Embedding community-engaged research principles in implementation science: The implementation science center for cancer control equity

Journal of Clinical and Translational Science, Journal Year: 2023, Volume and Issue: 7(1)

Published: Jan. 1, 2023

Gaps in the implementation of effective interventions impact nearly all cancer prevention and control strategies US including Massachusetts. To close these gaps, evidence-based must be rapidly equitably implemented settings serving racially, ethnically, socioeconomically, geographically diverse populations. This paper provides a brief overview The Implementation Science Center for Cancer Control Equity (ISCCCE) describes how we have operationalized our commitment to robust community-engaged center that aims gaps. We describe ISCCCE is organized principles research are embedded across center. Principles community engagement been components ISCCCE. intentionally integrated throughout structures processes developed evaluation assess whether quality partnerships reflects principles. comprehensive infrastructure studying efficient, pragmatic, equity-focused adaptation historically currently disadvantaged communities with built-in methods evaluate engagement. engaged designed maximize relevance on health centers.

Language: Английский

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Adaptation of the brainwriting premortem technique to inform the co-creation of COVID-19 testing strategies in underserved communities in South San Diego

BMC Health Services Research, Journal Year: 2024, Volume and Issue: 24(1)

Published: Jan. 3, 2024

Abstract Introduction Meaningful engagement of partners in co-creating and refining health-related programs can increase the initial uptake, sustained implementation, broad reach, effectiveness these programs. This is especially important for underserved communities where resources are limited need to be prioritized. Brainwriting premortem a novel qualitative approach partner that combines strengths individual idea generation with concept exercise addresses failure points prior implementation new Methods An adapted form brainwriting was used inform iterative refinements COVID-19 testing program at Federally Qualified Health Center (FQHC) San Diego. Patients providers from FQHC participated interviews two time (early- mid-implementation program). Interview data were transcribed, translated, analyzed using rapid approach. Key themes sub-themes identified program. Results A total 11 patients (7 Spanish- 4 English-speaking) 8 interviews. related possible reasons failure: advertising/sharing information; access testing; handling test results; staff patient safety; beliefs views regarding SARS-CoV-2 virus; options offered. Proposed solutions offered key failures except virus. Additional education, physical operations, recruitment strategies. Real-time changes flow components made response 7 suggestions providers. Changes process returning results most common, included sending via email distinct workflows based on result. Conclusion The technique allowed us incorporate perspective delivery refinement an effective tool context promising input ensure successful implementation. Future studies, particularly those requiring public health emergencies, should consider use this technique.

Language: Английский

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Community advisory boards as implementation strategies to center partner and patient voice in community health centers

Journal of Clinical and Translational Science, Journal Year: 2024, Volume and Issue: 9(1)

Published: Dec. 18, 2024

Community advisory boards (CABs) are a promising approach for strengthening patient and partner voices in community health center (CHC) evidence-based decision-making. This paper aims to describe how CHCs used CABs during the COVID-19 pandemic improve reach of testing among populations experiencing disparities identify transferable lessons future implementation. mixed methods study integrates brief quantitative surveys engagement (N = 20) one-on-one qualitative interviews 13) staff partners engaged CHC with cost analysis feedback from participating an online learning 17). reported high ratings engagement, all mean principles above 4 ("very good" or "often") out 5. Qualitative findings provided more in-depth understanding experiences serving on CAB highlighted such as trust mutual respect were reflected practices. We developed toolkit strategies governance prioritization, estimates ensure sustainment, guidance integrating quality improvement expertise, testimonies members benefits joining, template agendas facilitator training meeting success. In alignment Translational Science Benefits Model, this expands research impact through comprehensive measurement by transforming into action-orientated guide implement decision-making public impact.

Language: Английский

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Data sharing in the context of community-engaged research partnerships

Social Science & Medicine, Journal Year: 2023, Volume and Issue: 325, P. 115895 - 115895

Published: April 11, 2023

Over the past 20 years, National Institutes for Health (NIH) has implemented several policies designed to improve sharing of research data, such as NIH public access policy publications, genomic data policy, and Cancer Institute (NCI) Moonshot policy. In January 2023, a new gone into effect, requiring researchers submit Data Management Sharing Plan in proposals funding (NIH. Supplemental information the, 2020b; NIH. Final 2020a). These are based on idea that is key component scientific method, it enables creation larger repositories can lead questions may not be possible individual studies (Alter Gonzalez, 2018; Jwa Poldrack, 2022), allows enhanced collaboration, maximizes federal investment research. Important we must consider expanded whom do benefits accrue accrue? an era growing efforts engage diverse communities research, impact all participants they represent. We examine issue through community-engaged lens, informed by long-standing partnership between community health organization (Kruse et al., 2022). contend without effective engagement rich contextual knowledge, biases resulting from remain unchecked. provide recommendations would allow better related ensure both researcher understanding issues involved move toward shared benefits. By identifying good models evaluating contribute then using those systematically, will advance consideration perspective increase likelihood all.

Language: Английский

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Mobile Health Services for COVID-19: Counseling, Testing, and Vaccination for Medically Underserved Populations

American Journal of Public Health, Journal Year: 2022, Volume and Issue: 112(11), P. 1556 - 1559

Published: Oct. 12, 2022

Mobile health units can improve access to preventive services, especially for medically underserved populations. However, there is little published experience of mobile being used expand COVID-19 vaccination. In concert with local public departments and community members, we implemented a unit deployed it 12 predominantly low-income racial/ethnic minority communities in Massachusetts. We describe the success challenges this innovative program expanding (Am J Public Health. 2022;112(11):1556-1559. https://doi.org/10.2105/AJPH.2022.307021).

