Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
基本信息
- 批准号:10756399
- 负责人:
- 金额:$ 6.96万
- 依托单位:
- 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:2020-01-01 至 2023-08-24
- 项目状态:已结题
- 来源:
- 关键词:AccountabilityAddressAdultAfrican AmericanAfrican American populationBehavior TherapyBehavioral ModelCardiovascular DiseasesCaringCharacteristicsChildClinicClinicalClinical ServicesCommunitiesCommunity HealthCommunity ServicesComputerized Medical RecordConsolidated Framework for Implementation ResearchCost Effectiveness AnalysisCountyDataDiabetes MellitusFederally Qualified Health CenterGlycosylated hemoglobin AGoalsHealthHealth Care CostsHealth PromotionHealth care facilityHeart DiseasesHybridsHypertensionIndividualInterventionKnowledgeLifeLinkLipidsLiteratureMapsMethodsModelingMorbidity - disease rateNational Heart, Lung, and Blood InstituteNorth CarolinaObesityOutcomeParticipantPatientsPersonsProcessResearchResourcesRiskRisk FactorsRuralRural CommunityRural MinoritySelf EfficacySelf ManagementServicesStressSystemTranslationsUnited StatesWeightburden of illnesscardiometabolismcardiovascular disorder preventioncardiovascular disorder riskcardiovascular healthcare costsclinical encountercommunity cliniccomparison controlcontextual factorscostcost estimatedata resourcedensitydigitaldisease disparityeffectiveness evaluationeffectiveness/implementation designeffectiveness/implementation studyfamily managementgeographic disparityhealth assessmenthealth inequalitieshealth managementhealth service usehigh riskimplementation evaluationimplementation facilitatorsimplementation scienceimplementation strategyimprovedinnovationminority communitiesmortalityorganizational readinesspragmatic interventionpragmatic trialprematurepreventpreventive interventionpublic health relevanceracial disparityrural African Americanrural health networkrural healthcarerural settingscreeningservice providerssocialsocial health determinantsstandard of caretheories
项目摘要
ABSTRACT
Cardiovascular disease (CVD) exerts a disproportionate burden of morbidity and mortality on African
Americans in the rural southeast. Much of this excess has been attributed, directly and indirectly, to social
determinants of health and resulting health-related social needs. While CVD prevention interventions have
reduced overall disease burden, they have failed to eliminate racial and geographic disparities in CVD. New
models of care, such as Accountable Health Communities, address health-related social needs through
screening, referral, and community navigation services and have begun to demonstrate improvement in health
care cost, use, and CVD risk factors. Rural minority communities, where the burden of CVD risk factors and
social needs are high, healthcare facilities may be more fragile and density of resources may be lower, have
even greater need for effective and scalable solutions to addressing health and social needs. Our proposal is
anchored by Bandura's Self-Efficacy theory, Grey's Self and Family Management Framework, and Andersen's
Behavioral Model of Health Services Use. We will use the Consolidated Framework for Implementation
Research to study implementation and effectiveness of integrating health-promoting community resource data
into the EMR via CommunityRx (CRx). The CRx-CVD intervention is a digital solution that links patients with
community-based resources to address health-related social needs and cardiometabolic health in rural AA
patients. Our overall objective is to identify factors that influence implementation and assess the health
impact of a closed-loop referral system to community health-promoting resources in a rural setting. We use a
hybrid II implementation effectiveness design to conduct a controlled pragmatic trial of patients (adults 18
years and over, children 2-17 years; N=750) in a system of federally qualified health centers in rural North
Carolina. We hypothesize that integration of closed-loop referrals will increase patient knowledge of community
resources, enhance self-efficacy to manage CVD risk factors, increase utilization of community resources and
improve markers of cardiometabolic conditions. To our knowledge, this trial will be the first to evaluate the
implementation and health impact of a low intensity, scalable, clinic-initiated intervention targeting AA adults
and children at risk of CVD. Furthermore, we will conduct cost-effectiveness analysis related to implementation
of CRx-CVD to inform scaling the intervention. The long-term goal is to identify scalable interventions to
reduce CVD risk and health-related social needs of African Americans using a “whole person” approach to
health.
