Study protocol for a type III hybrid effectiveness-implementation trial of strategies to implement firearm safety promotion as a universal suicide prevention strategy in pediatric primary care.
Study protocol for a type III hybrid effectiveness-implementation trial of strategies to implement firearm safety promotion as a universal suicide prevention strategy in pediatric primary care.
复制标题
DOI：
10.1186/s13012-021-01154-8
复制
发表时间：
2021-09-22
期刊：
影响因子：
--
通讯作者：
Boggs JM
中科院分区：
文献类型：
--
作者：
Beidas RS;Ahmedani BK;Linn KA;Marcus SC;Johnson C;Maye M;Westphal J;Wright L;Beck AL;Buttenheim AM;Daley MF;Davis M;Elias ME;Jager-Hyman S;Hoskins K;Lieberman A;McArdle B;Ritzwoller DP;Small DS;Wolk CB;Williams NJ;Boggs JM
行为经济学的见解，或者有限的认知资源（例如时间、注意力）和心理启发如何塑造个人的决策和行为，在增加实施科学中基于证据的实践的努力中没有得到充分利用。以儿科初级保健中枪支安全促进为例，该案例解决了普遍自杀预防中证据与实践之间的差距，我们的目标是确定：是一种成本更低、更具可扩展性的行为经济知情实施策略（即“助推”），足以改变临床医生的行为，还是需要更密集和更昂贵的促进策略来克服实施障碍？青少年和儿童常规临床遭遇自杀预防 (ASPIRE) 混合 III 型有效性实施试验采用纵向整群随机设计。我们将测试两种实施策略的比较有效性，以支持临床医生使用基于证据的枪支安全实践 S.A.F.E。两个卫生系统的 32 个儿科诊所均使用枪支。两个卫生系统的所有儿科诊所都将接受 S.A.F.E.枪械材料，包括训练和缆锁。一半的练习（k = 16）将被随机接受助推；另一半 (k = 16) 将被随机接受 Nudge 加上 1 年的协助，以解决额外的实践和临床医生实施障碍 (Nudge+)。主要实施结果是家长报告的临床医生对 S.A.F.E 枪支计划的忠诚度。次要实施成果包括覆盖范围和成本。为了了解实施策略如何发挥作用，要测试的主要机制是实践适应性储备，这是一种自我报告的实践水平衡量标准，包括关系基础设施、促进性领导、意义建构、团队合作、工作环境和学习文化。 ASPIRE 试验将整合实施科学和行为经济学方法，以增进我们对在儿科初级保健中实施循证枪支安全促进实践的方法的理解。该研究回答了许多实践变革努力的核心问题：哪些策略足以支持变革，为什么？该试验的结果将为如何最好地实施基于证据的实践来解决儿科初级保健中的敏感健康问题提供宝贵的见解。 ClinicalTrials.gov，NCT04844021。注册日期为 2021 年 4 月 14 日。在线版本包含可在 10.1186/s13012-021-01154-8 获取的补充材料。
Insights from behavioral economics, or how individuals’ decisions and behaviors are shaped by finite cognitive resources (e.g., time, attention) and mental heuristics, have been underutilized in efforts to increase the use of evidence-based practices in implementation science. Using the example of firearm safety promotion in pediatric primary care, which addresses an evidence-to-practice gap in universal suicide prevention, we aim to determine: is a less costly and more scalable behavioral economic-informed implementation strategy (i.e., “Nudge”) powerful enough to change clinician behavior or is a more intensive and expensive facilitation strategy needed to overcome implementation barriers? The Adolescent and child Suicide Prevention in Routine clinical Encounters (ASPIRE) hybrid type III effectiveness-implementation trial uses a longitudinal cluster randomized design. We will test the comparative effectiveness of two implementation strategies to support clinicians’ use of an evidence-based firearm safety practice, S.A.F.E. Firearm, in 32 pediatric practices across two health systems. All pediatric practices in the two health systems will receive S.A.F.E. Firearm materials, including training and cable locks. Half of the practices (k = 16) will be randomized to receive Nudge; the other half (k = 16) will be randomized to receive Nudge plus 1 year of facilitation to target additional practice and clinician implementation barriers (Nudge+). The primary implementation outcome is parent-reported clinician fidelity to the S.A.F.E Firearm program. Secondary implementation outcomes include reach and cost. To understand how the implementation strategies work, the primary mechanism to be tested is practice adaptive reserve, a self-report practice-level measure that includes relationship infrastructure, facilitative leadership, sense-making, teamwork, work environment, and culture of learning. The ASPIRE trial will integrate implementation science and behavioral economic approaches to advance our understanding of methods for implementing evidence-based firearm safety promotion practices in pediatric primary care. The study answers a question at the heart of many practice change efforts: which strategies are sufficient to support change, and why? Results of the trial will offer valuable insights into how best to implement evidence-based practices that address sensitive health matters in pediatric primary care. ClinicalTrials.gov, NCT04844021. Registered 14 April 2021. The online version contains supplementary material available at 10.1186/s13012-021-01154-8.
登录
查看更多内容
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
25.8
作者：
Beidas RS;Buttenheim AM;Mandell DS
通讯作者：
Mandell DS
DOI：
10.1007/s11524-018-0261-7
发表时间：
2018-06-01
影响因子：
6.6
作者：
Azrael, Deborah;Cohen, Joanna;Miller, Matthew
通讯作者：
Miller, Matthew
用于残留抑郁症状的基于Web的程序的成本效益：正念情绪平衡。
DOI：
10.1176/appi.ps.202000419
发表时间：
2022-02-01
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Boggs JM;Ritzwoller DP;Beck A;Dimidjian S;Segal ZV
通讯作者：
Segal ZV
影响因子：
7.2
作者：
Aarons, Gregory A.;Sklar, Marisa;Brown, C. Hendricks
通讯作者：
Brown, C. Hendricks