DP24-004, PRC: Core, University of Pittsburgh Health Promotion and Disease Prevention Research Center

PROJECT SUMMARY/ABSTRACT: Failure to equitably implement evidence-based healthcare interventions and practices (EBIs) has perpetuated health and healthcare disparities in the US. Dissemination and implementation science (D&I) strives to address evidence to practice gaps through the application of implementation strategies—methods to address barriers that communities and people face adopting, implementing, and sustaining EBIs. However, these strategies are often chosen without precision, failing to account for local contexts, and thereby not improving disparities. Our University of Pittsburgh (Pitt) team has expertise in cross-cutting D&I methods that can address multiple CDC priorities, including using novel and human-centered methods to efficiently evaluate implementation determinants, empirically matching and tailoring implementation strategies to these determinants to improve equity, and conducting rigorous evaluations in the context of community-based participatory research (CBPR). Consistent with CBPR, our team collaborated with Pitt's Family Medicine leaders and providers to select the Prevention Research Center (PRC) Core Research Project goal to improve equitable Diabetes Self-Management Education and Support (DSMES) program implementation. To achieve this goal, develop a PRC, and advance the PRC network, we will leverage our broad bench of experts and apply theory-driven, pragmatic D&I methods to 1) Develop and support the health equity and D&I focused Pitt PRC; 2) Co-develop, test, and disseminate implementation strategies to support the adoption, implementation, and sustainment of EBIs to improve DSMES; and 3) Actively participate in the PRC network to co-develop and deploy equity and D&I methods across Centers and projects. In Aim 1, we will partner with the Pitt Clinical and Translational Science Institute (CTSI) and Pitt D&I Science Collaborative (DISC) of over 170 D&I partners to develop and support a facile, sustainable Pitt PRC that is poised to tackle emerging public health priorities. In Aim 2, we will work with community partners to adapt an evidence-based implementation support approach to support DSMES program implementation, leveraging our team's DSMES, human-centered design, and community engagement expertise. We will conduct a hybrid type 3 cluster-randomized trial to test this bundle vs. usual approaches for supporting DSMES program implementation across 24 family medicine practices, serving a total of 20,000 people with diabetes, specifically aiming to improve implementation in Black and rural patients who are currently underserved by standard approaches. In Aim 3, we will offer our team's expertise in CBPR, user-centered design, health equity, and D&I as we collaborate with the PRC Network to adapt, implement, evaluate, disseminate, and translate EBIs into clinical practice. We look forward to participating in PRC committees and conferences to share information and data, develop new methods, and collaborate to advance precision implementation science and public health.