ECHO Autism Replication: Step Wedge Randomized Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 148
- 主要终点
- Longitudinal Pattern of ASD Screening in PCP Charts
研究概览
简要总结
ECHO Autism was intended to assess rigorously the impact of a 12-session telemedicine training program on participating Primary Care Providers (PCP) knowledge, clinical behavior, and self-efficacy in the screening and care of children with Autism Spectrum Disorder (ASD). Each session is referred to as an "ECHO clinic".
详细描述
The study involved 10 sites (each referred to as an "ECHO Autism Hub"), each running a 12-session training program using a common curriculum and core lecture, with each site expected to recruit 15 PCPs. Sites were randomized in a stepped-wedge design with 5 clusters (2 sites per cluster) and a staggered start over a 1-year period. Staggering the start allowed for some control for potential temporal trends, as well as allowing the core team to focus on working with each site to ensure smooth startup of the training program at each site.
Outcomes are measured at baseline (Month 0), during the intervention (approximately 3 months after the start of the intervention) and after the end of the intervention (approximately 6 months after the start of the intervention). An additional measurement was made 3 months after the end of the intervention to assess whether deterioration occurs after clinic participation ends.
All participants received the intervention.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Current practice as a primary care provider (PCP)
- •Currently providing care for children
- •Professional training in: general pediatrics, family medicine, advance practice nursing (i.e. nurse practitioner or physician assistant)
- •Active medical license in the state of practice
- •Patient population is at least 50% underserved
排除标准
- •Trainee status (e.g., medical student, intern, resident, or other pre-professional trainee)
- •Subspecialist (e.g., psychiatrists, neurologists, developmental and behavioral pediatricians)
- •Practicing within the same practice as another PCP participant (i.e., only one PCP participant from any given practice may be enrolled as a research participant in the study)
结局指标
主要结局
Longitudinal Pattern of ASD Screening in PCP Charts
时间窗: Baseline (Month 0), mid-intervention (Month 3), post-intervention (Month 6), and end of follow-up (Month 9)
Clinical Practice/Behavior for ASD screening will be assessed at four time points by review of a subset of charts from each Primary Care Provider's practice. Four subsets of charts will be reviewed for appropriate ASD screening occurring during well-child visits. Data will be summarized into the percent of children appropriately screened for ASD by each PCP.
Longitudinal Pattern of Reported Co-occurring Medical Conditions Correctly Treated in PCP Charts
时间窗: Baseline (Month 0), mid-intervention (Month 3), post-intervention (Month 6), and end of follow-up (Month 9)
Clinical Practice/Behavior for treating co-occurring medical conditions will be assessed at four time points by review of a subset of charts from each Primary Care Provider's practice. All visits with an ASD will be reviewed. Data will be summarized into the percent of co-occurring medical conditions appropriately treated by each PCP.
次要结局
- Longitudinal Pattern of the Number of Perceived Barriers to Care(Baseline (Month 0), mid-intervention (Month 3), post-intervention (Month 6), and end of follow-up (Month 9))
- Number of Co-morbidities in Children With ASD(Baseline (Month 0), mid-intervention (Month 3), post-intervention (Month 6), and end of follow-up (Month 9))
- Longitudinal Pattern of Scores on Provider ASD Knowledge Assessment(Baseline (Month 0), mid-intervention (Month 3), post-intervention (Month 6), and end of follow-up (Month 9))
- Participant Satisfaction With ECHO Autism Program(At end of intervention (Month 6))
- PCP ECHO Program Attendance(At end of intervention (Month 6))
- Longitudinal Pattern of Scores on Provider ASD Self-Efficacy Assessment(Baseline (Month 0), mid-intervention (Month 3), post-intervention (Month 6), and end of follow-up (Month 9))
研究者
Karen Kuhlthau
Associate Professor of Pediatrics
Massachusetts General Hospital