Actions to Decrease Disparities in Risk and Engage in Shared Support for Blood Pressure Control (ADDRESS-BP) in Blacks

减少黑人风险差异并共同支持血压控制 (ADDRESS-BP) 的行动

• 批准号: 10273581
• 负责人: NADIA S ISLAM
• 金额: $ 15.11万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10273581
• 关键词: Address; Adoption; Area; Behavior; Biometry; Case Manager; Case Study; Clinic; Clinical; Clinical Services; Community Health Aides; Community Services; Complex; Data; Development; Disease; Dissemination and Implementation; Ensure; Environment; Evidence based intervention; Feedback; Focus Groups; Funding; Goals; Grant; Health; Health Services; Health system; Healthcare; Home Blood Pressure Monitoring; Hypertension; Institutes; Intervention; Knowledge; Level of Evidence; Logic; Low Income Population; Mentors; Mentorship; Methodology; Modeling; New York City; Organizational Change; Outcome; Population; Positioning Attribute; Primary Health Care; Process; Promoting Action on Research Implementation in Health Services framework; Provider; Public Health; Publications; Recommendation; Research; Research Methodology; Research Personnel; Research Training; Resources; Risk; Scanning; Site; Statistical Models; Stepparent; Structure; Surveys; System; Testing; Time; Training; Translations; Underserved Population; United States; United States National Institutes of Health; United States Public Health Service; Work; Writing; blood pressure regulation; career; career development; community burden; community clinic; community engagement; experience; hypertension control; implementation framework; implementation outcomes; implementation process; implementation research; implementation science; implementation strategy; improved; interest; low and middle-income countries; novel strategies; parent grant; population health; pragmatic trial; primary care setting; routine practice; rural setting; scale up; skills; symposium; therapy design; uptake; urban setting

PROJECT SUMMARY / ABSTRACT This application is a request for a diversity supplement for Dr. Joyce Gyamfi. The supplement aims to provide mentorship, training, and advance research experience via the recently funded Actions to Decrease Disparities in Risk and Engage in Shared Support for BP Control (ADDRESS-BP) grant (# HL151310), with a focus on scalability, a desired outcome in implementation science. Identifying factors (barriers and facilitators) that impact scalability of multi-level evidence-based interventions (MEBI) is critical to closing the evidence to practice gap in implementation science. Moreover, it is essential to understand the complex interaction between the intervention, environment (context), the facilitation strategy, and continuous stakeholder engagement to promote scalability in various contexts. Currently, there is no comprehensive operational process, roadmap, or logic model for scaling up MEBI; however, it is essential to bring interventions to scale at the population level to ensure significant public health impact. The research proposed as part of this diversity supplement aims to assess the potential scalability of the PACE intervention in the parent grant through active stakeholder engagement, in order to identify barriers and facilitators to the scalability of this MEBI. The Practice support And Community Engagement (PACE) uses practice facilitation (PF) as a sustainable implementation strategy to evaluate three MEBI which include nurse case management (NCM), home blood pressure monitoring (HBPM), and community health workers (CHW), delivered as an integrated community-clinic linkage model in New York City (NYC). Although this MEBI has the core components to be successfully executed in clinical settings, how PACE will be scaled in other urban and/or rural settings needs further research. Scalability, which is an essential implementation outcome must be assessed to ensure the translation of PACE to other clinical and community service systems. The implementation science framework - Promoting Action on Research in Health Services (PARiHS) - and the WHO/ExpandNet Scale -up recommendations- will guide the assessment. The use of the two frameworks via mixed- methodology (semi-structured surveys and focus groups with key stakeholders) and practice capacity data from Aim 2 of the parent grant will allow assessment of the interrelationship between evidence, context, and facilitation; and inform development of a logic model and an operational process for sustaining scale-up of PACE, which is a rational next step for the parent grant to improve population health in other high-burden communities beyond the initial study. Specifically in this diversity supplement, Dr. Gyamfi aims to accomplish the following research and training aims: SPECIFIC AIM 1: RESEARCH: SubAim 1A: Evaluate the context, barriers, and facilitators to implementation of the PACE blood pressure control intervention using the PARIHS framework (Environmental scan) at 20 primary care practices in New York City. SubAim 1B: Assess the potential for scalability of the PACE intervention in SubAim 1A using WHO/ExpandNet Scale-up recommendations. SubAim 1C: Develop robust operational process and logic model that will guide horizontal and vertical scale-up of PACE and assess the feasibility of the model via stakeholder feedback. SPECIFIC AIM 2: CAREER DEVELOPMENT: Engage in coursework, training, and mentorship to increase knowledge in implementation research by participating in the following coursework and training: 1) Training Institute for Dissemination and Implementation in Research and Health (TIDIRH), 2) Designing Interventions to Change Organizational Behavior; 3) Qualitative and Mixed Methods Research, 4) Biostatistics /Statistical Modeling for Implementation Research, 5) Grant writing. SPECIFIC AIM 3: GRANTSMANSHIP: Broaden the scope of knowledge in implementation research by attending conferences, drafting publications, and achieving the ultimate goal of this diversity supplement experience, which is to submit an Early Stage Investigator (ESI) K or R (e.g., R21) application to NIH focused on pilot testing and refining the logic model for scale-up of MEBI before the end of the supplement funding period.

