Community Partnership for Telehealth Solutions to Counter Misinformation and Achieve Equity (PRIME)

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ABSTRACT Use of cancer screening services for Latinx populations has lagged far behind the use for non-Latinx White populations; this has led to later stage detection and worse survival for Latinx people. Clinic-delivered video- texting combined with neighborhood-level navigation services is a telehealth-community solution that offers great promise for addressing cancer screening disparities, as it reduces multi-level barriers to care. Our proposed project, Community Partnership for Telehealth Solutions to Counter Misinformation and Achieve Equity (PRIME), will leverage partnerships among research centers, clinics, and community organizations to provide personalized support services informed by local knowledge and neighborhood-level data, and apply and evaluate novel technical and communication solutions. The goal of PRIME will be to improve colorectal cancer-related care delivery and reduce disparities in telehealth access and care by developing and testing telehealth tools and technologies using novel research methods. This research will use rapid methods and adaptive-evaluation processes and will apply the Health Equity Implementation Framework and components of the Reach Effectiveness-Adoption Implementation Maintenance (RE-AIM) framework, with an emphasis on effects on disparities in implementation and evaluation. PRIME will assess neighborhood-level social determinants of health and adapt and optimize a telehealth-solution to improve the quality, reach, and effectiveness of colorectal cancer screening in predominantly Latinx clinic populations aged 45-54 (Aim 1); test technical and communication solutions that use video-text messages to educate patients about colorectal cancer screening, link them to community-based services, and provide personalized navigation to support to improve uptake of screening and follow-up care, using a pragmatic stepped-wedge design (12 neighborhoods; 3,000 patients aged 45-54; Aim 2); and assess multi-level moderators of program effectiveness (including neighborhood-level social determinants of health, ethnicity, and preferred language) and organizational-level barriers and facilitators to implementation; and scale-up the program across neighborhoods and partnering clinical practice sites (n = 4; Aim 3). This project will leverage local resources and strengthen connections among health systems and trusted community-based organizations, increasing the likelihood of program sustainment. To ensure the project’s success, we have assembled an engaged group of community partners, including payers, health centers, community-based organizations, and patients, along with a multi-disciplinary research team of nationally renowned clinicians and scientists. If successful, the program will result in ready-to- implement strategies to reduce cancer-related disparities and improve preventive cancer care access, quality, and health outcomes for Latinx populations.