Community Partnership for Telehealth Solutions to Counter Misinformation and Achieve Equity (PRIME)

摘要 拉丁裔人口癌症筛查服务的使用远远落后于非拉丁裔白色人 这导致了晚期检测和拉丁裔人更差的生存率。诊所提供的视频- 短信与社区级导航服务相结合是一种远程医疗社区解决方案， 解决癌症筛查差异的巨大希望，因为它减少了多层次的护理障碍。我们 拟议的项目，远程保健解决方案社区伙伴关系，以打击错误信息和 实现公平（PRIME）将利用研究中心，诊所和社区之间的合作伙伴关系 组织提供个性化的支持服务，了解当地知识和社区水平 数据，并应用和评估新的技术和通信解决方案。PRIME的目标是 改善结肠直肠癌相关护理服务，减少远程医疗服务和护理方面的差距， 使用新的研究方法开发和测试远程保健工具和技术。这项研究将使用 快速方法和适应性评估程序，并将应用健康公平实施框架 和RE-AIM框架的组成部分， 强调对执行和评价中的差距的影响。PRIME将评估社区级别 健康的社会决定因素，并调整和优化远程医疗解决方案，以提高质量，覆盖范围， 在45-54岁的主要拉丁裔临床人群中进行结肠直肠癌筛查的有效性（目标1）;试验 技术和通信解决方案，使用视频文本消息来教育患者有关结直肠的知识 癌症筛查，将其与基于社区的服务联系起来，并提供个性化导航，以支持 采用实用的阶梯楔形设计（12个社区; 3，000名45-54岁的患者;目标2）;并评估项目有效性的多层次调节者（包括 社区层面的健康、种族和首选语言的社会决定因素）和组织层面的 实施的障碍和促进因素;并在社区和伙伴关系中扩大该计划 临床实践地点（n = 4;目标3）。该项目将利用当地资源并加强联系 在卫生系统和值得信赖的社区组织中， 自我维持。为了确保项目的成功，我们召集了一批社区合作伙伴， 包括付款人、健康中心、社区组织和患者，沿着多学科 由全国知名的临床医生和科学家组成的研究团队。如果成功，该计划将导致准备- 实施战略，减少与癌症有关的差距，改善预防性癌症护理的获得、质量 拉丁裔人口的健康状况。

ABSTRACT Use of cancer screening services for Latinx populations has lagged far behind the use for non-Latinx White populations; this has led to later stage detection and worse survival for Latinx people. Clinic-delivered video- texting combined with neighborhood-level navigation services is a telehealth-community solution that offers great promise for addressing cancer screening disparities, as it reduces multi-level barriers to care. Our proposed project, Community Partnership for Telehealth Solutions to Counter Misinformation and Achieve Equity (PRIME), will leverage partnerships among research centers, clinics, and community organizations to provide personalized support services informed by local knowledge and neighborhood-level data, and apply and evaluate novel technical and communication solutions. The goal of PRIME will be to improve colorectal cancer-related care delivery and reduce disparities in telehealth access and care by developing and testing telehealth tools and technologies using novel research methods. This research will use rapid methods and adaptive-evaluation processes and will apply the Health Equity Implementation Framework and components of the Reach Effectiveness-Adoption Implementation Maintenance (RE-AIM) framework, with an emphasis on effects on disparities in implementation and evaluation. PRIME will assess neighborhood-level social determinants of health and adapt and optimize a telehealth-solution to improve the quality, reach, and effectiveness of colorectal cancer screening in predominantly Latinx clinic populations aged 45-54 (Aim 1); test technical and communication solutions that use video-text messages to educate patients about colorectal cancer screening, link them to community-based services, and provide personalized navigation to support to improve uptake of screening and follow-up care, using a pragmatic stepped-wedge design (12 neighborhoods; 3,000 patients aged 45-54; Aim 2); and assess multi-level moderators of program effectiveness (including neighborhood-level social determinants of health, ethnicity, and preferred language) and organizational-level barriers and facilitators to implementation; and scale-up the program across neighborhoods and partnering clinical practice sites (n = 4; Aim 3). This project will leverage local resources and strengthen connections among health systems and trusted community-based organizations, increasing the likelihood of program sustainment. To ensure the project’s success, we have assembled an engaged group of community partners, including payers, health centers, community-based organizations, and patients, along with a multi-disciplinary research team of nationally renowned clinicians and scientists. If successful, the program will result in ready-to- implement strategies to reduce cancer-related disparities and improve preventive cancer care access, quality, and health outcomes for Latinx populations.