Long COVID Care Resources and Education to Advance Community Health (REACH)

长期的新冠肺炎护理资源和教育以促进社区健康 (REACH)

• 批准号: 10865545
• 负责人: Hector Fabio Bonilla
• 金额: $ 100万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10865545
• 关键词: Long; COVID; Care; Resources; Education

Long COVID affects millions of people in the U.S. and has disproportionately impacted vulnerable populations including low-income persons and communities of color who often face barriers to healthcare access. As trusted, accessible providers, federally-qualified healthcare centers (FQHCs) are well-positioned to help mitigate inequities by providing access to Long COVID care in their medically underserved communities. We propose that a care model, Long COVID Care Resources and Education to Advance Community Health (REACH) where a centrally-coordinated, multidisciplinary Long COVID hub program that supports and partners with networks of safety-net FQHCs in the community will help expand and improve the care of vulnerable patient populations suffering from Long COVID. The Stanford Long COVID hub program is a team-based multidisciplinary clinical and research program rooted in a primary care-specialty care partnership and, together with key community partners including Community Health Center Network and San Mateo Medical Center and others, our goal is to extend the reach of this program and expand access for vulnerable patients with Long COVID through the following specific aims: AIM 1: Improve community awareness and education on Long COVID for patients and clinicians. AIM 2: Support primary care providers in partner safety-net FQHCs by creating a collaborative learning community with peer-to-peer asynchronous and real-time consultation. AIM 3: Improve Long COVID care referral coordination and access at the Stanford hub clinic. Our approach is to build upon the evidence-based and well-established Chronic Care Model (CCM) with innovative components that are adaptive and responsive to the rapidly changing landscape of Long COVID care. We will implement the tiered educational outreach and peer-to-peer primary care support strategies across partnering FQHCs with synergistic expertise from our colleagues at the Evaluation Sciences Unit, Office of Community Engagement, and Center for Continuing Medical Education. We will utilize a stepped wedge design and evaluate the model with a formative and summative mixed-methods approach guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to assess overall project reach and impact and adapt strategies throughout the REACH project duration. As part of the cooperative, we will collaborate with AHRQ and other recipients in the Learning Community to share, incorporate, and disseminate learnings in a collective effort to support the primary care community in Long COVID education and management. Overall the goals are to expand access to comprehensive, coordinated, and person-centered care for vulnerable patients with Long COVID.

长期的COVID影响了美国数百万人，并对弱势群体造成了不成比例的影响，包括低收入人群和有色人种社区，他们经常面临医疗保健障碍。作为值得信赖的，可访问的提供者，联邦合格的医疗保健中心（CIMCs）处于有利地位，可以通过在医疗服务不足的社区提供长期COVID护理来帮助减轻不平等。我们提出了一个护理模式，即长期COVID护理资源和教育促进社区健康（REACH），其中一个中央协调的多学科长期COVID中心计划，支持社区中的安全网社区卫生服务中心网络并与之合作，将有助于扩大和改善对长期COVID弱势患者群体的护理。斯坦福大学Long COVID中心计划是一项基于团队的多学科临床和研究计划，植根于初级保健-专科保健合作伙伴关系，并与包括社区卫生中心网络和圣马特奥医疗中心等在内的主要社区合作伙伴一起，我们的目标是通过以下具体目标扩大该计划的覆盖范围，并扩大Long COVID弱势患者的可及性：AIM 1：提高社区对患者和临床医生的长期COVID的认识和教育。目标2：通过创建具有点对点异步和实时咨询的协作学习社区，支持合作伙伴安全网中的初级保健提供者。目标3：改善斯坦福大学中心诊所的长期COVID护理转诊协调和访问。我们的方法是建立在循证和完善的慢性病护理模式（CCM）的基础上，并采用创新的组件，以适应和应对快速变化的长期COVID护理环境。我们将实施分层教育外展和点对点初级保健支持战略，通过与评估科学部门，社区参与办公室和继续医学教育中心的同事的协同专业知识，在合作的CNOHC中实施。我们将采用阶梯式楔形设计，并在可及性、有效性、采用、实施和维护（RE-AIM）框架的指导下，采用形成性和总结性混合方法评估模型，以评估整个项目的可及性和影响，并在整个REACH项目期间调整策略。作为合作的一部分，我们将与AHRQ和学习社区的其他受助人合作，共同分享、整合和传播学习成果，以支持基层医疗社区的长期COVID教育和管理。总体而言，目标是扩大长期COVID弱势患者获得全面，协调和以人为本的护理的机会。