The OCHIN practice-based research network (PBRN) of >500 community health centers (CHCs) across 20 states will serve as the Implementation Laboratory for the Building Research in Implementation and Dissemination to close Gaps and achieve Equity in Cancer Control (BRIDGE-C2) Center. The OCHIN PBRN has the nation's largest network of CHCs sharing a centrally-hosted electronic health record (EHR), and a team of researchers, quality improvement coaches, and informaticists capable of supporting a large portfolio of dissemination and implementation research studies. OCHIN's member CHCs provide care for an underserved population of nearly 2.6 million patients, of whom 62% are from households earning <138% of the federal poverty level, 49% are insured by Medicaid, and 21% are uninsured. OCHIN hosts the CHCs' shared EHR, and has built a centralized data warehouse that includes longitudinal data elements for all patients across these CHCs. The BRIDGE-C2 Center's Implementation Laboratory will leverage and enhance the robust OCHIN PBRN (Aim 1a) and be led by an implementation scientist, supported by a multi-disciplinary team (Aim 1b). The Implementation Laboratory will engage stakeholders from the >500 CHC practices in research and coordinate dissemination of new knowledge to CHCs (Aim 2). The Laboratory will establish a Data Management Unit to build and maintain a data warehouse that supports the work of the BRIDGE-C2 Center, coordinate data sharing and regulatory requirements, ensure data quality and harmonization, and liaise with other laboratories across the Implementation Science Centers for Cancer Control consortium to develop common data elements and metric definitions that impact adoption of cancer screening and prevention evidence-based interventions (Aim 3). The Laboratory will also establish a Practice Surveillance Unit to enable identification of critical cancer screening and prevention disparities to target in future research, and rapidly and continuously monitor the progress and sustainability of strategies designed to enhance the implementation of evidence-based interventions in CHCs (Aim 4). The Implementation Laboratory will build on the foundational work that created the OCHIN PBRN. The diversity of practices in the Laboratory (e.g., rural/urban, large/small, different geographic regions) and the inclusion of specialized programs for vulnerable subpopulations strengthens the likelihood that findings will be relevant to many different CHC settings. Further, our ability to select a diverse sample of practices for BRIDGE-C2 Center research studies will enable the development of implementation strategies and support strategies to be spread to many other primary care networks. Thus, the Implementation Laboratory is well-poised to work with the Center to take on the grand challenge of advancing implementation science to improve cancer screening and prevention in underserved populations.
