Community Health Worker Integration into Healthcare Teams: Advancing a Theory-driven Implementation Science Model

社区卫生工作者融入医疗保健团队：推进理论驱动的实施科学模型

基本信息

批准号：
10038299
负责人：
Chidinma Adanna Ibe
金额：
$ 14.05万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10038299
关键词：
Address Adherence Administrator Behavioral Cardiovascular system Care given by nurses Caring Case Manager Clinic Clinical Cluster randomized trial Communities Community Health Aides Community Integration Complement Data Development Development Plans Diffusion Effectiveness Exposure to Federally Qualified Health Center Fostering Foundations Funding Future Goals Health Personnel Healthcare Healthcare Systems Hospitals Human Hypertension Internal Medicine Intervention Interview Investigation K-Series Research Career Programs Life Style Link Measures Medical Medical Care Team Mentors Methods Modeling National Heart, Lung, and Blood Institute Organizational Change Outcome Patient Self-Report Patient-Focused Outcomes Patients Perception Plant Roots Positioning Attribute Prevalence Primary Health Care Process Program Development Psychometrics Public Health Randomized Research Research Activity Research Personnel Research Training Role Scientist Self Management Shapes Site Structure Testing Training Training Activity Translations Universities Vulnerable Populations Work base blood pressure regulation bone care outcomes care providers career career development collaborative care community clinic compare effectiveness design disparity reduction experience health care service organization health care settings hypertension control implementation research implementation science improved innovation instrument medical schools meetings member multidisciplinary professor psychosocial racial and ethnic disparities randomized trial routine care safety net skills social socioeconomics standard of care theories uptake working group

项目摘要

PROJECT SUMMARY Racial and ethnic disparities in hypertension (HTN) prevalence and control are well-documented and persist despite targeted initiatives aimed at their reduction. The use of Community Health Workers (CHWs) has been endorsed as a best practice to reduce HTN disparities among members of vulnerable communities. Despite the strength of the evidence linking exposure to CHW-delivered interventions with improved HTN-related outcomes among vulnerable populations, the sub-optimal uptake of CHW interventions across healthcare systems at large, and barriers to CHWs’ full integration in healthcare teams in particular, may threaten efforts to utilize them in support of patients whose psychosocial and socioeconomic circumstances require CHWs’ qualities and skillsets. Dr. Chidinma A. Ibe is a social behavioral scientist and an Assistant Professor of General Internal Medicine at the Johns Hopkins University School of Medicine. She seeks to support the translation and diffusion of this innovative, effective workforce into routine care by conducting a theory-driven, systematic appraisal of the factors contributing CHWs’ integration into care teams. She is applying for a K01 Mentored Career Development Award in order to acquire the skills, experience, and pilot data necessary to lay the foundation for an R01 that will apply the lessons learned in the K01 research and training period to develop interventions that optimize CHW uptake across diverse healthcare systems. Her proposed study will examine contextual barriers to the diffusion of a CHW intervention that formed the crux of a stepped collaborative care intervention. She will leverage the RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvements for Everyone) Project, a pragmatic, cluster randomized trial aimed at reducing disparities in HTN control featuring the use of CHWs embedded in collaborative care teams, to: 1) illuminate the complement of intrapersonal, interpersonal, and structural factors associated with the CHWs’ integration into care teams; 2) develop a theoretically-rooted measure of CHW care team integration; 3) explore the extent to which CHWs’ integration into healthcare teams is related to patients’ cardiovascular, behavioral, care management, and process of care outcomes; and 4) use human-centered design methods to co-develop, in partnership with key stakeholders, an organizational change intervention to promote CHWs’ integration into care teams. Her career development plan is characterized by a blend of didactic and experiential training in implementation science, qualitative and mixed methods, and advanced statistical strategies, including psychometric testing. This proposed research, in combination with an exceptional mentoring team (Primary Mentor: Dr. Lisa A. Cooper; Co-Mentor, Dr. Jill Marsteller), coursework, and participation in relevant working groups, professional development programs, and scientific meetings, will position Dr. Ibe to achieve her goal of becoming an independent investigator with expertise in the application of implementation science theories and models to strengthen the development, implementation, and translation of CHW interventions in healthcare settings.

项目摘要高血压（HTN）患病率和控制的种族和种族差异已有据可查，并且持续存在尽管有针对性的计划旨在减少其减少。社区卫生工作者（CHW）的使用一直作为减少脆弱社区成员之间HTN差异的最佳实践。尽管有将暴露与CHW提供的干预措施与HTN相关结果改善的证据的强度在弱势群体中，整个医疗系统中的CHW干预措施的次优摄取尤其是CHWS在医疗团队中完全集成的障碍，可能会威胁要利用它们支持心理社会和社会经济环境需要CHW的素质和技能的患者。 Chidinma A. 约翰·霍普金斯大学医学院。她试图支持翻译和扩散通过对这些因素进行理论驱动的系统评估，创新，有效的劳动力为常规护理将CHWS的整合到护理团队中。她正在申请K01指导职业发展奖为了获取为R01奠定基础所必需的技能，经验和试点数据在K01研究和培训期内汲取的经验教训，以开发优化CHW吸收的干预措施跨潜水员的医疗保健系统。她提出的研究将研究以下背景障碍 CHW干预构成了阶梯式协作护理干预措施的关键。她将利用富人生活（减少护理高血压的不平等：为每个人的生活方式改善），务实，群集随机试验旨在减少HTN控制中的分布合作护理团队，至：1）阐明人际，人际关系和结构性因素的完成与CHWS集成到护理团队中； 2）开发一个理论上的CHW护理量度团队集成； 3）探索CHWS纳入医疗团队的程度与患者有关心血管，行为，护理管理和护理结果； 4）使用以人为本的与主要利益相关者合作共同开发的设计方法，一种组织变革干预措施促进CHW的整合到护理团队中。她的职业发展计划的特征是教学融合以及经验丰富的实施科学，定性和混合方法以及高级统计的培训策略，包括心理测试。这项拟议的研究结合了出色的心理团队（主要导师：Lisa A. Cooper博士；吉尔·马斯特尔博士的同事），课程工作和参与相关的工作组，专业发展计划和科学会议，将把IBE博士定位为实现她成为实施应用专家的独立调查员的目标科学理论和模型，以加强CHW的发展，实施和翻译医疗机构的干预措施。