摘要
心血管疾病(CVD)对非洲人的发病率和死亡率造成了不成比例的负担。
美国东南部农村这一过剩的大部分直接或间接地归因于社会
健康的决定因素和由此产生的与健康有关的社会需求。虽然CVD预防干预措施
尽管他们的研究结果显示,尽管他们的研究结果降低了总体疾病负担,但他们未能消除CVD中的种族和地理差异。新
保健模式,如负责任的卫生社区,通过以下方式解决与卫生有关的社会需求
筛查、转诊和社区导航服务,并已开始显示健康状况有所改善
护理成本、使用和心血管疾病风险因素。农村少数民族社区,心血管疾病风险因素的负担,
社会需求高,医疗设施可能更脆弱,资源密度可能更低,
更需要有效和可扩展的解决方案来满足健康和社会需求。我们的建议是
班杜拉的自我效能理论,格雷的自我和家庭管理框架,和安德森的
卫生服务使用行为模式。我们将利用《综合执行框架》
研究整合健康促进社区资源数据的实施情况和效果
通过CommunityRx(CRx)进入EMR。CRx-CVD干预是一种数字化解决方案,
以社区为基础的资源,以满足农村AA与健康有关的社会需求和心脏代谢健康
患者我们的总体目标是确定影响实施的因素,
闭环转诊系统对农村地区社区健康促进资源的影响。我们使用一个
混合II实施有效性设计,用于对患者(成人18
年龄及以上,2-17岁儿童; N=750)在北部农村联邦合格的卫生中心系统中
卡罗莱纳。我们假设闭环转诊的整合将增加患者对社区的了解
资源,提高自我效能,以管理心血管疾病的危险因素,增加社区资源的利用,
改善心脏代谢状况标志物。据我们所知,这次审判将是第一次评估
针对AA成人的低强度、可扩展、临床启动干预的实施和健康影响
和有CVD风险的儿童。此外,我们亦会就推行计划进行成本效益分析
CRx-CVD,以告知扩展干预。长期目标是确定可扩展的干预措施,
使用“全人”方法降低非裔美国人的心血管疾病风险和与健康相关的社会需求,
健康
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Giselle Corbie其他文献
Giselle Corbie的其他文献
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{{ truncateString('Giselle Corbie', 18)}}的其他基金
Heart Matters: Collaborate and Leverage Evidence in an African American Rural Network to Implement Risk Reduction Strategies for CVD (Heart Matters: Co-Learn to Reduce CVD)
心脏问题:在非裔美国人农村网络中合作并利用证据来实施 CVD 风险降低策略(心脏问题:共同学习减少 CVD)
- 批准号:
10182576 - 财政年份:2021
- 资助金额:
$ 6.96万 - 项目类别:
Heart Matters: Collaborate and Leverage Evidence in an African American Rural Network to Implement Risk Reduction Strategies for CVD (Heart Matters: Co-Learn to Reduce CVD)
心脏问题:在非裔美国人农村网络中合作并利用证据来实施 CVD 风险降低策略(心脏问题:共同学习减少 CVD)
- 批准号:
10662283 - 财政年份:2021
- 资助金额:
$ 6.96万 - 项目类别:
Heart Matters: Collaborate and Leverage Evidence in an African American Rural Network to Implement Risk Reduction Strategies for CVD (Heart Matters: Co-Learn to Reduce CVD)
心脏问题:在非裔美国人农村网络中合作并利用证据来实施 CVD 风险降低策略(心脏问题:共同学习减少 CVD)
- 批准号:
10463643 - 财政年份:2021
- 资助金额:
$ 6.96万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
10320421 - 财政年份:2020
- 资助金额:
$ 6.96万 - 项目类别:
Diversity Supplement: Implementation of EMR-Integrated Referrals
多样性补充:实施 EMR 集成转诊
- 批准号:
10543572 - 财政年份:2020
- 资助金额:
$ 6.96万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
10542812 - 财政年份:2020
- 资助金额:
$ 6.96万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
9886378 - 财政年份:2020
- 资助金额:
$ 6.96万 - 项目类别:
Implementation of EMR-Integrated Referrals to Link Clinical and Community Services to Reduce Health Inequity
实施 EMR 集成转诊,将临床和社区服务联系起来,减少健康不平等
- 批准号:
10078633 - 财政年份:2020
- 资助金额:
$ 6.96万 - 项目类别:
Reducing Cardiovascular Disease Risk Factors in Rural Communities in NC
减少北卡罗来纳州农村社区的心血管疾病危险因素
- 批准号:
8604189 - 财政年份:2014
- 资助金额:
$ 6.96万 - 项目类别:
Reducing Cardiovascular Disease Risk Factors in Rural Communities in NC
减少北卡罗来纳州农村社区的心血管疾病危险因素
- 批准号:
9566458 - 财政年份:2014
- 资助金额:
$ 6.96万 - 项目类别:
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