Focusing Implementation to Bring Effective Reminders: FIBER

聚焦落实，有效提醒：FIBER

基本信息

批准号：
7616581
负责人：
ADRIANNE C FELDSTEIN
金额：
$ 61.39万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-05-01 至 2012-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7616581
关键词：
Adopted Adoption Affect Age Area Case Manager Characteristics Clinic Clinical Cohort Studies Colorectal Cancer Colorectal Surgery Consult County Detection Effectiveness Elements Environment Ethnic Origin Evaluation Failure Focus Groups Future Gastroenterologist Gender Goals Health Health Planning Health system Healthcare Healthcare Systems Intervention Interview Knowledge Literature Mails Maintenance Medical center Methods Modeling Morbidity - disease rate Obesity Oregon Pathologist Patients Primary Health Care Process Process Measure Program Effectiveness Provider Public Health Qualitative Evaluations Race Randomized Controlled Trials Relative (related person)Research Research Infrastructure Research Personnel Risk Screening for cancer Screening procedure Series Site Specialist Surgeon System Telephone Time Translating Translations Washington aged cohort colorectal cancer screening cost cost effectiveness empowered follow-up health care service organization improved informant member mortality population based programs public health relevance response success therapy design

项目摘要

DESCRIPTION (provided by applicant): The Focusing Implementation to Bring Effective Reminders (FIBER) mixed-methods 4-year study will evaluate the implementation of a large-scale population-based colorectal cancer (CRC) screening patient reminder program and coordinated follow-up. FIBER will use the Practical Robust Implementation and Sustainability Model (PRISM), developed by the investigators, to guide the analyses. PRISM considers elements within the intervention design, external environment, intervention implementation and maintenance infrastructure, and characteristics of the adopting organization and its patients that are associated with program Reach, Effectiveness, Adoption, Implementation, and Maintenance (the RE-AIM evaluation framework). Primary aims: Among health plan members aged 50-80 who are due for colorectal cancer screening (n= 50,000); their primary care provider (PCP) teams (n=265); consulting specialists, and key staff (n=45); and key health care managers and staff (n=10) in 15 medical centers in Oregon and Washington: 1. To determine the Effectiveness and Maintenance of a CRC screening patient reminder program by conducting a practical randomized controlled trial (RCT) (n= 6000) to evaluate the short-term effect of program implementation on CRC screening and the cost per additional CRC screen, and using a longitudinal cohort study of CRC screening (n=44,000 patients not in the RCT) to estimate the longer- term effectiveness and costs of the program at the PCP team level. 2. To elucidate patient, PCP team, and system factors important to implementation success 3. To describe and explain the CRC screening patient reminder program Reach (to diverse patients), Effectiveness, Adoption, Implementation, and Maintenance, guided by the PRISM, to empower implementation improvements for further evaluation. 4. To create, refine, and disseminate an implementation guide for CRC screening reminder programs by combining the findings from Aims 1-3 and the perspectives from informant interviews of key staff at three future dissemination-implementation sites. PUBLIC HEALTH RELEVANCE: FIBER focuses on filling the knowledge gap regarding how local health care practices affect the translation of cancer screening evidence. FIBER will add to the growing literature in the increasingly important area of translating research findings into real-world practice. Many of the FIBER findings will be useful in other clinical areas and will be broadly applicable to health care organizations aiming to improve detection, treatment, and survivability of colorectal cancer.

描述（由申请人提供）：为期 4 年的聚焦实施以带来有效提醒 (FIBER) 混合方法研究将评估大规模基于人群的结直肠癌 (CRC) 筛查患者提醒计划和协调后续行动的实施情况。 FIBER 将使用研究人员开发的实用稳健实施和可持续性模型 (PRISM) 来指导分析。 PRISM 考虑干预设计、外部环境、干预实施和维护基础设施中的要素，以及与计划范围、有效性、采用、实施和维护（RE-AIM 评估框架）相关的采用组织及其患者的特征。主要目标：年龄在 50-80 岁且应接受结直肠癌筛查的健康计划成员（n= 50,000）；他们的初级保健提供者 (PCP) 团队 (n=265)；咨询专家和关键员工（n=45）；俄勒冈州和华盛顿州 15 个医疗中心的主要医疗保健管理人员和工作人员 (n=10)： 1. 通过进行实用的随机对照试验 (RCT) (n=6000) 来确定 CRC 筛查患者提醒计划的有效性和维持情况）评估计划实施对 CRC 筛查的短期影响以及每次额外 CRC 筛查的成本，并使用 CRC 筛查的纵向队列研究（n=44,000 名未参与 RCT 的患者）来估计PCP 团队层面的计划的长期有效性和成本。 2. 阐明对实施成功至关重要的患者、PCP 团队和系统因素 3. 描述和解释 CRC 筛查患者提醒计划在 PRISM 的指导下，达到（针对不同患者）、有效性、采用、实施和维护，以授权实施改进以进行进一步评估。 4. 结合目标 1-3 的调查结果以及对未来三个传播实施地点主要工作人员进行知情者访谈的观点，创建、完善和传播 CRC 筛查提醒计划的实施指南。公共卫生相关性：FIBER 致力于填补有关当地医疗保健实践如何影响癌症筛查证据转化的知识空白。将研究成果转化为现实世界实践这一日益重要的领域，FIBER 将为不断增长的文献增添新内容。 FIBER 的许多研究结果将在其他临床领域有用，并将广泛适用于旨在改善结直肠癌的检测、治疗和生存率的医疗保健组织。