Partnerships for Sustainable Research & Dissemination of Evidence Based Medicine

描述（由申请人提供）：减少健康差距日益意味着与社区更密切地合作，并为社区成员（包括全国12万名社区卫生工作者）量身定制服务和内容。卫生保健员接受的是各种各样的技能培训和维护，而且很少有循证资源。我们的工作假设是，当卫生保健中心拥有最好的、相关的、基于证据的信息时，健康差距就会减少。我们需要相反方向的信息流，CHW社区告知EBM社区他们需要什么证据以及他们如何需要这些证据。我们开发了一个基于web的“任务指南”原型系统，从用户需要完成的基于问题的任务的角度来处理信息提供。我们建议建立一个循证资源（EBR），包括一套工作指引，以协助卫生工作者与社区成员合作。与此同时，我们认识到有必要让社区卫生工作者在判断资源、任务和EBR本身方面发出自己的声音。针对这一功能，我们建议在现有的面向提供者的在线知识交换基础设施的基础上，建立一个为卫生保健工作者定制的知识交换平台。然后，我们将比较单独EBR与EBR+OKE的两组随机研究的相对疗效。完成后，我们将为CHW社区提供一套他们将自行审查的资源。更有力的是，我们将定义其成功的贡献者，包括资源和chw社区的相对价值。CHW社区将提供可用于构建未来循证资源的需求。在关于证据对卫生保健系统所有参与者的价值的反复讨论中，这些要求是无价的。

DESCRIPTION (provided by the applicant): Reducing health disparities has increasingly meant working more closely with the community and tailoring services and content to community members, including 120,000 Community health workers (CHWs) nationwide. CHWs receive a variable mix of training and maintenance of skills, and few evidence-based resources. Our working hypothesis is that health disparities are reduced when the CHW has the best, relevant, evidence-based information. We need Information flow in the opposite direction, where the CHW community informs the EBM community what evidence they need and how they need it. We have developed a prototype Web-based system of "Task Guides" that approaches Information provision from the perspective of problem-based tasks that users need to accomplish. We propose to create an Evidence-Based Resource (EBR), comprising a set of Task Guides, for CHWs' work with community members. At the same time, we recognize the need to provide CHWs a voice in judging the resources, the tasks, and the EBR Itself. For this function, building on an existing provider-oriented online knowledge exchange (OKE) Infrastructure, we propose to build a knowledge-exchange customized to CHWs. We will then compare the relative efficacy in a 2-arm randomized study of EBR alone vs. EBR+OKE. At completion, we will have supplied the CHW community with a set of resources they will have vetted for themselves. More powerfully, we will have defined the contributors to their success, including the relative value of the resources and of the community of CHWs. The CHW community will have provided requirements that can be used in constructing future evidence-based resources. These requirements are invaluable in the recurring discussion about the value of evidence to all participants in the health care system.