Actions to Decrease Disparities in Risk and Engage in Shared Support for Blood Pressure Control (ADDRESS-BP) in Blacks

减少黑人风险差异并共同支持血压控制 (ADDRESS-BP) 的行动

• 批准号: 10273581
• 负责人: NADIA S ISLAM
• 金额: $ 15.11万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10273581
• 关键词: Address; Adoption; Area; Behavior; Biometry; Case Manager; Case Study; Clinic; Clinical; Clinical Services; Community Health Aides; Community Services; Complex; Data; Development; Disease; Dissemination and Implementation; Ensure; Environment; Evidence based intervention; Feedback; Focus Groups; Funding; Goals; Grant; Health; Health Services; Health system; Healthcare; Home Blood Pressure Monitoring; Hypertension; Institutes; Intervention; Knowledge; Level of Evidence; Logic; Low Income Population; Mentors; Mentorship; Methodology; Modeling; New York City; Organizational Change; Outcome; Population; Positioning Attribute; Primary Health Care; Process; Promoting Action on Research Implementation in Health Services framework; Provider; Public Health; Publications; Recommendation; Research; Research Methodology; Research Personnel; Research Training; Resources; Risk; Scanning; Site; Statistical Models; Stepparent; Structure; Surveys; System; Testing; Time; Training; Translations; Underserved Population; United States; United States National Institutes of Health; United States Public Health Service; Work; Writing; blood pressure regulation; career; career development; community burden; community clinic; community engagement; experience; hypertension control; implementation framework; implementation outcomes; implementation process; implementation research; implementation science; implementation strategy; improved; interest; low and middle-income countries; novel strategies; parent grant; population health; pragmatic trial; primary care setting; routine practice; rural setting; scale up; skills; symposium; therapy design; uptake; urban setting

PROJECT SUMMARY / ABSTRACT This application is a request for a diversity supplement for Dr. Joyce Gyamfi. The supplement aims to provide mentorship, training, and advance research experience via the recently funded Actions to Decrease Disparities in Risk and Engage in Shared Support for BP Control (ADDRESS-BP) grant (# HL151310), with a focus on scalability, a desired outcome in implementation science. Identifying factors (barriers and facilitators) that impact scalability of multi-level evidence-based interventions (MEBI) is critical to closing the evidence to practice gap in implementation science. Moreover, it is essential to understand the complex interaction between the intervention, environment (context), the facilitation strategy, and continuous stakeholder engagement to promote scalability in various contexts. Currently, there is no comprehensive operational process, roadmap, or logic model for scaling up MEBI; however, it is essential to bring interventions to scale at the population level to ensure significant public health impact. The research proposed as part of this diversity supplement aims to assess the potential scalability of the PACE intervention in the parent grant through active stakeholder engagement, in order to identify barriers and facilitators to the scalability of this MEBI. The Practice support And Community Engagement (PACE) uses practice facilitation (PF) as a sustainable implementation strategy to evaluate three MEBI which include nurse case management (NCM), home blood pressure monitoring (HBPM), and community health workers (CHW), delivered as an integrated community-clinic linkage model in New York City (NYC). Although this MEBI has the core components to be successfully executed in clinical settings, how PACE will be scaled in other urban and/or rural settings needs further research. Scalability, which is an essential implementation outcome must be assessed to ensure the translation of PACE to other clinical and community service systems. The implementation science framework - Promoting Action on Research in Health Services (PARiHS) - and the WHO/ExpandNet Scale -up recommendations- will guide the assessment. The use of the two frameworks via mixed- methodology (semi-structured surveys and focus groups with key stakeholders) and practice capacity data from Aim 2 of the parent grant will allow assessment of the interrelationship between evidence, context, and facilitation; and inform development of a logic model and an operational process for sustaining scale-up of PACE, which is a rational next step for the parent grant to improve population health in other high-burden communities beyond the initial study. Specifically in this diversity supplement, Dr. Gyamfi aims to accomplish the following research and training aims: SPECIFIC AIM 1: RESEARCH: SubAim 1A: Evaluate the context, barriers, and facilitators to implementation of the PACE blood pressure control intervention using the PARIHS framework (Environmental scan) at 20 primary care practices in New York City. SubAim 1B: Assess the potential for scalability of the PACE intervention in SubAim 1A using WHO/ExpandNet Scale-up recommendations. SubAim 1C: Develop robust operational process and logic model that will guide horizontal and vertical scale-up of PACE and assess the feasibility of the model via stakeholder feedback. SPECIFIC AIM 2: CAREER DEVELOPMENT: Engage in coursework, training, and mentorship to increase knowledge in implementation research by participating in the following coursework and training: 1) Training Institute for Dissemination and Implementation in Research and Health (TIDIRH), 2) Designing Interventions to Change Organizational Behavior; 3) Qualitative and Mixed Methods Research, 4) Biostatistics /Statistical Modeling for Implementation Research, 5) Grant writing. SPECIFIC AIM 3: GRANTSMANSHIP: Broaden the scope of knowledge in implementation research by attending conferences, drafting publications, and achieving the ultimate goal of this diversity supplement experience, which is to submit an Early Stage Investigator (ESI) K or R (e.g., R21) application to NIH focused on pilot testing and refining the logic model for scale-up of MEBI before the end of the supplement funding period.

