Partnerships for Sustainable Research & Dissemination of Evidence Based Medicine

描述（由申请人提供）：减少健康差距越来越意味着与社区更密切地合作，并为社区成员提供量身定制的服务和内容，包括全国120，000名社区卫生工作者（CHW）。社区卫生工作者接受的培训和技能维持的组合各不相同，而且很少有基于证据的资源。我们的工作假设是，当CHW拥有最好的，相关的，基于证据的信息时，健康差距会减少。我们需要信息流在相反的方向，其中CHW社区通知循证医学社区，他们需要什么样的证据，他们如何需要it.We已经开发了一个原型基于Web的系统的“任务指南”，接近信息提供的角度来看，基于问题的任务，用户需要完成。我们建议为社区工作者与社区成员的工作建立一个以证据为基础的资源（EBR），包括一套任务指南。与此同时，我们认识到有必要让社区工作者在判断资源、任务和EBR本身时发表意见。对于这个功能，建立在现有的面向供应商的在线知识交换（OKE）基础设施，我们建议建立一个知识交换定制的CHW。然后，我们将在一项2组随机化研究中比较EBR单药与EBR+OKE的相对疗效。完成后，我们将为CHW社区提供一套他们自己审查的资源。更有力的是，我们将定义他们成功的贡献者，包括资源和社区卫生工作者社区的相对价值。CHW社区将提供可用于构建未来循证资源的要求。在反复讨论证据对医疗保健系统所有参与者的价值时，这些要求是非常宝贵的。

DESCRIPTION (provided by the applicant): Reducing health disparities has increasingly meant working more closely with the community and tailoring services and content to community members, including 120,000 Community health workers (CHWs) nationwide. CHWs receive a variable mix of training and maintenance of skills, and few evidence-based resources. Our working hypothesis is that health disparities are reduced when the CHW has the best, relevant, evidence-based information. We need Information flow in the opposite direction, where the CHW community informs the EBM community what evidence they need and how they need it. We have developed a prototype Web-based system of "Task Guides" that approaches Information provision from the perspective of problem-based tasks that users need to accomplish. We propose to create an Evidence-Based Resource (EBR), comprising a set of Task Guides, for CHWs' work with community members. At the same time, we recognize the need to provide CHWs a voice in judging the resources, the tasks, and the EBR Itself. For this function, building on an existing provider-oriented online knowledge exchange (OKE) Infrastructure, we propose to build a knowledge-exchange customized to CHWs. We will then compare the relative efficacy in a 2-arm randomized study of EBR alone vs. EBR+OKE. At completion, we will have supplied the CHW community with a set of resources they will have vetted for themselves. More powerfully, we will have defined the contributors to their success, including the relative value of the resources and of the community of CHWs. The CHW community will have provided requirements that can be used in constructing future evidence-based resources. These requirements are invaluable in the recurring discussion about the value of evidence to all participants in the health care system.