Abstract and Introduction
Abstract
Objective: A crucial yet currently insufficient step in biomedical research is the translation of scientific, evidence-based guidelines and recommendations into constructs and language accessible to every-day patients. By building a community of solution that integrates primary care with public health and community-based organizations, evidence-based medical care can be translated into language and constructs accessible to community members and readily implemented to improve health.
Methods: Using a community-based participatory research approach, the High Plains Research Network (HPRN) and its Community Advisory Council developed a process to translate evidence into messages and dissemination methods to improve health in rural Colorado. This process, called Boot Camp Translation, has brought together various community members, organizations, and primary care practices to build a community of solution to address local health problems.
Results: The HPRN has conducted 4 Boot Camp Translations on topics including colon cancer prevention, asthma diagnosis and management, hypertension, and the patient-centered medical home. Thus far, the HPRN has used Boot Camp Translations to engage more than 1000 rural community members and providers. Dissemination of boot camp messaging through the community of solution has led to increased colon cancer screening, improved care for asthma, and increased rates of controlled blood pressure.
Conclusions: Boot Camp Translation successfully engages community members in a process to translate evidence-based medical care into locally relevant and culturally appropriate language and constructs. Boot Camp Translation is an appropriate method for engaging community members in patient-centered outcomes research and may be an appropriate first step in building a local or regional community of solution.
Introduction
The magnitude and nature of the work required to translate findings from medical research into valid and effective clinical practice have been grossly underestimated. It frequently takes years or even decades for scientific discoveries to reach everyday clinical practice. Many discoveries never make it into daily practice. Numerous barriers limit the movement of evidence-based treatments into clinical practice. Poor adoption of evidence-based recommendations may be the result of the very research enterprise that created the recommendation. Scientific discoveries often use research terms, advanced clinical language, and medical constructs that are not understood by patients and community members. Translation of scientific, evidence-based guidelines and recommendations into constructs and language accessible to patients and community members may improve outcomes. If community members do not fully understand a preventive health care recommendation, they will not seek care to receive it. If patients do not fully understand the conceptual framework for a health condition and treatment options, they will not be able to engage in a meaningful conversation with a health care provider, successfully choose appropriate treatment options based on their preferences, or maintain adherence to recommended therapy.
Community engagement may be essential to achieving the mission of translating the best evidence into community and clinical practice to improve the health and well-being of the population. Community engagement efforts enhance public trust through long-term relationships with community-based groups. We believe the most appropriate framework for building and sustaining community engagement in the translational research process is community-based participatory research (CBPR), which is defined as a collaborative process that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community, with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities. More than a decade of experience with CBPR has shown that research can be more relevant, culturally proficient, and effective when conducted through community-academic partnerships. Rural communities often have a strong sense of civic duty and may be poised to develop robust communities of solution to provide local answers to local health problems. Engaging a broad spectrum of community members and health care providers in a locally prioritized health problem can provide the beginning steps for developing a community of solution that fosters stronger, more productive relationships between the community, patients, and their health care providers.