Understanding how implementation strategies work is vitally important for the deployment of evidence-based practices (EPBs) in healthcare settings. Specifically, mechanistic inquiry provides information on specific targets (e.g., buy-in, saliency) that must be engaged for a strategy to be successful. We used mixed-methods to investigate mechanisms of facilitation as part of a trial to implement S.A.F.E. Firearm, a brief evidence-based practice which includes firearm storage counseling and offering free cable locks in pediatric primary care during well-child visits. We used a mixed-methods approach to ascertain mechanisms. Quantitative analyses determined whether clinic-level adaptive reserve (e.g., mechanism) mediated the impact of facilitation (e.g., strategy) on reach (e.g., primary outcome). Adaptive reserve, evaluated via clinician survey, refers to a clinic’s ability to broadly make and sustain change and includes multiple components (i.e., relationship infrastructure, facilitative leadership, sensemaking, teamwork, work environment, and culture of learning). Importantly, adaptive reserve is not the specific capacity to implement a given EBP. Second, qualitative interviews guided by the updated Consolidated Framework for Implementation Research, and analyzed using deductive and inductive approaches, were conducted with pediatric clinicians, clinic change agents, and health system leaders to ascertain other mechanisms. Mixed methods integration occurred at completion of both activities. Quantitative analyses indicated that adaptive reserve did not mediate the effect of facilitation on reach. Qualitative findings illustrated other potential mechanisms of facilitation including: increasing buy-in and saliency to help overcome initial inertia and to support application of training principles in practice; strong collaborative relationships between facilitators and clinics to improve accountability; in-person visits or electronic communications that serve as reminders; reinforcing the why and how of the intervention (sensemaking); and fostering team collaboration to troubleshoot logistical barriers. While prior studies have found that adaptive reserve was related to facilitation, our mediation analysis did not support this hypothesis. Contextual factors may offer potential explanations, particularly a lower-intensity facilitation in this context commensurate with a smaller practice change (e.g., a brief program intended to take < 1 min), but further study is needed. Our qualitative results offer a potentially new mechanistic model of facilitation to be investigated in future studies.

ImportanceIncreased secure firearm storage can reduce youth firearm injury and mortality, a leading cause of death for children and adolescents in the US. Despite the availability of evidence-based secure firearm storage programs and recommendations from the American Academy of Pediatrics, few pediatric clinicians report routinely implementing these programs.ObjectiveTo compare the effectiveness of an electronic health record (EHR) documentation template (nudge) and the nudge plus facilitation (ie, clinic support to implement the program; nudge+) at promoting delivery of a brief evidence-based secure firearm storage program (SAFE Firearm) that includes counseling about secure firearm storage and free cable locks during all pediatric well visits.Design, Setting, and ParticipantsThe Adolescent and Child Suicide Prevention in Routine Clinical Encounters (ASPIRE) unblinded parallel cluster randomized effectiveness-implementation trial was conducted from March 14, 2022, to March 20, 2023, to test the hypothesis that, relative to nudge, nudge+ would result in delivery of the firearm storage program to an additional 10% or more of the eligible population, and that this difference would be statistically significant. Thirty pediatric primary care clinics in 2 US health care systems (in Michigan and Colorado) were included, excluding clinics that were not the primary site for participating health care professionals and a subset selected at random due to resource limitations. All pediatric well visits at participating clinics for youth ages 5 to 17 years were analyzed.InterventionsClinics were randomly assigned in a 1:1 ratio to receive either the nudge or nudge+.Main Outcomes and MeasuresPatient-level outcomes were modeled to estimate the primary outcome, reach, which is a visit-level binary indicator of whether the parent received both components of the firearm storage program (counseling and lock), as documented by the clinician in the EHR. Secondary outcomes explored individual program component delivery.ResultsA total of 47 307 well-child visits (median [IQR] age, 11.3 [8.1-14.4] years; 24 210 [51.2%] male and 23 091 [48.8%] female) among 46 597 children and 368 clinicians were eligible to receive the firearm storage program during the trial and were included in analyses. Using the intention-to-treat principle, a higher percentage of well-child visits received the firearm storage program in the nudge+ condition (49%; 95% CI, 37-61) compared to nudge (22%; 95% CI, 13-31).Conclusions and RelevanceIn this study, the EHR strategy combined with facilitation (nudge+) was more effective at increasing delivery of an evidence-based secure firearm storage program compared to nudge alone.Trial RegistrationClinicalTrials.gov Identifier: NCT04844021

