Shin Michelle B, Vu Thuy, Masud Manal, Duran Miriana C, Escoffery Ngoc Cam, Bishop Sonia, Winer Rachel L, Ko Linda K
Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
Cancer Epidemiology Prevention Program, Fred Hutchinson Cancer Center, Seattle, USA.
Cancer Causes Control. 2025 Jul 30. doi: 10.1007/s10552-025-02037-9.
Evaluate the impact of Implementation Studio (the "Studio") on community-based organizations' (CBOs) EBI implementation, including changes in breast and colorectal (CRC) cancer screening status among Hispanic/Latino/a EBI recipients.
A two-tiered, embedded framework consisted of 1) surveys (n = 38) comparing up-to-date breast and CRC screening status among EBI recipients pre/post-EBI delivery (Tier 1); and semi-structured interviews (n = 13 total; n = 7 leaders, n = 6 community health workers) with CBO staff assessing EBI implementation outcomes using rapid qualitative analysis methods (Tier 2) guided by Proctor's Implementation Research Outcomes Framework. Surveys and interviews were conducted in Spanish/English by phone/virtually September 2022-September 2023.
Up-to-date screening status increased by 16.6% for breast and 19.3% for CRC screening pre/post-EBI implementation, albeit not statistically significant overall (p = 0.168). CBOs reported that implementing EBIs cultivated their confidence and enhanced CBOs' workforce capacity (acceptability). CHWs (the primary EBI implementers) proficiently used the Studio tools to adapt the EBIs to improve fit and implement them in the rural Hispanic/Latino/a communities (appropriateness). Remote delivery increased the EBI accessibility for the community (feasibility). Key drivers of costs were CHWs' time to adapt and implement EBIs (costs). CBOs expressed the need to address clients' social needs to maintain EBI's impact (sustainability).
CBOs successfully implemented CHW-led EBIs, and their efforts increased up-to-date cancer screening among rural Hispanic/Latino/a community members. These findings demonstrate that Studio is a promising strategy for building CBOs' capacity to implement EBIs and increase cancer screening.
评估实施工作室（“工作室”）对社区组织（CBO）实施循证干预措施（EBI）的影响，包括西班牙裔/拉丁裔EBI接受者的乳腺癌和结直肠癌（CRC）筛查状况的变化。
采用两层嵌入式框架，包括：1）调查（n = 38），比较EBI实施前/后EBI接受者的最新乳腺癌和CRC筛查状况（第1层）；以及与CBO工作人员进行的半结构化访谈（共n = 13；n = 7名领导者，n = 6名社区卫生工作者），使用由普罗克特的实施研究成果框架指导的快速定性分析方法评估EBI实施结果（第2层）。2022年9月至2023年9月通过电话/虚拟方式以西班牙语/英语进行调查和访谈。
在EBI实施前/后，乳腺癌的最新筛查状况增加了16.6%，CRC筛查增加了19.3%，尽管总体上无统计学意义（p = 0.168）。CBO报告称，实施EBI增强了他们的信心并提高了CBO的劳动力能力（可接受性）。社区卫生工作者（主要的EBI实施者）熟练使用工作室工具来调整EBI以提高适应性并在农村西班牙裔/拉丁裔社区实施（适宜性）。远程交付增加了社区对EBI的可及性（可行性）。成本的主要驱动因素是社区卫生工作者调整和实施EBI的时间（成本）。CBO表示需要满足客户的社会需求以维持EBI的影响（可持续性）。
CBO成功实施了由社区卫生工作者主导的EBI，他们的努力提高了农村西班牙裔/拉丁裔社区成员的最新癌症筛查率。这些发现表明，工作室是建设CBO实施EBI能力和增加癌症筛查的一种有前景的策略。
