Southwest Health Extension Partnership to Enhance Research Dissemination (SHEPERD)

加强研究传播的西南健康推广伙伴关系 (SHEPERD)

• 批准号: 9058468
• 负责人: Walter Perry Dickinson
• 金额: $ 499.41万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-01 至 2018-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9058468
• 关键词: Southwest; Health; Extension; Partnership; Enhance

 DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) causes one in three deaths reported each year in the United States. Strategies derived from patient-centered outcomes research (PCOR) that address CVD risk factors can greatly reduce the burden of CVD. Primary care practices must transform to deliver a higher level of PCOR evidence- based prevention to decrease cardiovascular risk. PCOR interventions that emphasize patient-centered care including self-management support, team-based care, improved information systems, and active quality improvement have been shown to be effective. Practices often require assistance integrating new programs into clinical operations. Practice facilitation has been shown to enhance implementation of new programs for patients with chronic disease in primary care. Other methods of practice support, including academic detailing, collaborative learning sessions, and health information technology assistance, have also been shown to be effective, by themselves and in combination with practice facilitation. Patient involvement may also aid practice transformation. Increasingly, practices are actively including patients as part o the change process through the creation of patient advisory councils and including patients in practice quality improvement teams. Another method of patient involvement to inform implementation of evidence-based care is the Boot Camp Translation process, in which patients collaborate with primary care clinicians, staff members, and community members to translate best practices into culturally and community relevant implementation at the local level. However, while these efforts have had considerable success, no study has looked at the incremental value of adding patient engagement strategies to the more standard approaches to practice transformation listed above. This project would implement the Southwest Health Extension Program to Enhance Research Dissemination (SHEPERD) as a cooperative program to build primary care practice capacity for quality improvement, change management, and implementation of PCOR findings in small and medium size primary care practices in Colorado and New Mexico, with an initial focus on cardiovascular care. It also would conduct a cluster randomized trial with an external matched cohort control group to examine the Reach, Effectiveness, Adoption, Implementation, and Maintenance of two approaches to practice transformation to implement PCOR interventions for reducing cardiovascular risks in primary care practices, comparing the impact of 1) a standard practice transformation support intervention (including practice facilitation, practice assessment with feedback, HIT assistance, academic detailing, and collaborative learning sessions) to 2) an approach that adds patient engagement activities (including patient advisory councils and boot camp translation) as part of the practice transformation support. This project will provide critical information regarding the added value of patient engagement in practice transformation efforts and will also result in a network of practices across the region with increased capacity for practice transformation and implementation of PCOR findings.

 描述（由申请人提供）：心血管疾病（CVD）导致美国每年报告的三分之一的死亡。从以患者为中心的结果研究（PCOR）中得出的解决CVD风险因素的策略可以大大减轻CVD的负担。初级保健实践必须转变，提供更高水平的PCOR循证预防，以降低心血管风险。PCOR干预措施强调以患者为中心的护理，包括自我管理支持，基于团队的护理，改进的信息系统和积极的质量改进已被证明是有效的。实践往往需要协助将新程序整合到临床操作中。实践促进已被证明可以加强初级保健中慢性病患者新项目的实施。实践支持的其他方法，包括学术细节，协作学习课程，和健康信息技术援助，也被证明是有效的，本身和实践促进相结合。病人的参与也可能有助于实践的转变。越来越多的做法是积极包括病人作为一部分的变化过程中，通过创建病人咨询委员会，并包括病人在实践质量改进小组。另一种让患者参与实施循证护理的方法是靴子营翻译过程，在该过程中，患者与初级保健临床医生、工作人员和社区成员合作，将最佳实践转化为地方一级的文化和社区相关实施。然而，尽管这些努力取得了相当大的成功，但没有研究关注将患者参与策略添加到上述更标准的实践转型方法中的增量价值。该项目将实施西南健康推广计划，以加强研究传播（SHEPERD），作为一项合作计划，以建立初级保健实践能力，以提高质量，变革管理，并在科罗拉多和新墨西哥州的中小型初级保健实践中实施PCOR结果，最初重点是心血管护理。它还将与外部匹配的队列对照组进行一项群集随机试验，以检查两种实践转变方法的范围、有效性、采用、实施和维持，以实施PCOR干预措施，减少初级保健实践中的心血管风险，比较1）标准实践转变支持干预措施（包括实践促进、实践评估与反馈、HIT协助、学术细节和协作学习课程）到2）增加患者参与活动（包括患者咨询委员会和靴子训练营翻译）作为实践转变支持的一部分的方法。该项目将提供关于患者参与实践转变工作的附加值的重要信息，还将在整个区域形成一个实践网络，提高实践转变和实施变革和组织振兴方案调查结果的能力。