Background:Implementation strategies are potential tools for advancing equity goals in healthcare. Implementation scientists have increased attention to the integration of equity considerations into implementation research, but limited concrete guidance is available for developing implementation strategies to improve equity. Main:In parallel to an active hybrid effectiveness-implementation trial in two large health systems, our research team explored potential inequities in implementation across four non-study clinics, developed equity focused audit and feedback procedures, examined the feasibility of our approach, and identified design insights that could be tested in future work to inform equitable program scale-up. Based on our experiences deploying these strategies in pilot format, our research team identified key complexities meriting further examination in future work. These considerations are vital given the dearth of guidance on delivering feedback to clinicians in efforts to improve equity. Key takeaways include the importance of understanding local data culture, engaging constituents in co-design for the full feedback cycle, leveraging feedback for shared discourse, and centering multi-level strategies as part of robust implementation approaches. Conclusion:Prioritizing health equity in implementation science requires that research teams probe, interrogate, and innovate - and in doing so, grapple with central conceptual and pragmatic considerations that arise in the design of implementation strategies. Our work emphasizes the value of bidirectional and continuous learning.

Clinical opioid overdose risk prediction models can be useful tools to reduce the risk of overdose in patients prescribed long-term opioid therapy (LTOT). However, evolving overdose risk environments and clinical practices in addition to potential harmful model misapplications require careful assessment prior to widespread implementation into clinical care. Models may need to be tailored to meet local clinical operational needs and intended applications in practice. To update and validate an existing opioid overdose risk model, the Kaiser Permanente Colorado Opioid Overdose (KPCOOR) Model, in patients prescribed LTOT for implementation in clinical care. The retrospective cohort study consisted of 33, 625 patients prescribed LTOT between January 2015 and June 2019 at Kaiser Permanente Colorado, with follow-up through June 2021. The outcome consisted of fatal opioid overdoses identified from vital records and non-fatal opioid overdoses from emergency department and inpatient settings. Predictors included demographics, medication dispensings, substance use disorder history, mental health history, and medical diagnoses. Cox proportional hazards regressions were used to model 2-year overdose risk. During follow-up, 65 incident opioid overdoses were observed (111.4 overdoses per 100,000 person-years) in the study cohort, of which 11 were fatal. The optimal risk model needed to risk-stratify patients and to be easily interpreted by clinicians. The original 5-variable model re-validated on the new study cohort had a bootstrap-corrected C-statistic of 0.73 (95

Attention to health equity is critical in the implementation of firearm safety efforts. We present our operationalization of equity-oriented recommendations in preparation for launch of a hybrid effectiveness-implementation trial focused on firearm safety promotion in pediatric primary care as a universal suicide prevention strategy. In Step 1 of our process, pre-trial engagement with clinican partners and literature review alerted us that delivery of a firearm safety program may vary by patients' medical complexity, race, and ethnicity. In Step 2, we selected the Health Equity Implementation Framework to inform our understanding of contextual determinants (i.e., barriers and facilitators). In Step 3, we leveraged an implementation pilot across 5 pediatric primary care clinics in 2 health system sites to study signals of inequities. Eligible well-child visits for 694 patients and 47 clinicians were included. Our results suggested that medical complexity was not associated with program delivery. We did see potential signals of inequities by race and ethnicity but must interpret with caution. Though we did not initially plan to examine differences by sex assigned at birth, we discovered that clinicians may be more likely to deliver the program to parents of male than female patients. Seven qualitative interviews with clinicians provided additional context. In Step 4, we interrogated equity considerations (e.g., why and how do these inequities exist). In Step 5, we will develop a plan to probe potential inequities related to race, ethnicity, and sex in the fully powered trial. Our process highlights that prospective, rigorous, exploratory work is vital for equity-informed implementation trials.

