Using Context to Improve Implementation of Evidenced-based Interventions for Colorectal Cancer Screening in Rural Primary Care (Precise CRC)
利用背景改善农村初级保健中结直肠癌筛查循证干预措施的实施(精准 CRC)
基本信息
- 批准号:9753984
- 负责人:
- 金额:$ 17.06万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-08-01 至 2021-07-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAreaAwarenessCancer ControlCancer Control ResearchCaringClinicClinical ResearchColonoscopyColorectal CancerCommunitiesConsentDataDoctor of PhilosophyElectronic MailEnsureEnvironmentEvidence based interventionExposure toFaceFamily PracticeGoalsGrowthHealthHealth SciencesHealth behaviorIndividualInformation TechnologyInfrastructureInstitutesInterventionIntervention StudiesInterviewKnowledgeLeadershipLow Income PopulationLow incomeMalignant NeoplasmsMedicaidMentorsMethodsModalityModelingOregonOutcomePatientsPerformancePersonsPopulationPragmatic clinical trialPrimary Health CareProviderPublic Health SchoolsReadinessResearchResearch ActivityResearch AssistantResearch DesignResearch InstituteResearch MethodologyResearch PersonnelRuralSecureSurveysSystemTelephoneTestingTimeTrainingTraining ActivityTranslational ResearchUniversitiesVisitWorkarmauthoritycancer carecancer preventioncare costscare deliverycare outcomescareer developmentclinical carecolorectal cancer screeningcostdesigndevelopmental psychologyevidence baseexperiencefollow-uphealth planimplementation researchimplementation scienceimplementation strategyimprovedinformantmedical schoolsmulti-component interventionmultidisciplinarymultimodalitypractice-based research networkprofessorprogramsresponseroutine practicerural patientsrural settingrural underservedscreeningscreening disparitiesskillssocialtreatment as usual
项目摘要
PROJECT SUMMARY
Candidate: Dr. Melinda Davis has a PhD in social developmental psychology and is a Research Assistant
Professor in the Oregon Health & Science University (OHSU) School of Medicine (Department of Family
Medicine) and Assistant Professor in the OHSU-PSU School of Public Health (Health Behavior). She is the
Director of Community Engaged Research for the Oregon Rural Practice-based Research Network (ORPRN)
at OHSU. This K07 builds upon her applied experience as a practice facilitator and participatory researcher,
addresses critical gaps in scientific training, and provides pilot data for an R01 submission in year 3 in
response to PAR-16-238. Guided by a multidisciplinary team of mentors, Dr. Davis will, through this K07,
consolidate her skills in implementation science, mixed-methods, and cancer prevention and control. She will
also secure her transition to research independence.
Research Focus: Bridging the gap between knowledge of evidence based interventions (EBIs) and
application in “real world” settings is a critical issue in cancer prevention and control research. Screening for
colorectal cancer (CRC) saves lives, yet disparities exist for rural and low-income populations. Although direct
mail (DM) programs can increase CRC screening rates by nearly 40%, this EBI is not yet routine practice.
Moreover, implementation and intervention outcomes vary widely across settings. Research is needed to
inform how best to scale DM programs and to support follow-up colonoscopy on positive fecal tests. Guided by
the social ecological model and consolidated framework for implementation research we propose three aims:
Aim 1: Identify factors associated with higher levels of primary care practice readiness to implement direct
mail programs to increase colorectal cancer (CRC) screening.
H1: Leadership culture and higher levels of adaptive reserve will be associated with readiness.
Aim 2: Pilot test tailored implementation support for a direct mail program in four rural primary care
practices clustered in one Medicaid Accountable Care Organization (ACO).
Aim 3: Elucidate barriers, facilitators, and adaptations to direct mail program components and the
associated impact on implementation and intervention outcomes.
Training Goals: The training proposed fills critical gaps to enable Dr. Davis to conduct trials to improve the
identification, adaptation, and implementation of EBIs to improve cancer prevention in rural primary care. The
mentoring, training, and research aims ensure scientific growth in three areas: (1) Knowledge of advanced
implementation science research methods; (2) Mixed methods research design and analysis; and (3) Leading
multidisciplinary teams in cancer prevention and control.
Environment: The OHSU Department of Family Medicine provides institutional support for this K07. Research
and training activities also utilize the robust infrastructure of the Oregon Rural Practice-based Research
Network (ORPRN), Oregon Clinical and Translational Research Institute (OCTRI), Knight Cancer Institute, and
the Kaiser Permanente Northwest Center for Health Research.
Methods: We will use an intervention mixed method design with embedded convergent and sequential
components. To achieve Aim 1, we will conduct a multimodal (email, phone, in-person) survey of ORPRN
practices (N~190), which are spread across Oregon's 16 Medicaid ACOs. We use generalized linear mixed
models to identify factors associated with higher levels of readiness. To achieve Aim 2, we will use practice
facilitation informed by the Getting to Outcomes™ approach, an evidence-based model that uses 10 steps to
help organizations implement EBIs, to implement DM programs into four rural primary care clinics clustered in
one Medicaid ACO (PacificSource Health Plans). We will assess the number of eligible patients reached
(implementation outcomes) and the impact on CRC screening (intervention outcomes) and use a merging
approach to cross-tabulate findings from clinic performance data with qualitative themes from observation visits
and a baseline assessments of adaptive reserve and practice-readiness. In Aim 3, we will interview key
informants from each practice (N~20) to identify DM program adaptations and elucidate barriers and facilitators
to implementation.
Outcomes: The training and research activities in this K07 fill critical gaps in scientific training for Dr. Davis.
Findings provide essential pilot data on practice readiness, implementation strategies, and intervention
adaptations which will inform an R01 submission in year 3 in response to PAR-16-238 to scale DM programs
across rural clinics served by Oregon's Medicaid ACOs in a two arm pragmatic clinical trial. Findings address
NCI agency priorities to implement EBIs and study multilevel interventions, help address long-standing CRC
screening disparities, and propel Dr. Davis to research independence.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
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会议论文数量(0)
专利数量(0)
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Melinda Marie Davis的其他文献
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{{ truncateString('Melinda Marie Davis', 18)}}的其他基金
ANTECEDENT (pArtNerships To Enhance alCohol scrEening, treatment, anD intErveNTion)
前因(加强酒精筛查、治疗和干预的合作)
- 批准号:
10259696 - 财政年份:2019
- 资助金额:
$ 17.06万 - 项目类别:
Using Context to Improve Implementation of Evidenced-based Interventions for Colorectal Cancer Screening in Rural Primary Care (Precise CRC)
利用背景改善农村初级保健中结直肠癌筛查循证干预措施的实施(精准 CRC)
- 批准号:
9386322 - 财政年份:2017
- 资助金额:
$ 17.06万 - 项目类别:
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