Research Program

项目总结 本补编将探讨新冠肺炎大流行对癌症筛查和预防的影响(即， 在社区卫生中心(CHC)接受护理的患者中，通过利用 在实施和传播中建立研究，以缩小差距，实现癌症公平 控制(桥-C2)中心实施实验室基础设施。社区卫生中心适应并改变了这种方式 他们在当前的大流行期间提供护理。例如，我们的实验室CHC显示出80%的下降 2020年3月至4月的面对面办公室访问，其中通常提供癌症预防护理。这 补充将允许我们的团队收集所需的数据，以便为我们的桥-C2的研究提供信息并进行调整 中心家长格兰特在新冠肺炎大流行期间提供医疗保健的新现实。我们会 跟踪和了解社区健康中心为改变医疗保健提供流程而制定的实施战略 和优先事项，特别是癌症预防护理，并与各种利益攸关方分享这些关键经验教训 包括实施癌症控制计划科学中心(ISC3)和全美的社区卫生中心。 有了这个补充，我们将扩展我们的母公司Grant的工作，以回答以下问题：(1)什么 新冠肺炎对癌症预防服务的提供有什么影响；(2)州内和州外有什么 卫生与公众卫生委员会对“新冠肺炎”疫情的地方反应和州/县行动的差异；(3)什么 CHC用来调整现有或采用新战略并实施运营更改的流程 在新冠肺炎的背景下重新调整护理与癌症预防护理指南；以及，(4)这些发现是如何 告知布里奇-C2中心未来的工作？一旦得到回答，更多的问题将变得显而易见，从而导致 更大规模的调查和额外的赠款资金申请。桥-C2中心和它的国家 为190多万受影响的患者提供服务的不同地理位置的社区健康中心实施实验室 健康差距具有得天独厚的优势，可以扩大其母公司赠款，以快速回答这些重要问题。 本补编的目的是：目标1：确定和监测新冠肺炎大流行对分娩的影响 和接受为期12个月的癌症预防护理；目标2：确定CHCs使用的流程、 他们得到了外部支持和援助，以实施和调整癌症预防护理，以适应COVID- 19大流行背景，以及为使护理与癌症预防指南相一致而采用的业务变化； 目标3：将调查结果迅速传播给各种相关的利益攸关方。这项补充工作将：(1) 通过了解如何快速实施或取消本地适应来推进实施科学 在危机中实施；(2)指导癌症预防建议，以确定新的或适应的方法，以 提供癌症预防护理；以及(3)迅速提取和广泛传播关键的执行结果，以 NCI实验室和中心、CHC和其他初级保健机构。

PROJECT SUMMARY This supplement will explore how the COVID-19 pandemic is impacting cancer screening and prevention (i.e., cancer preventive care) among patients receiving care in community health centers (CHCs) by leveraging the The Building Research in Implementation and Dissemination to close Gaps and achieve Equity in Cancer Control (BRIDGE-C2) Center Implementation Laboratory infrastructure. CHCs adapted and changed the way they deliver care during the current pandemic. For example, our Laboratory CHCs showed an 80% decline of in-person office visits, March to April 2020, in which cancer preventive care is typically delivered. This supplement will allow our team to collect the data needed to inform and align the research of our BRIDGE-C2 Center Parent Grant with the new realities of providing healthcare during the COVID-19 pandemic. We will track and understand the implementation strategies made by CHCs to change healthcare delivery processes and priorities, especially cancer preventive care, and share these critical lessons with a variety of stakeholders including the Implementation Science Centers in Cancer Control Program (ISC3) and CHCs across the US. With this supplement we will extend the work of our Parent Grant to answer the following questions: (1) What impact has COVID-19 had on the delivery of cancer preventive care; (2) What are the within and across state variations in CHC response to local levels of the COVID-19 outbreak and state / county actions; (3) What processes did CHCs use to adapt existing or adopt new strategies and implement operational changes to realign care with cancer preventive care guidelines in the COVID-19 context; and, (4) How do these findings inform BRIDGE-C2 Center's future work? Once answered, more questions will become apparent leading to larger scale investigations and additional requests for grant funding. The BRIDGE-C2 Center with its national Implementation Laboratory of geographically diverse CHCs caring for over 1.9 million patients impacted by health disparities is uniquely positioned to extend its Parent Grant to quickly answer these important questions. The Aims of this supplement are: Aim 1: Identify and monitor the impact of the COVID-19 pandemic on delivery and receipt of cancer preventive care over a 12-month period; Aim 2: Identify the processes CHCs used, the external support and assistance they received to implement and adapt cancer preventive care to the COVID- 19 pandemic context, and operational changes employed to realign care with cancer prevention guidelines; and, Aim 3: Rapidly disseminate findings to a variety of relevant stakeholders. This supplemental work will: (1) advance implementation science by understanding how local adaptations were rapidly implemented or de- implemented in a crisis; (2) guide cancer prevention recommendations on identifying new or adapted ways to deliver cancer preventive care; and (3) rapidly distill and widely disseminate critical implementation findings to NCI laboratories and centers, CHCs and other primary care settings.