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Care team and practice-level implementation strategies to optimize pediatric collaborative care: study protocol for a cluster-randomized hybrid type III trial.
Kolko, David J; McGuier, Elizabeth A; Turchi, Renee; Thompson, Eileen; Iyengar, Satish; Smith, Shawna N; Hoagwood, Kimberly; Liebrecht, Celeste; Bennett, Ian M; Powell, Byron J; Kelleher, Kelly; Silva, Maria; Kilbourne, Amy M.
Afiliación
  • Kolko DJ; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. kolkodj@upmc.edu.
  • McGuier EA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Turchi R; Department of Pediatrics, Drexel University College of Medicine and St. Christopher's Hospital for Children, Philadelphia, PA, USA.
  • Thompson E; PA Medical Home Program, PA Chapter, American Academy of Pediatrics, Media, PA, USA.
  • Iyengar S; Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA.
  • Smith SN; Department of Health Management & Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
  • Hoagwood K; Department of Child and Adolescent Psychiatry, New York University Langone Health, New York, NY, USA.
  • Liebrecht C; Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA.
  • Bennett IM; Departments of Family Medicine and Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
  • Powell BJ; Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA.
  • Kelleher K; Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
  • Silva M; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.
  • Kilbourne AM; Nationwide Children's Hospital Research Institute, Columbus, OH, USA.
Implement Sci ; 17(1): 20, 2022 02 22.
Article en En | MEDLINE | ID: mdl-35193619
BACKGROUND: Implementation facilitation is an effective strategy to support the implementation of evidence-based practices (EBPs), but our understanding of multilevel strategies and the mechanisms of change within the "black box" of implementation facilitation is limited. This implementation trial seeks to disentangle and evaluate the effects of facilitation strategies that separately target the care team and leadership levels on implementation of a collaborative care model in pediatric primary care. Strategies targeting the provider care team (TEAM) should engage team-level mechanisms, and strategies targeting leaders (LEAD) should engage organizational mechanisms. METHODS: We will conduct a hybrid type 3 effectiveness-implementation trial in a 2 × 2 factorial design to evaluate the main and interactive effects of TEAM and LEAD and test for mediation and moderation of effects. Twenty-four pediatric primary care practices will receive standard REP training to implement Doctor-Office Collaborative Care (DOCC) and then be randomized to (1) Standard REP only, (2) TEAM, (3) LEAD, or (4) TEAM + LEAD. Implementation outcomes are DOCC service delivery and change in practice-level care management competencies. Clinical outcomes are child symptom severity and quality of life. DISCUSSION: This statewide trial is one of the first to test the unique and synergistic effects of implementation strategies targeting care teams and practice leadership. It will advance our knowledge of effective care team and practice-level implementation strategies and mechanisms of change. Findings will support efforts to improve common child behavioral health conditions by optimizing scale-up and sustainment of CCMs in a pediatric patient-centered medical home. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04946253 . Registered June 30, 2021.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Atención Dirigida al Paciente Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies Aspecto: Implementation_research / Patient_preference Límite: Child / Humans Idioma: En Revista: Implement Sci Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Atención Dirigida al Paciente Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies Aspecto: Implementation_research / Patient_preference Límite: Child / Humans Idioma: En Revista: Implement Sci Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido