BRIDGE-C2 Equity Fellowship for Cancer Prevention for Gender-Expansive Patients

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OVERALL PROJECT SUMMARY The Building Research in Implementation and Dissemination to close Gaps and achieve Equity in Cancer Control (BRIDGE-C2) Center will take on the grand challenge of advancing implementation science to improve cancer screening and prevention in underserved populations. This work is urgently needed because cancer screening and prevention disparities exist with regard to delivery of evidence-based interventions (EBIs). Effective strategies to improve implementation of EBIs in primary care community health centers (CHCs) that can eliminate these disparities are not known or poorly understood. Implementation science can contribute new knowledge that will transform CHCs' ability to serve the nation's most vulnerable populations. The BRIDGE-C2 Center will: 1) create a sustainable infrastructure for developing, conducting, and continuously evaluating implementation strategies that enhance primary care's ability to equitably deliver evidence-based cancer screening and prevention interventions to all people, emphasizing closing care gaps for vulnerable populations; 2) build capacity and training opportunities, and engage a multi-disciplinary team of implementation science and methods experts, to facilitate the development of innovative approaches relevant to our grand challenge; and 3) identify strategies to improve implementation of cancer screening and prevention EBIs in primary care, and conduct research / develop pragmatic methods to tailor, enhance, and support the adoption and sustainability of these strategies. We will build on the strong established partnerships between researchers at Oregon Health & Science (OHSU) primary care, the OHSU Knight Cancer Institute, and the OCHIN Implementation Laboratory (a well-established national network of >500 CHCs that share an electronic health record through the OCHIN Practice-Based Research Network). The BRIDGE-C2 Center will conduct pilot studies that develop and test strategies to improve implementation of EBIs, rapidly scale up successful pilots to conduct large scale pragmatic trials, and widely disseminate effective innovations to primary care practices caring for underserved populations. Woven throughout these activities will be the Center's focus on mentoring and training early career implementation scientists and leveraging collaborations to increase implementation science capacity. The Center's Administrative Core will serve as the nucleus that bridges the Research Program and Implementation Laboratory, providing support for research activities, leadership, governance, investigator development, dissemination, evaluation, and a connection to the national ISCCC network. Our first two research pilots aim to improve cervical cancer screening and follow-up care and tobacco cessation. Our first two methods pilots will create novel capabilities to predict needed implementation support based on provider and practice characteristics. We will spread our discoveries and create mechanisms for widely disseminating our findings and innovations to scientific, professional, and community networks to increase implementation of cancer screening and prevention EBIs and decrease health disparities.