Rural research capacity: a co-created model for research success.

PURPOSE: The United States' National Institutes of Health (NIH) have long challenged academia to improve clinical trial enrollment, especially in underrepresented populations; inclusive of geography, age, disability status, racial and ethnic minorities. It has been shown that rural and urban residents enrolled in clinical trials have similar outcomes, yet, rural healthcare systems struggle to provide opportunities to rural residents to participate in clinical trials when infrastructure is limited or unsupportive of research programs and/or research staffing levels are insufficient. To fully address the barriers to clinical trial access in rural areas, it is not adequate to simply open more trials. Community receptivity of research as well as organizational and community capacity must be considered. This project was determined by the Oregon Health and Science University's Institutional Review Board to be generalizable research across the chosen counties and was approved to operate under a waiver of written consent. Participants received a cash incentive in appreciation for their time and verbally agreed to participate after reviewing a project information sheet. METHODS: The research team co-created a community-responsive approach to the receipt, review, and acceptance of clinical trials in a rural community setting. An adapted 5 step Implementation Mapping approach was used to develop a systematic strategy intended to increase the success, and therefore, the number of clinical trials offered in a rural community. RESULTS: The research team and participating rural community members pilot-tested the implementation of a co-designed research review strategy, inclusive of a Regional Cultural Landscape and three co-created project submission and feasibility review forms, with a cancer early detection clinical trial. The proposed clinical trial required engagement from primary care and oncology. Utilizing the research review strategy demonstrated strong researcher-community stakeholder communication and negotiation, which resulted in early identification and resolution of potential barriers, hiring a local clinical research coordinator, and timely trial opening. CONCLUSION: To the knowledge of the research team, the work described is the first to use a community-engaged approach for creating a clinical trial implementation strategy directly supportive of rural-sitting community stakeholders in receiving, reviewing, and approving cancer-related clinical trials in their community. Participating community members and leaders had the chance to negotiate research protocol changes or considerations directly with researchers interested in conducting a cancer clinical trial in their rural setting.

The Community Research Liaison Model: Facilitating community-engaged research.

The Community Research Liaison Model (CRLM) is a novel model to facilitate community-engaged research (CEnR) and community-academic research partnerships focused on health priorities identified by the community. This model, informed by the Principles of Community Engagement, builds trust among rural communities and expands capacity for community and investigator-initiated research. We describe the CRLM development process and how it is operationalized today. We followed a multi-phase process to design and implement a community engagement model that could be replicated. The resulting CRLM moves community-academic research collaborations from objectives to outputs using a conceptual framework that specifies our guiding principles, objectives, and actions to facilitate the objectives (i.e., capacity, motivations, and partners), and outputs. The CRLM has been fully implemented across Oregon. Six Community Research Liaisons collectively support 18 predominantly rural Oregon counties. Since 2017, the liaison team has engaged with communities on nearly 300 community projects. The CRLM has been successful in facilitating CEnR and community-academic research partnerships. The model has always existed on a dynamic foundation and continues to be responsive to the lessons learned by the community and researchers. The model is expanding across Oregon as an equitable approach to addressing health disparities across the state.

New approach to assessment of medication safety in a community hospital.

Use of medications for hospitalized patients is nearly universal, and medication-related injuries are common. Accurate assessment of harm is foundational to development of effective hospital medication safety plans. Using methods nearly identical to those in large national studies, the author examined incidence and typology of medication-related injury. This practice innovation provided a community hospital with its first systematic assessment of medication-related injury. The information gained provided a clearer picture of injury and promoted collaboration.

Nursing's role in advance care planning for hispanic / latino individuals / El papel de enfermería en la planificación anticipada de la atención de las personas hispanas / latinas

End-of-life care decisions are challenging for most people and cultural beliefs may facilitate or hinder such decisions. Advance care planning provides a venue to interact with and communicate to healthcare professionals a person's documented health and medical treatment wishes at end of life. Open communication, cultural accommodation, and mutual understanding among the healthcare provider, patient, andfamily are key to effective advance care planning. This article discusses how Hispanic / Latino people address end-of-life care and what cultural aspects are especially relevant for this population. The nurse's role in assisting Hispanics / Latinos with advanced care planning is presented at various levels of the nursing professional spectrum.

Las decisiones relacionadas con las fases terminales de la vida son difíciles para la mayoría de las personas. Las creencias culturales pueden facilitar o dificultar dichas decisiones. La planeación adelantada del cuidado provee el mecanismo para interactuar y comunicarse con los profesionales de la salud sobre los deseos de la persona para el final de su vida. La comunicación abierta, la adaptación cultural y el entendimiento mutuo entre el proveedor de la salud, el paciente y la familia son la clave para una planeación adelantada efectiva. Este artículo analiza cómo la gente hispano/latina enfrenta las fases terminales de la vida y qué aspectos culturales tienen una relevancia especial para esta población. El papel del personal de enfermería que trabaja con los hispano/latinos en la planeación de las fases terminales de la vida es presentado en los varios niveles profesionales de enfermería.

A documentation approach for faith community nursing.

Faith Community Nursing: Scope and Standards of Practice (American Nurses Association and Health Ministries Association, 2005) establishes the professional responsibility for documenting relevant data in a retrievable format that is both confidential and secure. Documentation systems used by faith community nurses (FCNs) need to be accurate, yet simple and concise. This article presents an approach to documenting FCN activities, the provided care, and outcomes of that care, while emphasizing the use of standardized nursing language.

Planning considerations for a Mars Sample Receiving Facility: summary and interpretation of three design studies.

It has been widely understood for many years that an essential component of a Mars Sample Return mission is a Sample Receiving Facility (SRF). The purpose of such a facility would be to take delivery of the flight hardware that lands on Earth, open the spacecraft and extract the sample container and samples, and conduct an agreed-upon test protocol, while ensuring strict containment and contamination control of the samples while in the SRF. Any samples that are found to be non-hazardous (or are rendered non-hazardous by sterilization) would then be transferred to long-term curation. Although the general concept of an SRF is relatively straightforward, there has been considerable discussion about implementation planning. The Mars Exploration Program carried out an analysis of the attributes of an SRF to establish its scope, including minimum size and functionality, budgetary requirements (capital cost, operating costs, cost profile), and development schedule. The approach was to arrange for three independent design studies, each led by an architectural design firm, and compare the results. While there were many design elements in common identified by each study team, there were significant differences in the way human operators were to interact with the systems. In aggregate, the design studies provided insight into the attributes of a future SRF and the complex factors to consider for future programmatic planning.