O PTIMIZE 1 seeks to provide patients, care partners, and clinicians with tools-educational brochures and tip sheets-to foster thoughtful conversations about deprescribing.We agree that accurate medication reconciliation is an essential first step to such conversations.A pharmacy notebook such as the one you describe, involving indications for each medicine and patient memos with reasons for discontinuation, could be extremely useful.We would be very interested to see this approach tested as part of a deprescribing intervention, as it is consistent with engaging patients and caregivers and increasing trusting conversations.

This project illuminates the unique struggles and barriers lesbians face. A community advisory board (CAB) was developed and 31 in-depth interviews were conducted with lesbians aged 56-84 in the Rocky Mountain region. Interviews were audio recorded, transcribed, and coded using critical discourse analysis. Themes included: a culture of identity-hiding; lack of recognition and discrimination in health care; channeling passion, fear, and anger into action; concerns about aging; and identified health needs and opportunities. There is a need for innovative and equitable services that understand the barriers and struggles that older lesbian adults face so they can receive high-quality care.

Insights from behavioral economics, or how individuals’ decisions and behaviors are shaped by finite cognitive resources (e.g., time, attention) and mental heuristics, have been underutilized in efforts to increase the use of evidence-based practices in implementation science. Using the example of firearm safety promotion in pediatric primary care, which addresses an evidence-to-practice gap in universal suicide prevention, we aim to determine: is a less costly and more scalable behavioral economic-informed implementation strategy (i.e., “Nudge”) powerful enough to change clinician behavior or is a more intensive and expensive facilitation strategy needed to overcome implementation barriers? The Adolescent and child Suicide Prevention in Routine clinical Encounters (ASPIRE) hybrid type III effectiveness-implementation trial uses a longitudinal cluster randomized design. We will test the comparative effectiveness of two implementation strategies to support clinicians’ use of an evidence-based firearm safety practice, S.A.F.E. Firearm, in 32 pediatric practices across two health systems. All pediatric practices in the two health systems will receive S.A.F.E. Firearm materials, including training and cable locks. Half of the practices (k = 16) will be randomized to receive Nudge; the other half (k = 16) will be randomized to receive Nudge plus 1 year of facilitation to target additional practice and clinician implementation barriers (Nudge+). The primary implementation outcome is parent-reported clinician fidelity to the S.A.F.E Firearm program. Secondary implementation outcomes include reach and cost. To understand how the implementation strategies work, the primary mechanism to be tested is practice adaptive reserve, a self-report practice-level measure that includes relationship infrastructure, facilitative leadership, sense-making, teamwork, work environment, and culture of learning. The ASPIRE trial will integrate implementation science and behavioral economic approaches to advance our understanding of methods for implementing evidence-based firearm safety promotion practices in pediatric primary care. The study answers a question at the heart of many practice change efforts: which strategies are sufficient to support change, and why? Results of the trial will offer valuable insights into how best to implement evidence-based practices that address sensitive health matters in pediatric primary care. ClinicalTrials.gov, NCT04844021 . Registered 14 April 2021.

