Program for Research on the Outcomes of VA Education
- Conditions
- Smoking CessationHypertension
- Interventions
- Other: DataOther: Panel Management SupportOther: Education
- Registration Number
- NCT01677533
- Lead Sponsor
- VA New York Harbor Healthcare System
- Brief Summary
The PROVE aims to test the efficacy of panel management support and educational intervention in VA Primary Care Clinical Microsystems. The study will test three increasingly intensive methods for implementing panel management strategies among health care providers in VA primary care clinics: providing only panel data, providing panel management support, and providing support plus clinical microsystem-enhancing education and training.It is hypothesized that the group receiving panel management and educational interventions will have better smoking cessation and hypertension outcomes than the group receiving only panel management assistance. It is further supposed that the later will have better smoking cessation and hypertension patient outcomes than the data-only group.
- Detailed Description
Objective:
The specific aims for this study are: (1) to identify health professional educational and clinical microsystem determinants of outcomes for hypertension and smoking cessation in veterans. (2) to test the efficacy of three increasingly intensive methods for implementing panel management strategies among health care providers in VA primary care clinics: providing only panel data, providing panel management support, and providing support plus clinical microsystem-enhancing education and training.
Research design:
This project will consist of two phases. Phase I (one year) is the development of the necessary measurement and data infrastructure to assess health professional education, microsystem function, and clinical outcomes. In Phase 2 (two years) the study team will conduct a clinical demonstration project, comparing three interventions in a randomized controlled trial. Primary care teams will be randomly allocated to one of three arms: 1) panel management data, 2) panel management data and support, and 3) panel management data, support and education. The investigators will assess the impact of the implementation of panel management on primary patient outcomes in hypertension and smoking cessation (blood pressure and quit rates). The investigative team will also assess the impact of the implementation of panel management on secondary, intermediary, patient (patient activation, adherence, behavior change), provider (knowledge and attitudes, self-efficacy, job satisfaction) and microsystem outcomes (collective efficacy, teamwork, use of data, redesign of patient processes and provider roles/responsibilities, use of panel management strategies).
Methodology:
The study will utilize a multi-method, quasi-experimental design at VA NYHHS. Primary care is delivered through two teams at the Manhattan and five teams at the Brooklyn campuses. Patients, staff, nurses, and physicians are assigned to specific teams, thereby limiting contamination in this study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 5000
- non-specialized primary care clinical microsystems
- specialized clinical microsystems
- pilot clinical patient-aligned care teams
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description PM-Support Data Team will receive data and panel management support PM-Data Data Team will receive data only. PM-Support Panel Management Support Team will receive data and panel management support PM-Education Data Team will receive data, panel management support, and educational interventions. PM-Education Panel Management Support Team will receive data, panel management support, and educational interventions. PM-Education Education Team will receive data, panel management support, and educational interventions.
- Primary Outcome Measures
Name Time Method Change in Smoking Status Baseline and 12 months clinical outcome
Change in Blood Pressure Reading Baseline and 12 months clinical outcome
- Secondary Outcome Measures
Name Time Method Change in Proportion of panel smokers offered smoking cessation resources by study arm Baseline and 12 months Change in weight Baseline and most recent at 12 months Change in Provider Self-efficacy with Panel Management Tasks Baseline and 12 months Change in Proportion of smokers on the panel received any cessation medications Baseline and 12 months This information will be culled from the Vista Smoking Database
Change in Patient Activation 6 months and 12 months The Patient Activation Measure (PAM) is used to assess patients' self-reported knowledge, skill, and confidence in self-managing of health and chronic conditions
Change in Provider Job Satisfaction Baseline and 12 months Change in Provider's assessments of training that they received in panel management and working within a PACT team Baseline and 12 months Change in Patient Perceptions of Quality of Care 6 months and 12 months Change in Provider Behavior change expertise 6 months and 12 months Change in Microsystem function and collective efficacy Baseline and 12 months
Trial Locations
- Locations (2)
VA NYHHS Manhattan Campus
🇺🇸New York, New York, United States
VA NYHHS Brooklyn Campus
🇺🇸Brooklyn, New York, United States