Implementing Networks Self-management Tools Through Engaging Patients and Practices
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 467
- Primary Endpoint
- Primary measure for CS-PAM
Study Overview
Brief Summary
The purpose of this project is to use the Agency for Healthcare Research and Quality patient self-management support tools and resources across four practice-based research networks and 16 member practices using a community-based participatory intervention called Boot Camp Translation.
Detailed Description
Specific Aim 1: Implement the Agency for Healthcare Research and Quality SMS Resources and Tools (SMS Library/Toolkit) across four participating networks and 16 practices using Boot Camp Translation in a stepped-wedge design.
Specific Aim 2: Assess the impact of implementation on practice staff and patients engaged in chronic care management.
Specific Aim 3: Identify the factors related to successful implementation.
Background and Significance:
With almost one-half of Americans projected to have at least one chronic condition before 2020 it will be paramount that the health care system reduce the burden to primary care for disease management by facilitating the development of activated, informed individuals who are proficient in self-management skills. This represents a significant cultural shift in health management, and clinicians and staff may lack confidence introducing and promoting self-management support (SMS). In fact, SMS is the area of disease management least often implemented and most challenging to integrate into usual care. This difficulty occurs at the patient and clinician level. Using the Patient Activation Measure (PAM), Hibbard and colleagues found that 60% of patients feel passive about managing their own health and a third of patients had barriers in knowledge and confidence in caring for themselves.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 70 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Clinicians and office staff for small- to medium-sized practices
- •Patients regularly interacting with care manager
- •Patients having at least one chronic health condition
- •Ages 18-70
Exclusion Criteria
- •Large or health system practice setting
- •Non-English speaking
Arms & Interventions
Boot Camp Translation
Boot Camp Translation is rolled out in a stepped wedge design across participating PBRNs to assist practices with SMS implementation. The Boot Camp Translation "intervention" initiates practices to review and begin uptake and implementation of tools from the AHRQ Self-Management Support tool library.
Intervention: Boot Camp Translation - community-participatory process (Other)
Outcomes
Primary Outcomes
Primary measure for CS-PAM
Time Frame: Changes from baseline, 2 months, 4 months, 6 months and 8 months into implementation periods
The CS-PAM will be used to assess the attitudes of practice clinicians and clinical staff toward self-management. This instrument will be administered to practices five times during the project with a control measurement period followed by four implementation periods of two months. The data structure is hierarchical (individuals nested within practices) and longitudinal (repeated measures on individuals over time).
Secondary Outcomes
- Theory of Planned Behavior measurement of individual caregiver intention to change(Changes from baseline, 2 months, 4 months, 6 months and 8 months into implementation periods)
- A mixed methods assessment of barriers and facilitators to implementation(1 month and 3 months after Boot Camp Translation)
Investigators
Lyle J. Fagnan
Professor of Family Medicine
Oregon Health and Science University