Language: Английский

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Challenges and recommendations for measuring time devoted to implementation and intervention activities in health equity-focused, resource-constrained settings: a qualitative analysis

Implementation Science Communications, Journal Year: 2023, Volume and Issue: 4(1)

Published: Sept. 1, 2023

There is little guidance for conducting health equity-focused economic evaluations of evidence-based practices in resource-constrained settings, particularly with respect to staff time use. Investigators must balance the need low-touch, non-disruptive cost data collection on providing services priority subpopulations.This investigation took place within a pilot study examining implementation bundled screening intervention combining social determinants and colorectal cancer at four federally qualified centers (FQHCs) Boston metropolitan area. Methods collecting personnel costs activities, including passive (automatic) active (non-automatic, requiring effort) collection, as well three alternate wordings self-reporting time-use, were evaluated qualitatively using collected through interviews FQHC (including clinicians, population staff, community workers) assessments completeness.Passive methods simple execute resulted no missing data, but missed activities that outside planned meetings. Active spreadsheets was users when applied care processes already tracked this fashion yielded accurate use data. However, tasks where not typical, broken up over multiple sessions, more challenging Questions asking about typical rather than specific period, patients, most reliable actionable Still, even best-performing question had substantial variability estimates. Participants noted patient characteristics interest research, language spoken, adverse health, issues related poverty or mental all contributed significantly variability.Passively are least burdensome should be pursued research efforts possible, accompanied by qualitative ensure an reflection effort. When workflows these also strong methods. Self-reported will questions inquire "typical" types patients.

Language: Английский

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The opinions of community-centered engagement and health care during and after COVID-19 pandemic

Frontiers in Psychiatry, Journal Year: 2023, Volume and Issue: 14

Published: May 5, 2023

OPINION article Front. Psychiatry, 05 May 2023Sec. Public Mental Health Volume 14 - 2023 | https://doi.org/10.3389/fpsyt.2023.1168860

Language: Английский

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Bundling Colorectal Cancer Screening Outreach with Screening for Social Risk in Federally Qualified Health Centers: A Stepped-Wedge Implementation-Effectiveness Study

Journal of General Internal Medicine, Journal Year: 2024, Volume and Issue: 39(7), P. 1188 - 1195

Published: Feb. 8, 2024

Abstract Background Bundling is combining individual interventions to meet quality metrics. offers of cancer screening with for social determinants health (SDOH) may enable centers assist patients risks and yield efficiencies. Objective To measure effects bundling fecal immunochemical testing (FIT) SDOH in federally qualified (FQHCs). Design Clustered stepped-wedge trial. Participants Four Massachusetts FQHCs randomized implement bundled FIT-SDOH over 8-week “steps.” Intervention Outreach 50–75-year-olds overdue CRC offer FIT screening. The implementation strategy used facilitation training data monitoring reporting. Main Measures Implementation process descriptions, from meetings, rates. Rates were compared between control each “step” by fitting generalized linear mixed-effects models random intercepts FQHCs, patients, FQHC. Key Results tailored processes their infrastructure, workflows, staffing prioritized different groups outreach. Two population outreach, two integrated within established programs, such as pre-visit planning. Of 34,588 screening, 54% female; 20% Black, 11% Latino, 10% Asian, 47% white; 32% had Medicaid, 16% Medicare, private insurance, uninsured. Odds completion “steps” controls higher overall among outreach (overall: adjusted odds ratio (aOR) 2.41, p = 0.005; prioritized: aOR 2.88, 0.002). did not differ across Conclusions As healthcare systems are required conduct more screenings, it notable that a long-standing requirement increased even when newer requirement. This was feasible real-world safety-net clinical conserve resources, especially complex or intensive strategies. Clinical Trials Registration NCT04585919

Language: Английский

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A Federally Qualified Health Center-led Ethics & Equity Framework & Workflow Checklist: An Invited Commentary in Response to a Relational Public Health Framing of FQHCs During COVID-19

The Journal of Law Medicine & Ethics, Journal Year: 2024, Volume and Issue: 52(1), P. 41 - 44

Published: Jan. 1, 2024

With disparate rates of morbidity and mortality among minoritized communities, COVID-19 illuminated the need for equity-informed practices in public health. Pacia et al posit FQHCs as entities that addressed inequity when others failed. This commentary further situates how address health crisis institutional racism related inequities every day presents a FQHC-led Ethics Equity Framework Workflow Checklist to guide ethical equitable engagement with FQHCs.

Language: Английский

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Adapting the Evidence Academy model for virtual stakeholder engagement in a national setting during the COVID-19 pandemic

Journal of Clinical and Translational Science, Journal Year: 2023, Volume and Issue: 7(1)

Published: Jan. 1, 2023

Abstract The COVID-19 pandemic raised the importance of adaptive capacity and preparedness when engaging historically marginalized populations in research practice. Rapid Acceleration Diagnostics Underserved Populations’ Equity Evidence Academy Series (RADx-UP EA) is a virtual, national, interactive conference model designed to support engage community-academic partnerships collaborative effort improve practices that overcome disparities SARS-CoV-2 testing technologies. RADx-UP EA promotes information sharing, critical reflection discussion, creation translatable strategies for health equity. Staff faculty from Coordination Data Collection Center developed three events with diverse geographic, racial, ethnic representation attendees project teams: February 2021 (n = 319); November 242); September 2022 254). Each event included data profile; 2-day, virtual event; summary report; community dissemination product; an evaluation strategy. Operational translational delivery processes were iteratively adapted each across one or more five domains: assets, knowledge learning, social organization, flexibility, innovation. can be generalized beyond tailored by academic input respond local national emergencies.

Language: Английский

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