Patients with dementia and multiple chronic conditions (MCC) frequently experience polypharmacy, increasing their risk of adverse drug events. To elucidate patient, family, and physician perspectives on medication discontinuation and recommended language for deprescribing discussions in order to inform an intervention to increase awareness of deprescribing among individuals with dementia and MCC, family caregivers and primary care physicians. We also explored participant views on culturally competent approaches to deprescribing. Qualitative approach based on semi-structured interviews with patients, caregivers, and physicians. Patients aged ≥ 65 years with claims-based diagnosis of dementia, ≥ 1 additional chronic condition, and ≥ 5 chronic medications were recruited from an integrated delivery system in Colorado and an academic medical center in Maryland. We included caregivers when present or if patients were unable to participate due to severe cognitive impairment. Physicians were recruited within the same systems and through snowball sampling, targeting areas with large African American and Hispanic populations. We used constant comparison to identify and compare themes between patients, caregivers, and physicians. We conducted interviews with 17 patients, 16 caregivers, and 16 physicians. All groups said it was important to earn trust before deprescribing, frame deprescribing as routine and positive, align deprescribing with goals of dementia care, and respect caregivers’ expertise. As in other areas of medicine, racial, ethnic, and language concordance was important to patients and caregivers from minority cultural backgrounds. Participants favored direct-to-patient educational materials, support from pharmacists and other team members, and close follow-up during deprescribing. Patients and caregivers favored language that explained deprescribing in terms of altered physiology with aging. Physicians desired communication tips addressing specific clinical situations. Culturally sensitive communication within a trusted patient-physician relationship supplemented by pharmacists, and language tailored to specific clinical situations may support deprescribing in primary care for patients with dementia and MCC.

1.Describe the justification for methodological approach in this pragmatic trial design.2.Discuss the justification for the ALIGN intervention and preliminary results of the intervention in the SNF setting. Sub-acute rehabilitation (SNF), intended for short stay care transitions, cares for 1/3 of older adults in the last six months of life with low penetration of hospice and palliative care. ALIGN (Assessing & Listening to Individual Goals and Needs) is a palliative care social worker led intervention aimed to improve quality of life (QOL), goals of care (GOC) alignment, and provide support to patients and caregivers. Determine the feasibility of conducting a trial of ALIGN in older persons and their caregivers admitted to SNF and conduct exploratory analysis of ALIGN vs usual care on patient goals of care alignment (curative, life-prolonging/rehabilitative, comfort), QOL (FACT-G), and caregiver reaction assessment (CRA) and burden (Zarit). To conduct a pilot pragmatic randomized step wedge design of the ALIGN intervention versus usual care in three SNFs with 120 older adults and caregivers (optional) admitted with advanced medical illness (LACE score >7) to determine feasibility and preliminary efficacy. To date, 362 SNF patients met illness criteria and the team was able to approach 127 patients within required 72 hours of admission. Enrollment rate for patients = 68%, caregivers = 36%. Caregivers are often not available to participate in-person, alternate approaches are being tested. Baseline GOC alignment = 50%. Baseline FACT-G = 70.0 (+16.9) demonstrating compromised QOL, CRA Self Esteem scale (1-5) = 1.8 (+0.5) showing some benefit finding, and Zarit = 14.5 (+9.2) showing moderate burden. A pragmatic trial of the ALIGN intervention is feasible and needed based on low GOC alignment, low QOL, and moderate caregiver burden.

Background Due to a history of oppression and lack of culturally competent services, lesbian, gay, bisexual and transgender (LGBT) seniors experience barriers to accessing social services. Tailoring an evidence-based ageing in place intervention to address the unique needs of LGBT seniors may decrease the isolation often faced by this population. Objective To describe practices used in the formation of a community-based participatory research (CBPR), partnership involving social workers, health services providers, researchers and community members who engaged to establish a LGBT ageing in place model called Seniors Using Supports To Age In Neighborhoods (SUSTAIN). Methods A case study approach was employed to describe the partnership development process by reflecting on past meeting minutes, progress reports and interviews with SUSTAIN's partners. Results Key partnering practices utilized by SUSTAIN included (i) development of a shared commitment and vision; (ii) identifying partners with intersecting spheres of influence in multiple communities of identity (ageing services, LGBT, health research); (iii) attending to power dynamics (e.g. equitable sharing of funds); and (iv) building community capacity through reciprocal learning. Although the partnership dissolved after 4 years, it served as a successful catalyst to establish community programming to support ageing in place for LGBT seniors. Conclusion Multi-sector stakeholder involvement with capacity to connect communities and use frameworks that formalize equity was key to establishing a high-trust CBPR partnership. However, lack of focus on external forces impacting each partner (e.g. individual organizational strategic planning, community funding agency perspectives) ultimately led to dissolution of the SUSTAIN partnership even though implementation of community programming was realized.

