(provided by the applicant): There is growing awareness of the gap between knowledge gained from medical research and application of that knowledge in Evidence-Based Practice (EBP) to improve the health of communities. To achieve more widespread adoption, a more collaborative approach to working with different consumers of EBP, including potential recipients, is needed if we are to achieve meaningful population-level change in uptake of EBP. Many of the people who are most at risk of poor health outcomes are members of medically underserved populations. These include individuals of low socioeconomic status, those who possess low level of health literacy, and members of marginalized ethnic and minority groups. EBP is essential in health care and health promotion, since it provides direction and rationale for guiding health behaviors, decision-makings and treatment. We must therefore develop innovative approaches to disseminating EBP among the medically underserved. We will focus on the Asian-American (AA) community in the Chicago metropolitan area. The Chicago metropolitan area has the largest concentration of AA in the Midwest and the 6"^ largest in the United States. More than 65% of AA in Chicago are foreign-born immigrants and refugees and come from low-income, limited English proficient backgrounds. AAs have the lowest rates of preventive cancer screenings of all minority groups in the U.S. and cancer is the number one cause of mortality only in this group. Cultural differences, the language barrier, and traditional AA health beliefs make innovative dissemination strategies a priority need, if we are to extend the reach and impact of EBP to this population. We will design our dissemination product based on a close understanding of target AA community in our region, and in full collaboration with them, using a community-based participatory research framework. The content of our demonstration effort will be EBP for preventive colorectal cancer screening. Specifically, we aim to create a research and dissemination infrastructure for the AA community, to determine community based organization capacity for participation and to pilot and evaluate the success of our dissemination model using colorectal cancer as our disease focus. We expect that we will create an academic-community partnership and a research-community infrastructure to investigate dissemination approaches, guide development of a multifaceted approach to disseminating EBP and to generate lessons learned from the dissemination process.
We propose to mount EBP dissemination infrastructure that will allow us to investigate and evaluate approaches that have the potential to improve communication of EBP to the medically underserved Asian American community. We will use a practical, market-oriented framework to develop and test dissemination approaches. We will draw on the talents of a trans-disciplinary team as well as those of community stakeholders, with the aim of co-creating a multi-level approach to accelerating adoption of EBP.