: Traditional methods for translating EB information into clinical practice have not worked well, especially in underserved, multiethnic (vulnerable) communities. There is a scarcity of studies on effective dissemination methods in rural, frontier and impoverished areas. The concept of using health extension agents, patterned after the 100-year experience of the Agricultural Extension Service, which transformed farming in this country, has been suggested as a model for translating evidence-based information into primary care, but few studies of this model have been conducted. The long term goal of this proposal is for Health Extension Rural Office: Translating Research into Localities (HERO TRalLs) to build an efficient, sustainable infrastructure that can adapt deliver and evaluate methodology for translating evidence-based information into rural primary care practices serving rural, underserved, multiethnic populations.
Three specific aims will be addressed: 1) To establish a sustainable HERO TRalLs infrastructure to rapidly develop and conduct dissemination interventions predicated on existing evidence-based tools, 2) To conduct a mixed-method, comparative effectiveness (CE) trial of two interventions for disseminating an evidence-based toolkit for treating chronic non-cancer pain (CNCP), in two rural Federally Qualified Health Center (FQHC) primary care practice systems in New Mexico, 3) To adapt and produce two dissemination manuals: a) health extension agent policies and procedures and b) an evidence-based CNCP treatment toolkit. A sustainable infrastructure will be molded by leveraging existing strengths and expanding the missions of three academic organizations: 1) the Health Extension Rural Offices (HEROs) based on the Agricultural Extension Service concept, 2) a state-wide practice-based research network, the Research Involving Outpatient Settings Network (RIOS Net), and 3) a community-oriented Clinical and Translational Science Center (CTSC). A Community Stakeholder Advisory Board will build research capacity with representatives from public health, a Medicaid managed care organization, a parent FQHC association, a Quality Improvement Organization, the Board of Pharmacy, and a community coalition. We will test the health exchange, practice detailing intervention in a CE trial using an adapted state-of-the-art EB toolkit for treating of CNCP.
Traditional methods for translating evidence-based (EB) information into clinical practice have not worked well, especially in rural, underserved, multiethnic communities. The concept of using health extension agents to disseminate EB information will be tested in a mixed-method, comparative effectiveness trial for disseminating EB information on treating chronic non-cancer pain. Using health exchange agents to disseminate EB information has the potential to transform primary care and improve the health of people living in rural areas.