OBJECTIVE: To identify which English and Spanish terms Latino parents consider motivating, as well as culturally and linguistically appropriate, for provider use during weight counseling of overweight and obese Latino youth.METHODS: Latino parent perceptions of common Spanish and English terms for overweight were discussed with 54 parents in 6 focus groups (3 English, 3 Spanish). Atlas.ti software was used for qualitative analysis. An initial codebook was used to code passages for English and Spanish terminology separately. Subsequent changes to the coded passages and creation of new codes were made by team consensus.RESULTS: "Demasiado peso para su salud" (too much weight for his/her health) was the only phrase for excess weight that was consistently identified as motivating and inoffensive by Spanish-speaking parents. "Sobrepeso" (overweight), a commonly used term among health care providers, was motivating to some parents but offensive to others. English-speaking parents had mixed reactions to "unhealthy weight," "weight problem," and "overweight," finding them motivating, confusing, or insulting. Parents found "fat" "gordo" and "obese" "obeso" consistently offensive. Most participants found growth charts and the term "BMI" confusing. Parents consistently reported that providers could enhance motivation and avoid offending families by linking a child's weight to health risks, particularly diabetes.CONCLUSIONS: "Demasiado peso para su salud" (too much weight for his/her health) was motivating to many Spanish-speaking Latino parents. Among English-speaking Latino parents, no single English term emerged as motivating, well-understood, and inoffensive. Linking a child's excess weight with increased health risks was motivating and valuable to many parents regardless of language spoken.

This qualitative study conducted by a community-research partnership used multiple types of data collection to examine variables relevant for LGBTQ older adults who wished to age in place in their urban Denver neighborhood. Focus groups, interviews, and a town hall meeting were used to identify barriers and supports to aging in place. Participants (N = 73) identified primarily as lesbian or gay, aged 50-69, and lived with a partner. Ageism, heterosexism, and cisgenderism emerged as cross-cutting themes that negatively impact access to health care, housing, social support, home assistance, and legal services. Resilience from weathering a lifetime of discrimination was identified as a strength to handle aging challenges. Recommendations for establishing an aging in place model included establishing welcoming communities and resource centers and increasing cultural competence of service providers. This study provides a unique contribution to understanding the psychosocial, medical, and legal barriers for successfully aging in place.

Background/Aims: Patient input is critical to ensuring that research studies and their outcomes are relevant to patient priorities and needs. Research teams need a way to quickly identify appropriate patient partners for engaged research, and patients anxious for a voice in research need a way to access research teams and organizations. The Patient Stakeholder Council (PSC) and Colorado Patient Partners in Research (CoPPiR) network address these needs. The PSC broadly informs research agendas while the CoPPiR network connects patients with research teams, giving teams a way to rapidly identify, contact and recruit patient partners with specific characteristics. Methods: Kaiser Permanente Colorado’s Institute for Health Research, Denver Health’s Center for Health Systems Research (CHSR), and the CHSR’s Community Advisory Panel are partnering equally to create these resources, and methods will be the focus of this presentation. All three partners defined the purpose and goals of the PSC and are collaborating to recruit and train all members of the PSC. Simultaneously, the three partners are building the CoPPiR network infrastructure. The CoPPiR website provides a centralized means of providing information about the network, facilitating recruitment of members and responding to requests from individual research teams. Both resources explicitly prioritize recruitment of members reflecting the demographic, socioeconomic and racial/ethnic characteristics of these two health system memberships. Results: The outcomes of the successful creation of both the PSC and the CoPPiR network include improving research teams’ abilities to write patient-centered research proposals and conduct studies whose outcomes are more relevant to patient populations. Equally important is the empowerment of patient research partners to influence overall research agendas and, in individual research studies, to voice concerns, insights and preferences of patients. Conclusion: Tackling the needs of both patients and researchers in the development of engagement resources provides a win-win in the effort to increase the quality and meaningfulness of patient-centered outcomes research. Further, establishing both a broadly focused panel and a mechanism for matching patient partners with specific research teams to provide deeper insights on a particular disease burden or health condition effectively addresses distinct needs of research organizations and provides a model for replication elsewhere.

