Partnership for Implementation of Evidence-Based Practices in Rural Primary Care

描述（由申请人提供）：我们的目的是发展和维持一个实施伙伴关系，重点是通过农村社区卫生中心的循证实践。我们将使用循证质量改进（EBQI）的方法，以促进参与性研究伙伴关系（社区卫生中心的患者和供应商）致力于适应，采用和循证实践的评估。社区卫生合作伙伴的能力建设目标是：1）与研究机构合作，培养EBQI能力并使其制度化; 2）评估和发展评价循证实践实施情况的内部能力; 3）发展成功申请外部资金的内部能力，为持续实施循证实践提供资金。该伙伴关系的临床目标是在农村初级保健诊所实施双相情感障碍和酒精使用障碍的循证做法。该合作伙伴关系的科学目标是：1）识别，理解和克服障碍，发展和维持一个致力于在农村社区卫生中心实施循证实践的合作伙伴关系; 2）制定，完善和手册化农村社区卫生中心EBQI指南。 方法-我们的实施研究经验的退伍军人事务部的心理健康质量提高研究计划的基础上，我们将与社区卫生中心的患者和供应商合作，以适应双相情感障碍和酒精使用障碍的循证实践。使用RE-AIM评估框架，我们将评估实施对患者水平和组织水平结果的影响。作为一个框架，我们将评估执行伙伴关系的影响，还将开展EBCJI进程，以改进执行伙伴关系的结构/进程，并真实的改进EBQI方法。总结性评价将评估循证做法的可持续性。 公共卫生相关性：社区卫生中心是美国最大的初级保健网络，为生活在医疗服务不足的农村社区（53%）和内城社区（47%）的1500多万美国人提供服务。 实施循证实践可改善临床结局，但采用率较低。拟议的实施伙伴关系的结果和产品将与数百家诊所和数百万患者相关，并可能促进美国农村地区持续采用循证实践。

DESCRIPTION (provided by applicant): We purpose to develop and sustain an Implementation Partnership that will focus on the adoption of evidence-based practices by rural Community Health Centers. We will use Evidence-Based Quality Improcement (EBQI) methods to foster a participatory research partnership with (Community Health Center patients and providers) devoted to the adaption, adoption, and evaluation of evidence-based practices. The capacity building goals of the Community Health partners are to: 1) cultivate and institutionalize a capacity for EBQI in partnership with research faculty; 2) assess and develop an internal capacity for evaluating the implementation of evidence-based practices; 3) develop an internal capacity to successfully apply for an external funding to finance the sustained implementation of evidence-based practices. The clinical goals of the partnership are to implement evidence-based practices for bipolar disorder and alcohol use disorders in rural primary care clinics. The scientific goals of the partnership are to: 1) identify, understand, and overcme barriers to developing and maintaining a partnership devoted to the implementation of evidence-based practices in rural Community Health Centers; and 2) develop, refine, and manualize an EBQI Guide for rural Community Health Centers. METHODS - Building on our implementation research experience in the Department of Veterans Affairs' Mental Health Quality Enhancement Research Initiative, we will collaborate with Community Health Center patients and providers to adapt evidence-based practices for bipolar disorder and alcohol use disorders. Using the RE-AIM evaluation framework, we will evaluate the impact of implementation on patient level and organizational level outcomes. A framework, we will evaluate the impact of Implementation Partnership and the EBCJI process will also be conducted in order to improve the structure/process of the Implementation Partnership and to refine EBQI methods in real time. A summative evaluation will assess the sustainability of the evidence-based practices. PUBLIC HEALTH RELEVANCE: Community Health Centers are the nation's largest primary care network, providing services to over 15 million Americans living in medically underserved rural communities (53%) and inner-city neighborhoods (47%). Implementation if evidence-based practices improves clinical outcomes, yet adoption rates are low. Findings and products from the proposed Implementation Partnership will have relevance to hundreds of clinics and millions of patients, and could promote the sustained adoption of evidence-based practices across rural America.