项目摘要 /摘要 该应用程序是为乔伊斯·吉姆菲（Joyce Gyamfi）博士提供多样性补充的要求。该补品旨在 通过最近资助的行动提供指导，培训和提高研究经验 降低风险差异并参与对BP控制（地址BP）赠款的共同支持（＃ HL151310），重点是可伸缩性，这是实施科学的预期结果。识别因素 （障碍和促进者）影响多层次循证干预措施（MEBI）的可伸缩性的（MEBI）是 关闭证据至关重要，以实施实施科学差距。而且，必须 了解干预，环境（环境），便利之间的复杂相互作用 策略，以及在各种情况下促进可扩展性的持续互动。现在， 没有用于扩大MEBI的全面操作过程，路线图或逻辑模型；然而， 至关重要 影响。作为这种多样性补充剂的一部分提出的研究旨在评估潜力 通过积极的利益相关者参与对父母赠款的步调干预的可伸缩性， 确定障碍和促进因子的可扩展性。实践支持和社区 参与（PACE）使用实践促进（PF）作为一种可持续的实施策略 评估三个MEBI，包括护士病例管理（NCM），家庭血压监测 （HBPM）和社区卫生工作者（CHW）作为综合社区链接联系 纽约市（NYC）的模特。尽管此MEBI具有成功的核心组成部分 在临床环境中执行，如何在其他城市和/或农村环境中缩放步伐。 研究。可伸缩性，这是必不可少的实现结果，以确保 将步伐转换为其他临床和社区服务系统。实施科学 框架 - 促进卫生服务研究行动（PARIHS）以及WHO/EXTAPTNET 规模 - up建议 - 将指导评估。通过混合 - 使用两个框架 方法论（半结构化调查和与主要利益相关者的焦点小组）和实践能力 父母赠款的AIM 2的数据将允许评估证据之间的相互关系， 背景和促进；并告知逻辑模型的开发和运营过程 维持速度的扩大规模，这是父母赠款改善人口的合理下一步 除了初步研究之外，其他高负荷社区的健康。 特别是在这种多样性补充中，Gyamfi博士旨在完成以下研究和 培训目的：特定目标1：研究：Subaim 1A：评估背景，障碍和 促进者使用PARIHS实施PACE血压控制干预措施 纽约市20种初级保健实践的框架（环境扫描）。 Subaim 1B：评估 使用WHO/ExpandNet缩放的Subaim 1A中速度干预的可伸缩性的潜力 建议。 Subaim 1C：开发可指导的强大操作过程和逻辑模型 速度的水平和垂直缩放，并通过利益相关者评估模型的可行性 反馈。 特定目标2：职业发展：从事课程，培训和指导 通过参加以下课程和 培训：1）研究与健康的传播与实施培训研究所（Tidirh）， 2）设计干预措施以改变组织行为； 3）定性和混合方法 研究，4）实施研究的生物统计学 /统计建模，5）授予写作。 特定目的3：授予技巧：扩大实施研究中知识的范围 通过参加会议，起草出版物并实现这种多样性的最终目标 补充经验，即提交早期阶段调查员（ESI）K或R（例如R21） NIH的应用集中于试点测试和完善逻辑模型，以扩大MEBI 补充资金期末。