The Health Care Systems Research Network's (HCSRN) Patient Engagement in Research Scientific Interest Group (PER SIG) held a half-day workshop for researchers attending HCSRN's 22nd annual conference, April 16, 2016, in Atlanta, Georgia. The workshop blended didactic and interactive content to facilitate co-learning. Both researchers and patient partners developed the content, including three broad topics: engagement of patient partners in developing research studies, nurturing partnerships, and assessing the impact of patient engagement in research. Each module presented approaches relevant to the specific topic, including lessons from the literature and in-the-field experience. Patient partners reflected on their experience related to each module, and the interactive portion included small group exercises and in-depth discussion. Workshop attendees (n=32) collectively contributed to suggestions for future work in the area of patient-engaged research. Conclusions reached by workshop planners and attendees included the recognition that engaging patient partners in research requires a set of skills not normally used or even valued in scientific research methods and requires longer timelines than those generally accepted by research funding organizations. Effective engagement requires a paradigm shift from researchers as all-knowing to scientific team members who acknowledge the importance of patient partners as co-equal. When engaging patients in research, every aspect of engagement should be conducted with an emphasis on equality among partners and the stated agreement that patient partners bring valid expertise –– their experiences as patients –– to the research process.

Background/Aims: “Beyond the Publishable Paper: Finding the Story in Your Research” was a workshop developed by the Colorado Clinical and Translational Sciences Institute Partnership of Academicians and Community for Translation to inspire the research community to think beyond journal publication as a means for translating and disseminating research findings. Aimed at attracting researchers, community research partners (present or in the future), health sciences students and trainees, the workshop objectives were to: a) demonstrate how the arts can be incorporated into the translation and dissemination process of research; b) identify elements of a good story; c) guide participants in creating a story from research results; d) identify strategies for sharing research results through storytelling; and e) practice performance art for storytelling. Methods: The 3-hour interactive, hands-on workshop taught participants the art of effective storytelling by kicking off with a performance of Loose Change, a research-based theatrical production developed from a Care Equity Project by Kaiser Permanente Colorado’s Arts Integrated Resources Team. After learning about the elements of good storytelling, participants broke into groups and developed stories based on research findings in the two-page “Middle School Overview of 2013 Data” reported by Healthy Kids Colorado Survey. The workshop finale was a 5-minute performance by one of the groups illustrating the story they saw in the middle school data on “unintentional injury and violence.” Results: Participant postevaluation of the workshop was positive: a) The majority of respondents agreed or strongly agreed the workshop was a valuable use of their time (18 of 20); b) Most (15 of 20) thought the workshop was somewhat or very relevant to their work; and c) Holding the workshop in a community space, Su Teatro Cultural and Performing Arts Center, Denver, rather than on campus, supported participant learning and was worth additional effort to get there (17 of 20 respondents agreed or strongly agreed). Conclusion: The workshop successfully modeled performance art as a tool for research dissemination, outlined a format for drawing stories out of data and provided hands-on practice in story development, theatrical performance and sharing.

