Pragmatic Implementation Science Approaches to Assess and Enhance Value of Cancer Prevention and Control in Rural Primary Care

项目概要/摘要-行政核心我们建议的实施科学中心的主题是“务实的实施科学方法，以评估和提高农村初级保健癌症预防和控制的价值”。我们将应用和推进框架，务实的方法，以及与成本，效益和价值相关的措施，这些措施是严格的，但也可以在农村初级保健环境中推广，这些环境往往与低资源和高需求人口作斗争。这些模型和方法将用于指导癌症预防和控制（CPC）循证方案的选择和实施。我们最初将专注于农村初级保健环境中的肺癌筛查，首先在科罗拉多，然后通过与完善的初级保健网络合作在全国范围内进行（即，国家研究网络）。我们的总体框架将是我们增强的RE-AIM/PRISM模型，它是广泛使用的范围，有效性，采用，实施和维护框架的扩展，并增加了上下文因素（例如，干预措施的特点、实施和可持续性基础设施）。它将作为从不同利益攸关方的角度制定和测试成本、效益和价值创新评估的基础，以了解和指导实施工作。我们将有意义地参与，并包括患者，供应商和工作人员利益相关者的观点在我们所有的研究。我们的试点实施研究将适应，实施和评估策略，使用患者参与的方法来指导实施与肺癌筛查相关的共同决策和戒烟。我们的方法部门将完善和评估我们的实用成本评估方法，以确定从患者，提供者和交付人员的角度（S）的实施/复制成本，然后开发和试点测试关于不同RE-AIM结果的相对效益的偏好的简要调查措施。然后，我们将评估RE-AIM结果偏好和不同CPC计划选择之间的关系。最后，我们的外联和网络股将参与a）针对初级和中级职业调查员和从业人员的外联活动，包括在线专业发展（例如，研究生证书课程、微型认证）以及量身定制的指导和技术援助方法; B）支持研究成果打包和交流的传播活动;以及c）利用多种渠道促进CPC和实施科学伙伴关系的协作活动，包括制定共享的务实的D&I措施和数据。

Project Summary/Abstract – Administrative Core The theme of our proposed Implementation Science Center is “Pragmatic implementation science approaches to assess and enhance the value of cancer prevention and control in rural primary care.” We will apply and advance frameworks, pragmatic methods, and measures related to cost, benefits, and value that are rigorous, but also generalizable across rural primary care settings that are often struggling with low resources, and a high need population. These models and methods will be used to guide selection and implementation of evidence-based programs for cancer prevention and control (CPC). We will initially focus on lung cancer screening in rural primary care settings, first in Colorado and then nationally through collaboration with a well- established primary care network (i.e., National Research Network). Our overarching framework will be our enhanced RE-AIM/PRISM model, which is an extension of the broadly used Reach, Effectiveness, Adoption, Implementation, and Maintenance framework with the addition of contextual factors (e.g., Intervention characteristics, implementation and sustainability infrastructure). It will serve as the basis to develop and test innovative assessments of costs, benefits, and value from the perspective of different stakeholders to understand and guide implementation. We will meaningfully engage with and include the perspectives of patients, providers, and staff stakeholders in all our studies. Our pilot Implementation Study will adapt, implement, and evaluate strategies using stakeholder-engaged approaches to value to guide the implementation of shared decision-making and smoking cessation related to lung cancer screening. Our Methods Unit will refine and evaluate our pragmatic cost assessment methods to determine implementation/replication costs from the perspective(s) of patients, providers, and delivery staff and then develop and pilot test brief survey measures of preferences regarding the relative benefit of different RE-AIM outcomes. We will then assess relationships among RE-AIM outcomes preferences and selection of different CPC programs. Finally, our Outreach and Network Unit will engage in a) outreach activities targeted at junior and mid-career investigators and practitioners including online professional development (e.g., graduate certificate program, micro-certification) and tailored mentoring and technical assistance approaches; b) dissemination activities to support the packaging and communication of research findings; and c) collaboration activities to facilitate partnerships on CPC and implementation science using multiple channels and including development of shared pragmatic D&I measures and data.