项目概要/摘要 此申请是 Joyce Gyamfi 博士的多样性补充请求。该补充的目的是 通过最近资助的行动提供指导、培训和先进的研究经验 减少风险差异并共同支持 BP 控制 (ADDRESS-BP) 拨款 (# HL151310），重点关注可扩展性，这是实施科学中期望的结果。识别因素 影响多层次循证干预措施（MEBI）可扩展性的（障碍和促进因素） 对于缩小实施科学中的证据与实践差距至关重要。此外，还必须 了解干预、环境（背景）、促进之间复杂的相互作用 战略和利益相关者的持续参与，以促进各种环境下的可扩展性。现在， 没有扩展 MEBI 的全面操作流程、路线图或逻辑模型；然而， 必须在人口层面扩大干预措施，以确保显着的公共卫生 影响。作为多样性补充的一部分提出的研究旨在评估潜力 通过积极的利益相关者参与，PACE 干预母公司赠款的可扩展性，以便 确定此 MEBI 可扩展性的障碍和促进因素。实践支持和社区 参与（PACE）使用实践促进（PF）作为可持续的实施策略 评估三个 MEBI，其中包括护士病例管理 (NCM)、家庭血压监测 (HBPM) 和社区卫生工作者 (CHW)，作为综合社区与诊所的联系来提供 纽约市 (NYC) 的模特。虽然这个MEBI拥有成功的核心组件 在临床环境中执行时，如何在其他城市和/或农村环境中扩展 PACE 需要进一步 研究。可扩展性是一个重要的实施结果，必须对其进行评估，以确保 将 PACE 转化为其他临床和社区服务系统。实施科学 框架 - 促进卫生服务研究行动 (PARiHS) - 和 WHO/ExpandNet 扩大规模的建议将指导评估。通过混合使用这两个框架 方法（半结构化调查和关键利益相关者的焦点小组）和实践能力 来自母基金目标 2 的数据将允许评估证据之间的相互关系， 背景和便利；并为逻辑模型和操作流程的开发提供信息 持续扩大 PACE 规模，这是家长补助金改善人口的合理下一步 初步研究之外的其他高负担社区的健康状况。 具体而言，在这份多样性补充中，Gyamfi 博士旨在完成以下研究和 培训目标： 具体目标 1：研究：子目标 1A：评估背景、障碍和 使用 PARIHS 实施 PACE 血压控制干预措施的促进者 纽约市 20 个初级保健机构的框架（环境扫描）。子目标 1B：评估 使用 WHO/ExpandNet Scale-up 实现 SubAim 1A 中 PACE 干预的可扩展性潜力 建议。 SubAim 1C：开发稳健的操作流程和逻辑模型来指导 PACE 的横向和纵向扩展，并通过利益相关者评估该模型的可行性 反馈。 具体目标 2：职业发展：参与课程作业、培训和指导，以实现 通过参加以下课程来增加实施研究的知识 培训：1) 研究与健康传播和实施培训机构 (TIDIRH)， 2）设计干预措施来改变组织行为； 3) 定性和混合方法 研究，4）生物统计学/实施研究的统计建模，5）资助写作。 具体目标 3：资助：扩大实施研究的知识范围 通过参加会议、起草出版物并实现这种多样性的最终目标 补充经验，即提交早期研究者（ESI）K或R（例如R21） NIH 的申请重点是在 MEBI 上市之前进行试点测试和完善逻辑模型以扩大 MEBI 补充资金期限结束。