The Implementation Science Center for Cancer Control Equity - Implementation Lab

基于证据的癌症控制干预措施如果规模化，可以预防美国一半以上的癌症 然而，在全国范围内，这些策略在临床和 在社区环境中，特别是在为社会经济弱势群体服务的环境中。我们提出 在马萨诸塞州的社区卫生中心（CHC）建立实施实验室（I-Lab） (MA)增加社区卫生环境中的实施科学，使一系列关于 通过和实施癌症预防和控制战略，并允许对癌症进行快速周期检测， 在为健康不平等人口服务的环境中采取创新办法。我们建议与 马萨诸塞州社区卫生中心联盟，马萨诸塞州一个强大的初级保健协会，和31个马萨诸塞州 联盟成员的社区卫生中心都使用可互操作的综合数据报告平台， 报告和可视化系统（DRVS），用于通报和评价执行情况和质量改进 活动我们将建立一个三层实施实验室， 在社区卫生服务中心之间做好实施准备，并为试点实施和评估提供支持， 在准备开展实施活动的社区卫生中心中采取循证干预措施。 I-Lab将包括5个社区卫生中心作为活跃的试点，10个社区卫生中心在学习社区，最多16个社区卫生中心在 第1-5年的早期参与层。I-Lab将提供一系列实施支持要素， 其成员，由传播和实施互动系统框架（ISF）提供信息， 包括一个虚拟和面对面的学习社区，以提高组织能力， 支持团队指导将循证策略融入临床实践， 从业人员为I-Lab试点提供持续的技术援助，并提供财政资源支持CHC 参与各种创新和优先试点实施研究。I-Lab及其成员，以及我们的 ISCCCE研究者将得到数据管理部门的支持，以协调数据收集、数据收集和分析。 I-Lab成员和ISCCCE研究者之间的数据共享和数据相关通信。我们还将 设立一个做法监督股，以监测正在进行的执行活动，跟踪 快速循环试点研究，为未来试点研究的发展提供信息，并评估非预期的负面影响 对社区卫生中心其他健康差异举措的影响。为了实现I-Lab的目标，我们 组建了一个研究，实施，临床和社区卫生团队，具有丰富的经验， 癌症预防干预，癌症护理公平，实施科学，社区健康改善， 研究设计和生物统计学。我们的最终目标是推进癌症控制的实施科学 并在MA的CHC中创建一个实施科学生态系统， 部署循证癌症预防和控制战略，并提高健康公平性。

Evidence-based interventions for cancer control could prevent more than half of cancers in the U.S. if scaled nationally, yet there remains a substantial gap in the adoption of these strategies across clinical and community settings, particularly in settings that serve socioeconomically vulnerable populations. We propose to develop an implementation laboratory (I-Lab) of community health centers (CHCs) across Massachusetts (MA) to increase implementation science in community health settings, enable a range of studies on the adoption and implementation of cancer prevention and control strategies, and allow for rapid-cycle testing of innovative approaches in settings that serve health disparities populations. We propose to partner with the Massachusetts League of Community Health Centers, a robust primary care association in MA, and 31 Mass League member CHCs that all use an interoperable, comprehensive data reporting platform, the Data Reporting and Visualization System (DRVS), to inform and evaluate implementation and quality improvement activities. We will develop a three-tiered Implementation Laboratory (I-Lab) that builds capacity and implementation readiness among MA CHCs and provides support for pilot implementation and evaluation of evidence-based interventions among a subset of CHCs that are ready to undertake implementation activities. The I-Lab will include 5 CHCs as active pilot sites, 10 CHCs in the learning community, and up to 16 in the early engagement tier across years 1-5. The I-Lab will offer a range of implementation supporting elements to its members, informed by the Interactive Systems Framework for Dissemination and Implementation (ISF), including a virtual and in-person learning community to enhance organizational capacity, an implementation support team to guide integration of evidence-informed strategies into clinical practice, an implementation practitioner to provide ongoing technical assistance to I-Lab pilot sites, and financial resources to support CHC participation in a variety of innovative and priority pilot implementation studies. The I-Lab, its members, and our ISCCCE investigators will be supported by a Data Management Unit to coordinate data collection, data sharing, and data-related communication across I-Lab members and ISCCCE investigators. We will also establish a Practice Surveillance Unit to monitor ongoing implementation activities, track outcomes of the rapid-cycle pilot studies, inform the development of future pilot studies, and assess for unintended negative impacts on other health disparities initiatives across the CHCs. To achieve the aims of the I-Lab, we have assembled a research, implementation, clinical, and community health team with extensive experience in cancer prevention interventions, cancer care equity, implementation science, community health improvement, research design and biostatistics. Our ultimate goals are to advance implementation science in cancer control and to create an implementation science ecosystem in CHCs across MA that engages health centers in deploying evidence-based strategies for cancer prevention and control and increases health equity.