An Implementation Strategy for the Adoption of an Evidence-Based Guideline for Pit-and-Fissure Sealants: Using a Framework From Organizational Development
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 896
- 试验地点
- 2
- 主要终点
- Change in Providers' Rates of Placing or Treatment Planning Sealants for Occlusal NCCLs
研究概览
简要总结
The purpose of this implementation science study is to determine whether Deliberative Loops are effective in increasing providers' adherence to the non-cavitated caries component of the American Dental Association's pit-and-fissure sealant evidence-based clinical practice guideline. The investigators use a stepped wedge design to randomly assign dental clinics to the Deliberative Loop intervention. In a Deliberative Loop, stakeholders receive background information, participate in a facilitated discussion, and share their views with leadership. The Deliberative Loop intervention is designed to help stakeholders form informed opinions; in this study, stakeholders will be forming informed opinions about the implementation interventions they think will increase their clinic's adherence to the guideline. The investigators hypothesize that compared with the pre-intervention period, following the intervention, providers will place or treatment plan sealants for significantly more occlusal non-cavitated carious lesions.
详细描述
The purpose of this implementation science study is to determine whether Deliberative Loops are effective in increasing providers' adherence to the non-cavitated caries component of the American Dental Association's pit-and-fissure sealant evidence-based clinical practice guideline. The investigators use a stepped wedge design to randomly assign dental clinics to the Deliberative Loop intervention. In a Deliberative Loop, stakeholders receive background information, participate in a facilitated discussion, and share their views with leadership. The Deliberative Loop intervention is designed to help stakeholders form informed opinions; in this study, stakeholders will be forming informed opinions about the implementation interventions they think will increase their clinic's adherence to the guideline. The investigators hypothesize that compared with the pre-intervention period, following the intervention, providers will place or treatment plan sealants for significantly more occlusal non-cavitated carious lesions (NCCL).
All persons employed by Kaiser Permanente Northwest or Permanente Dental Associates and who work in a Kaiser Permanente Northwest dental clinic at any level [e.g., part time, full time] will be eligible to participate in the study. This includes both service providers and front-of-the-house staff, approximately 1,200 employees.
This is a Stage III study.
Participating sites include the 16 general dental clinics of Kaiser Permanente Northwest. All clinics are located within the United States.
The estimated time from when the study opens to enrollment until completion of data collection is 16 months. It will take approximately one to two months for each individual participant to complete all study-related tasks, depending on how soon after the introductory session the Deliberative session can be scheduled.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Sequential
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Employed by Kaiser Permanente Northwest Dental or Permanente Dental Associates
- •Work in a Kaiser Permanente Northwest dental clinic
排除标准
- 未提供
结局指标
主要结局
Change in Providers' Rates of Placing or Treatment Planning Sealants for Occlusal NCCLs
时间窗: from one month before the first step to two months after the final step, 1 year.
The change in the providers' rates of placing or treatment planning sealants for occlusal NCCLs from before to after clinic stakeholders are exposed to the Deliberative Loop intervention
次要结局
- Total Program Costs(from planning the survey to gather background information to two months after the final step; an average of 1 year)
- Cost Per Clinic(from planning the survey to gather background information to two months after the final step; an average of 1 year)
- Cost Per Member Per Month (PMPM)(from planning the survey to gather background information to two months after the final step; an average of 1 year)
- Annualized Costs for Guideline Implementation Interventions(from planning the survey to gather background information to two months after the final step; an average of 1 year)
- NCCL Treatment Costs- Total Program Costs Per Sealant(from planning the survey to gather background information to two months after the final step; an average of 1 year)
- NCCL Treatment Costs- Total Program Costs Per Sealant Per Clinic(from planning the survey to gather background information to two months after the final step; an average of 1 year)
- NCCL Treatment Costs- Per Sealant Per Member Per Month (PMPM)(from planning the survey to gather background information to two months after the final step; an average of 1 year)
- Sealant Treatment Plan Resolution(when a clinic was exposed to the intervention (when they received their survey results) to December 31, 2021. (Vanguard- 9.34 months; Cluster 1- 7.84 months; Cluster 2- 6.39 months; Cluster 3- 5.30 months; Cluster 4- 3.33 months; Cluster 5- 2.75 months))
- Cost Effectiveness(from one month before the first step to two months after the final step, 1 year)
研究者
Deborah Polk
Assistant Professor
University of Pittsburgh