Advancing Health Equity through Implementation Science: Phase II Administrative Supplement

通过实施科学促进健康公平：第二阶段行政补充

• 批准号: 10814629
• 负责人: Matthew P Banegas
• 金额: $ 11.34万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10814629
• 关键词: Address; Administrative Supplement; Adopted; Adoption; Appointment; Cancer Control; Caring; Clinic; Clinical; Collaborations; Colonoscopy; Communication; Communities; Community Health; Data Set; Databases; Decision Making; Documentation; Electronic Health Record; Ensure; Evaluation; Federally Qualified Health Center; Financial Hardship; Funding; Healthcare; Healthcare Systems; Informatics; Intervention Studies; Laboratories; Lead; Learning; Malignant Neoplasms; Medicaid; Methods; Modeling; Patients; Persons; Phase; Population; Positioning Attribute; Preparation; Prevention; Primary Care; Process; Recommendation; Reporting; Resources; Risk; Role; Rural; Screening for cancer; Series; Services; Site; Social Work; Social Workers; Testing; Transportation; Universities; Variant; Washington; Work; design; food insecurity; guidebooks; health equity; health inequalities; housing instability; implementation science; implementation strategy; improved; member; patient navigation; patient screening; pilot test; primary care clinic; primary care practice; rapid test; referral services; response; rural area; social; social health determinants; social interventions; tool; user centered design; waiver

SUMMARY Social determinants of health and its downstream social risks such as housing instability, food insecurity, and financial strain, are key drivers of cancer health inequities. Healthcare systems’ engagement in identifying and addressing social needs is a new and evolving field. In particular, limited resources exist to guide healthcare clinics in selecting, implementing, and optimizing social service resource locators (SSRLs) for their specific context. The purpose of this supplement is to draw on learnings from our team’s previous pilot efforts in supporting clinics’ adoption of different SSRL approaches to develop a pragmatic guide for implementation of social risk referral-making and documentation. This supplement is a collaborative effort across four ISC3 Centers: BRIDGE-C2, Harvard ISCCCE, OPTICC (Optimizing Implementation in Cancer Control) Center, and Washington University-ISC3. We propose to: (1) develop a pragmatic, applied guidebook (the Guide) for clinics seeking to implement, expand, or optimize efforts to address patient-reported social risks using Assistance strategies; (2) use rapid-cycle testing to identify best practices for implementing the Guide; and (3) iterate and disseminate the refined Guide. In Aim 1, we will develop a pragmatic Guide to help primary care practices: 1) select an Assistance strategy and a related SSRL approach, and associated workflows for conducting these strategies in practice, including documenting social risk referrals; and 2) adopt, optimize, and sustain these workflows. Subsequently, in Aim 2 we will 1) provide the Guide to diverse clinics (urban and rural Federally Qualified Health Centers; primary care clinics) at different stages of SSRL implementation, in three ISC3 laboratories; 2) identify facilitators and barriers to implementing the Guide; and 3) identify the support needed to use the Guide. ISCCCE, OPTICC, and WU-ISC3 will use a series of rapid cycle turns with their clinical partner sites. We will use the Phase I supplement outer context dataset to identify key social resource needs that should be addressed in each clinic setting and rapid cycle testing using user-centered designed methods will be used to refine the Guide based on pilot learnings. Rapid tests using OPTICC state II methods of small changes for improvement will be tracked systematically. We will also track the implementation strategies used to support the Guide’s use, whether provided by ISC3 center staff or participating clinic sites. Clinics were selected to ensure variation in the ‘community vital signs’ associated with the populations they serve, as determined using our outer contextual database that was developed in Phase 1, and in the stages of implementing Assistance strategies, increasing generalizability. Finally, in Aim 3, we will finalize refining the Guide based on the findings of Aim 2, and disseminate it as a public good. Ultimately, this proposal will lead a public guide that can immediately be disseminated across ISC3 members’ community partners, and nationwide.

