Evaluating the implementation of a multi-level mHealth study to improve hydroxyurea utilization in sickle cell disease.
Evaluating the implementation of a multi-level mHealth study to improve hydroxyurea utilization in sickle cell disease.
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DOI：
10.3389/frhs.2022.1024541
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Klesges, L M
中科院分区：
文献类型：
--
作者：
Hankins, J S;Potter, M B;Fernandez, M E;Melvin, C;DiMartino, L;Jacobs, S R;Bosworth, H B;King, A A;Simon, J;Glassberg, J A;Kutlar, A;Gordeuk, V R;Shah, N;Baumann, A A;Klesges, L M
镰状细胞病(SCD)是一种进行性遗传病，会导致器官损伤和寿命缩短。羟基脲是一种未得到充分利用的循证药物，可减少SCD的并发症并提高存活率。在NIH资助的镰刀细胞疾病实施联盟(SCDIC)的一项多点临床试验中，我们评估了多水平多组件移动健康(MHealth)患者和提供者干预的实施情况，以针对低羟基尿素使用的决定因素和背景。考虑到干预的复杂性及其实施过程中的情境变异性，我们结合了不同的行为和实施理论、模型和框架来促进对干预实施的评估。在本报告中，我们描述了与利益攸关方的接触、实施过程的规划以及评估实施结果的最终分析计划。在19次会议期间，一个由16名成员组成的多学科SCDIC实施团队创建、构思和实施了一个项目，该项目利用干预图谱来指导设计干预及其评估计划。该过程包括五个步骤：(1)低羟基尿素利用率需求评估，(2)概念框架开发，(3)干预设计过程，(4)模型和框架的选择，(5)干预实施的设计性评估。行为学理论指导了多层次移动健康干预的需求评估和设计。在设计评估方法时，我们结合了两个实施框架，以最好地考虑组织、提供者和患者层面的背景复杂性：(1)实施研究综合框架，详细说明在多个层面(用户、组织、干预特征、更广泛的社区)实施移动健康干预的障碍和促进者，以及(2)技术接受模型()，一个专门用于解释使用新信息技术(包括移动健康)意图的概念模型。采用REACH有效性采用实施和维护(RE-AIM)框架来衡量结果。我们的研究项目可以作为潜在方法的案例研究，将不同的模型/框架结合起来，帮助组织和规划干预措施的评估，以提高药物依从性。对我们的过程的描述可以作为未来研究的蓝图，开发和测试新的策略，以促进SCD患者的循证治疗。
Sickle Cell Disease (SCD) is a progressive genetic disease that causes organ damage and reduces longevity. Hydroxyurea is an underutilized evidence-based medication that reduces complications and improves survival in SCD. In a multi-site clinical trial, part of the NIH-funded Sickle Cell Disease Implementation Consortium (SCDIC), we evaluate the implementation of a multi-level and multi-component mobile health (mHealth) patient and provider intervention to target the determinants and context of low hydroxyurea use. Given the complexity of the intervention and contextual variability in its implementation, we combined different behavioral and implementation theories, models, and frameworks to facilitate the evaluation of the intervention implementation. In this report, we describe engagement with stakeholders, planning of the implementation process, and final analytical plan to evaluate the implementation outcomes. During 19 meetings, a 16-member multidisciplinary SCDIC implementation team created, conceived, and implemented a project that utilized Intervention Mapping to guide designing an intervention and its evaluation plan. The process included five steps: (1) needs assessment of low hydroxyurea utilization, (2) conceptual framework development, (3) intervention design process, (4) selection of models and frameworks, and (5) designing evaluation of the intervention implementation. Behavioral theories guided the needs assessment and the design of the multi-level mHealth intervention. In designing the evaluation approach, we combined two implementation frameworks to best account for the contextual complexity at the organizational, provider, and patient levels: (1) the Consolidated Framework for Implementation Research (CFIR) that details barriers and facilitators to implementing the mHealth intervention at multiple levels (users, organization, intervention characteristics, broader community), and (2) the Technology Acceptance Model (TAM), a conceptual model specific for explaining the intent to use new information technology (including mHealth). The Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework was used to measure the outcomes. Our research project can serve as a case study of a potential approach to combining different models/frameworks to help organize and plan the evaluation of interventions to increase medication adherence. The description of our process may serve as a blueprint for future studies developing and testing new strategies to foster evidence-based treatments for individuals living with SCD.
影响因子：
1.7
作者：
Bello-Manga, Halima;Haliru, Lawal;Ahmed, Kudrat Abdulkareem;Tabari, Abdulkadir Musa;Farouk, Bilkisu Usman;Bahago, Gloria Yimi;Kazaure, Aisha Shuaibu;Muhammad, Abdulrasheed Sani;Gwarzo, Samira Abubakar;Baumann, Ana A.;DeBaun, Michael R.;King, Allison A.
通讯作者：
King, Allison A.