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

描述(由申请人提供)：我们的目标是发展和维持一个执行伙伴关系，该伙伴关系将侧重于农村社区卫生中心采用循证做法。我们将使用循证质量实施(EBQI)方法来促进与(社区卫生中心患者和提供者)的参与性研究伙伴关系，致力于适应、采用和评估循证实践。社区卫生合作伙伴的能力建设目标是：1)与研究人员合作，培养EBQI能力并使之制度化；2)评估和发展评估循证实践实施情况的内部能力；3)发展内部能力，成功申请外部资金，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。该伙伴关系的科学目标是：1)确定、理解和克服阻碍发展和维持致力于在农村社区卫生中心实施循证实践的伙伴关系的障碍；以及2)开发、完善和手册《农村社区卫生中心EBQI指南》。方法-基于我们在退伍军人事务部精神健康质量提高研究倡议中的实施研究经验，我们将与社区卫生中心患者和提供者合作，调整双相情感障碍和酒精使用障碍的循证做法。使用RE-AIM评估框架，我们将评估实施对患者层面和组织层面结果的影响。为了建立一个框架，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，并实时完善EBQI方法。总结性评价将评估循证做法的可持续性。

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.