Background/Aims: With the establishment of the Patient-Centered Outcomes Research Institute in 2010 and subsequent explosion in recognition of the importance of patient perspectives in research to improve patient decision-making and health outcomes, patient engagement in research is an increasingly critical aspect of the research process. The HMORN Patient Engagement in Research Scientific Interest Group (PER SIG) was established to improve the ability of member organization research teams to effectively and meaningfully engage patients and other stakeholders in the continuum of research, from developing appropriate research questions to disseminating research findings. One of the 2014 goals for the PER SIG was to create an engagement checklist to guide research teams in planning and recruiting for patient engagement, and provide best practices for their engagement. Methods: We created a comprehensive questionnaire encompassing all aspects of the engagement process, including prompts for intentionality/justification for engaging patients, patient roles and stages of participation, logistical details and planning, human resource issues (e.g. compensation, contracts), IRB oversight, recruiting, training for patient and research team members, communication plans, and engagement monitoring and evaluation. We fielded our Web-based survey to all members of the PER SIG and other research colleagues with experience engaging patients as members of research teams. Results: We received 23 responses to the survey. From the results and comments provided, we created a draft checklist of items and practices critical to the engagement process. This draft was vetted by PER SIG members and discussed at a monthly PER SIG conference call, then finalized as a “working draft.” Broader dissemination is currently underway, and this abstract, leading to further dissemination at the annual meeting, is one goal of the dissemination plan. Discussion: Patient engagement in research is a complex process requiring thoughtful planning and preparation as well as continued monitoring and evaluation throughout the life of the research project. The patient engagement checklist provides research teams with guidance for each step of the process, promoting use of best practices and encouraging meaningful engagement of patients as members of the research team.

BACKGROUND:Community engagement (CE)has become a major element in medical research. In alliance with the goals of the Clinical and Translational Sciences Award program, Colorado Immersion Training in Community Engagement (CIT) is a community-campus partnership that aims to introduce an expanded pool of researchers to community-based participatory research (CBPR) and CE. OBJECTIVES:To describe CIT components and preliminary results. METHODS:CIT attempts to support a change in the research trajectory of academic health researchers, program developers, and graduate students toward CE. The program occurs on campus and in six community settings: Urban African American, urban Asian and refugee, urban Latino, urban American Indian/Alaska Native, rural northeast Colorado, and rural San Luis Valley. Components include a 4-week Directed Reading, a seminar on CBPR, 4-day community immersion, reflection, and 6-month support. Evaluation describes recruitment, implementation, and participants' understanding of CBPR and skills post-training. RESULTS:Fifty-eight people have participated. A comprehensive curriculum was developed to address (1) principals of CBPR, (2) health disparities, (3) listening to community, (4) self-reflection, and (5) engagement tools. Community immersions expose participants to a community's culture and opportunities to discuss health issues with a range of community members. Local "community guides" enhance participants' experience. Of the first two cohorts, 90% changed the way they plan to approach their research, 94% changed how they viewed community involvement in research, and 77% learned new skills to help engage communities in research. CONCLUSIONS:CIT applies to and positively impacts researchers from a variety of disciplines. CIT creates opportunities for long lasting partnerships between researchers and communities.

Background/Aims Lesbian, Gay, Bisexual and Transgender (LGBT) seniors face barriers to accessing social services. We describe formation of an interdisciplinary community-research partnership called SUSTAIN (Seniors Using Supports To Age In Neighborhoods), whose ultimate goal is to develop and adapt an aging-in-place model in a Denver metropolitan neighborhood that is home to a high concentration of LGBT individuals. Methods Established in 2009, SUSTAIN partners represent a cross-segment of service deliver, community building, education, and research interests including social service agencies; local LGBT community members; the Denver Gay, Lesbian, Bisexual, & Transgender Commission; a regional affiliate of Services and Advocacy for Gay, Lesbian, Bisexual, & Transgender Elders (SAGE); the LGBT community center for the state of Colorado; an affirming church leader; an area agency on aging; a non-profit healthcare and research organization; and a university researcher specializing in aging. Discussions were conducted among partners and written comments were solicited to understand community experience and reflections on the partnership. Results The success of our SUSTAIN partnership hinged on several features. First, most partners’ affiliations bridged at least two of the aging, LGBT, and research communities we were uniting. Second, the partnership development mechanism required at least fifty-percent of funds be allocated to community partners, which was crucial for establishing trust. Third, SUSTAIN’s core values embraced a commitment to collaborative principles and explicitly addressed power imbalances. Conclusions Members with existing capacity to connect communities and formalized funding frameworks that emphasize equity may be key ingredients for growing a sustainable community-research partnership.