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Evaluation of an implementation support program for rural communities using a two-tiered, embedded framework.

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Summary
This summary is machine-generated.

Community health workers (CHWs) used Implementation Studio to deliver evidence-based interventions (EBIs), increasing cancer screening rates in Hispanic/Latino/a communities. The Studio enhanced CBO capacity and EBI implementation, showing promise for future public health initiatives.

Keywords:
Cancer screeningCommunity engagementEvidence-based interventionsImplementation supportProgram evaluationRural communities

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Area of Science:

  • Public Health
  • Health Services Research
  • Health Equity

Background:

  • Community-based organizations (CBOs) play a vital role in delivering health interventions.
  • Effective implementation of evidence-based interventions (EBIs) is crucial for improving health outcomes.
  • Targeting cancer screening among underserved populations, such as Hispanic/Latino/a communities, remains a priority.

Purpose of the Study:

  • To evaluate the impact of Implementation Studio on CBOs' capacity to implement EBIs.
  • To assess changes in breast and colorectal cancer (CRC) screening status among Hispanic/Latino/a EBI recipients.
  • To explore CBO staff perceptions of EBI implementation using Proctor's Implementation Research Outcomes Framework.

Main Methods:

  • A two-tiered framework combining pre/post-EBI delivery surveys (n=38) and semi-structured interviews (n=13) with CBO leaders and community health workers (CHWs).
  • Surveys assessed up-to-date breast and CRC screening status.
  • Interviews explored implementation outcomes (acceptability, appropriateness, feasibility, cost, sustainability) using rapid qualitative analysis.

Main Results:

  • Up-to-date cancer screening increased by 16.6% for breast and 19.3% for CRC, though not statistically significant (p=0.168).
  • CBOs reported enhanced workforce capacity and confidence (acceptability).
  • CHWs effectively adapted and implemented EBIs using Studio tools, improving community fit (appropriateness) and accessibility (feasibility).

Conclusions:

  • CBOs successfully implemented CHW-led EBIs, leading to increased cancer screening among rural Hispanic/Latino/a individuals.
  • Implementation Studio is a promising strategy for building CBO capacity to implement EBIs.
  • The findings highlight the potential of Studio to improve cancer screening rates in underserved populations.