ACCISIS-Chicago

ACCISIS-芝加哥

• 批准号: 10471227
• 负责人: Karen E Kim
• 金额: $ 103.3万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-21 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471227
• 关键词: Adoption; African American; African American population; Area; Asian Americans; Cancer Control; Caring; Centers for Disease Control and Prevention (U.S.); Chicago; Clinic; Cluster randomized trial; Colorectal Cancer; Communities; Community Outreach; Consolidated Framework for Implementation Research; County; Data; Data Analyses; Data Collection; Disease; Education; Education and Outreach; Effectiveness; Evidence based intervention; Feces; Federally Qualified Health Center; Feedback; Funding; Geography; Goals; Health system; Hispanic; Hispanic Populations; Illinois; Incidence; Individual; Intervention; Interview; Leadership; Link; Low Income Population; Malignant Neoplasms; Measures; Mediation; Modeling; Patients; Persons; Phase; Pilot Projects; Population; Population Heterogeneity; Poverty; Precancerous Polyp; Preparation; Provider; Review Literature; Services; Site; Testing; Uncertainty; Uninsured; Work; base; colorectal cancer screening; cooking; design; effectiveness evaluation; ethnic minority; evidence base; follow-up; implementation process; implementation science; implementation strategy; innovation; medical specialties; meetings; mortality; multi-component intervention; multilevel analysis; pilot test; prevent; primary care services; primary outcome; programs; prospective; racial and ethnic; scale up; trial design

PROJECT SUMMARY Screening for colorectal cancer (CRC) not only detects disease early but also prevents cancer by finding and removing precancerous polyps. The overall goal of our project, Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science in Chicago (ACCSIS-Chicago), is to test a multilevel, multicomponent intervention to increase rates of CRC screening, follow-up, and referral-to-care among racial/ethnic minority and low income populations in Chicago, Illinois. In this project, we will include two different types of implementation strategies: 1) evidence-based multilevel, multicomponent intervention to increase rates of CRC screening, follow-up, and referral-to-care; and 2) implementation support strategies to support the implementation process that contribute to the adoption, implementation and sustainment of our proposed multilevel, multicomponent intervention. We will partner with 4 federally qualified health centers (FQHCs), which have 35 clinics in the Chicago area and provided primary care service to nearly 188,000 racial/ethnic minority and low income populations in 2016. During the UG3 Planning-Exploratory Phase, we will work with one of the 4 FQHC partners to pilot test, measure, and refine our proposed multilevel, multicomponent intervention in preparation for the experimental trial in the UH3 Implementation Phase, as well as assess the effectiveness of our implementation support strategies. In the UH3 Implementation Phase, we will use a stepped wedge cluster randomized trial design to examine the effectiveness and impact of our multilevel, multicomponent intervention on increasing rates of CRC screening, follow-up, and referral-to-care across our 4 partner FQHCs. The selection of our intervention components will be based on intensive literature review, and findings and lessons learned from our previous studies and projects. Our multilevel intervention components will include EMR provider reminders, provider assessment and feedback, patient navigation, provider education and community outreach. We will also test one local innovation, IL ColonCARES, during the UGH Phase to increase the rate of follow-up after a positive stool test among uninsured patients by linking uninsured patients with specialty services. We expect the finding from this study to have broad impact on understanding the implementation process to increase colorectal cancer screening, follow up, and referral to care across diverse health systems.

项目总结 结直肠癌筛查不仅可以早期发现疾病，还可以通过发现和预防癌症 切除癌前息肉。我们项目的总体目标是加速结直肠癌筛查 和通过芝加哥实施科学(ACCSIS-芝加哥)的后续行动，是测试多级别、 多因素干预，以提高结直肠癌筛查、随访和转诊到护理的比率 伊利诺伊州芝加哥的少数族裔和低收入人群。在这个项目中，我们将包括两个 不同类型的实施战略：1)以证据为基础的多层次、多成分干预，以 提高CRC筛查、随访和转诊至护理的比率；以及2)实施支助战略，以 支持有助于采用、实施和维持我们的 提议的多层次、多成分干预。我们将与4个联邦合格的健康中心合作 在芝加哥地区有35家诊所，为近188,000人提供初级保健服务 2016年的种族/少数民族和低收入人口。在UG3规划-探索阶段，我们将 与4个FQHC合作伙伴之一合作，试行测试、测量和完善我们提议的多级别、 多组分干预，为UH3实施阶段的试验性试验做准备 评估我们的执行支助战略的有效性。在UH3实施阶段，我们 将使用阶梯式楔形群组随机试验设计来检验我们的 提高结直肠癌筛查、随访和转诊至护理的比率的多层次、多因素干预 我们的4个合作伙伴FQHC。我们干预成分的选择将基于大量的文献 回顾，以及从我们以前的研究和项目中获得的结论和教训。我们的多层次干预 组件将包括电子病历提供者提醒、提供者评估和反馈、患者导航、 提供者教育和社区外展。我们还将测试一项本地创新，IL COLOCARES，在 UGH阶段通过链接提高未参保患者粪便检测阳性后的随访率 为未参保的患者提供专科服务。我们预计这项研究的发现将对以下方面产生广泛影响 了解增加结直肠癌筛查、随访和转诊的实施过程 在不同的卫生系统中提供医疗服务。