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

项目总结/摘要 这份申请是Joyce Gyamfi博士的多样性补充申请。该补充旨在 通过最近资助的行动提供指导、培训和先进的研究经验， 减少风险差异和参与共同支持BP控制（ADDRESS-BP）赠款（# HL 151310），重点是可扩展性，实现科学的理想成果。识别因素 影响多层次循证干预（MEBI）可扩展性的因素（障碍和促进因素） 这对于缩小实施科学中的证据与实践差距至关重要。此外，还必须 理解干预、环境（背景）、促进之间的复杂相互作用 战略，以及利益相关者的持续参与，以促进各种情况下的可扩展性。目前， 没有全面的操作过程、路线图或逻辑模型用于按比例放大MEBI;然而， 必须在人口水平上采取大规模干预措施，以确保重要的公共卫生 冲击作为这一多样性补充的一部分提出的研究旨在评估 通过积极的利益相关者参与，PACE干预在父母补助金中的可扩展性， 确定MEBI可扩展性的障碍和促进因素。实践支持和社区 参与（PACE）使用实践促进（PF）作为可持续的实施战略， 评价了三种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-诊所联系提供 模特在纽约市（NYC）。虽然这个MEBI有核心组件， 在临床环境中执行，PACE如何在其他城市和/或农村环境中扩展需要进一步研究。 research.可伸缩性是一项重要的实施成果，必须对其进行评估，以确保 将PACE转化为其他临床和社区服务系统。实施科学 促进卫生服务研究行动（PARiHS）和世卫组织/扩展网 扩大建议-将指导评估。通过混合使用两个框架- 方法（半结构化调查和与主要利益攸关方的重点小组）和实践能力 来自母基金目标2的数据将允许评估证据， 背景和促进;并为逻辑模型和操作过程的发展提供信息， 持续扩大PACE，这是父母赠款改善人口的合理下一步 在初步研究之外的其他高负担社区的健康状况。 具体来说，在这一多样性补充，Gyamfi博士的目标是完成以下研究， 培训目标：具体目标1：研究：子目标1A：评估背景、障碍和 使用PARIHS实施PACE血压控制干预的促进者 在纽约市的20个初级保健实践的框架（环境扫描）。子目标1B：评估 利用WHO/ExpandNet Scale-up，PACE干预在SubAim 1A中的可扩展性潜力 建议.子目标1C：开发强大的操作流程和逻辑模型， 横向和纵向扩大计算机设备行动伙伴关系，并通过利益攸关方评估该模式的可行性 反馈 具体目标2：职业发展：参与课程，培训和指导， 通过参加以下课程增加实施研究的知识， 培训：1）研究和卫生传播和实施培训研究所， 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）生物统计学/统计建模实施研究，5）补助金写作。 具体目标3：资助：扩大实施研究的知识范围 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，即提交早期研究者（ESI）K或R（例如，R21） 应用到NIH集中在试点测试和完善的逻辑模型，以扩大MEBI之前， 资金补充期结束。

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.