implementation

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Abundant evidence documents persistent and pervasive health and health care disparities across the lifecourse in the United States, especially according to race/ethnicity and socioeconomic status. The primary objective of the SPHERE (Stanford Precision Health Equity in Race and Ethnicity) Implementation Core is to promote effective dissemination and adoption of precision health approaches to decrease health disparities at the local, regional, state, and national levels. Precision health includes disease prevention and treatment for maintenance of health and wellness across the lifecourse that is proactive, predictive, effective, efficient, and equitable. Precision health holds great potential for revolutionizing health disparities research and interventions through a better understanding of the complex interplay between biological, behavioral, environmental, and social factors that contribute to health inequalities and influence population health. Taking into consideration root causes, the implementation Core will use a socio-ecological framework that conceptualizes health and wellness as a product of biological, behavioral, environmental, and social factors. Additionally, the Implementation Core will engage patients, community organizations, and key stakeholders from health disparities community in all phases of the Implementation Core activities in accordance with principles of community-based participatory research and patient engagement. In close collaboration with consortium partners, the strategies that are developed, implemented, and evaluated as part of this core will build upon findings from the individual research projects to promote dissemination and implementation at the local, regional, and national levels to directly reduce health disparities. In support of the proposed projects, the Implementation Core's objectives are to: 1) Develop and evaluate the SPHERE ethical guidelines for participation in precision health research and delivery of precision health approaches among American Indians, Latinos, and Asians; 2) Establish a “Precision Health Innovation Lab” in Stanford Primary Care where precision health implementation strategies can be rapidly tested and refined among racial/ethnic minority and low-income patients. 3) Systematically assess the potential for dissemination and implementation of precision health interventions with mixed methods using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) model among American Indians, Latinos, and Asians; and 4) Develop, implement, and evaluate a precision health-training curriculum for providers that serve racial/ethnic minority and low-income patients in community settings. Through the development of ethical principles, evidence to support implementation and dissemination, and capacity building resources and activities, the Implementation Core will effectively translate findings from the SPHERE studies into community- based strategies to impact health disparities at the local, regional, and, potentially, national levels.