总结 健康的社会决定因素及其下游社会风险，如住房不稳定、粮食不安全， 财政紧张是癌症健康不公平的主要驱动因素。医疗保健系统参与识别和 解决社会需求是一个新的和不断发展的领域。特别是，指导医疗保健的资源有限 诊所选择，实施和优化社会服务资源定位器（SSRL）， 上下文本补充材料的目的是借鉴我们团队以前的试点工作的经验， 支持诊所采用不同的SSRL方法，以制定实施 社会风险档案制作和记录。本补充材料是由四个ISC 3 中心：BRIDGE-C2、哈佛ISCCCE、OPTICC（优化癌症控制实施）中心和 华盛顿大学-ISC 3.我们建议：（1）为诊所编制实用的指引 寻求实施、扩大或优化使用援助解决患者报告的社会风险的努力 （2）使用快速周期测试来确定实施《指南》的最佳做法;（3） 传播修订后的《指南》。在目标1中，我们会制订一套实用的指引，以协助基层医疗服务： 选择援助策略和相关的SSRL方法，以及执行这些策略和方法的相关工作流 实践中的战略，包括记录社会风险转介; 2）采用，优化和维持这些 工作流程。随后，在目标2中，我们将：1）向各种诊所（联邦城市和农村）提供指南， 合格的保健中心;初级保健诊所），在三个ISC 3 实验室; 2）确定实施指南的促进因素和障碍;以及3）确定所需的支持 使用指南。ISCCCE、OPTICC和WU-ISC 3将在其临床中使用一系列快速循环 合作伙伴网站。我们将使用第一阶段补充外部背景数据集来确定关键的社会资源需求 应在每个诊所设置和快速循环测试中使用以用户为中心的设计方法进行解决 将用于根据试点经验完善指南。使用OPTICC状态II方法快速测试小型 将有系统地跟踪改进的变化。我们还将跟踪所使用的实施策略 支持指南的使用，无论是由ISC 3中心工作人员还是参与临床研究中心提供。诊所 选择以确保与他们所服务的人群相关的“社区生命体征”的变化， 使用我们在第一阶段开发的外部上下文数据库确定，并在 实施援助战略，提高普遍性。最后，在目标3中，我们将最终完善 根据目标2的结果提供指导，并作为公益物加以传播。最终，这一提议将导致 可以立即在ISC 3成员的社区合作伙伴中传播的公共指南，以及 全国范围

项目成果

Conceptions of Legacy Among People Making Treatment Choices for Serious Illness: Protocol for a Scoping Review.

• DOI: 10.2196/40791
• 发表时间: 2022-12-09
• 期刊: JMIR RESEARCH PROTOCOLS
• 影响因子: 1.7
• 作者: Figueroa Gray, Marlaine;Banegas, Matthew P;Henrikson, Nora B
• 通讯作者: Henrikson, Nora B

Association of Social Risk Factors With Mortality Among US Adults With a New Cancer Diagnosis.

• DOI: 10.1001/jamanetworkopen.2022.33009
• 发表时间: 2022-09-01
• 期刊: JAMA NETWORK OPEN
• 影响因子: 13.8
• 作者: Banegas, Matthew P.;Dickerson, John F.;Zheng, Zhiyuan;Murphy, Caitlin C.;Tucker-Seeley, Reginald;Murphy, James D.;Yabroff, K. Robin
• 通讯作者: Yabroff, K. Robin

The Association Between Social Isolation and Memory Loss Among Older Adults.

老年人的社会孤立与记忆丧失之间的关联。

• DOI: 10.3122/jabfm.2022.210497r2
• 发表时间: 2022
• 期刊: Journal of the American Board of Family Medicine : JABFM
• 作者: Mosen,DavidM;Banegas,MatthewP;Keast,ErinM;Ertz-Berger,BriarL
• 通讯作者: Ertz-Berger,BriarL

The Cancer Financial Experience (CAFÉ) study: randomized controlled trial of a financial navigation intervention to address cancer-related financial hardship.

• DOI: 10.1186/s13063-022-06344-3
• 发表时间: 2022-05-13
• 期刊: TRIALS
• 影响因子: 2.5
• 作者: Henrikson, Nora B.;Anderson, Melissa L.;Dickerson, John;Ewing, John J.;Garcia, Robin;Keast, Erin;King, Deborah A.;Lewis, Cara;Locher, Blake;McMullen, Carmit;Norris, Consuelo M.;Petrik, Amanda F.;Ramaprasan, Arvind;Rivelli, Jennifer S.;Schneider, Jennifer L.;Shulman, Lisa;Tuzzio, Leah;Banegas, Matthew P.
• 通讯作者: Banegas, Matthew P.