(PCP)团队(n=265)；咨询专家和主要工作人员(n=45)；以及俄勒冈州和华盛顿州15个医疗中心的主要医疗保健经理和工作人员(n=10)：1.通过实施一项实用的随机对照试验(RCT)(n=6000)来评估计划实施对CRC筛查的短期效果和每一次额外CRC筛查的成本，并使用CRC筛查的纵向队列研究(n=44,000名不在RCT中的患者)来评估在PCP团队水平上该计划的长期有效性和成本，以确定CRC筛查患者提醒计划的有效性和维持性。2.阐明患者、PCP团队和系统因素对实施成功的重要性3.在PRISM的指导下，描述和解释CRC筛查患者提醒计划(针对不同患者)的范围、有效性、采用、实施和维护，以授权实施改进以进行进一步评估。4.通过结合目标1-3的调查结果和对未来三个传播--实施地点的关键工作人员的线人访谈的观点，创建、完善和传播《儿童权利公约筛查提醒方案实施指南》。

DESCRIPTION (provided by applicant): The Focusing Implementation to Bring Effective Reminders (FIBER) mixed-methods 4-year study will evaluate the implementation of a large-scale population-based colorectal cancer (CRC) screening patient reminder program and coordinated follow-up. FIBER will use the Practical Robust Implementation and Sustainability Model (PRISM), developed by the investigators, to guide the analyses. PRISM considers elements within the intervention design, external environment, intervention implementation and maintenance infrastructure, and characteristics of the adopting organization and its patients that are associated with program Reach, Effectiveness, Adoption, Implementation, and Maintenance (the RE-AIM evaluation framework). Primary aims: Among health plan members aged 50-80 who are due for colorectal cancer screening (n= 50,000); their primary care provider (PCP) teams (n=265); consulting specialists, and key staff (n=45); and key health care managers and staff (n=10) in 15 medical centers in Oregon and Washington: 1. To determine the Effectiveness and Maintenance of a CRC screening patient reminder program by conducting a practical randomized controlled trial (RCT) (n= 6000) to evaluate the short-term effect of program implementation on CRC screening and the cost per additional CRC screen, and using a longitudinal cohort study of CRC screening (n=44,000 patients not in the RCT) to estimate the longer- term effectiveness and costs of the program at the PCP team level. 2. To elucidate patient, PCP team, and system factors important to implementation success 3. To describe and explain the CRC screening patient reminder program Reach (to diverse patients), Effectiveness, Adoption, Implementation, and Maintenance, guided by the PRISM, to empower implementation improvements for further evaluation. 4. To create, refine, and disseminate an implementation guide for CRC screening reminder programs by combining the findings from Aims 1-3 and the perspectives from informant interviews of key staff at three future dissemination-implementation sites.