Identifying Successful Strategies for Implementing Team-Based Home Blood Pressure Monitoring in Primary Care
确定在初级保健中实施基于团队的家庭血压监测的成功策略
基本信息
- 批准号:10198144
- 负责人:
- 金额:$ 69.46万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-08-15 至 2022-07-31
- 项目状态:已结题
- 来源:
- 关键词:AbbreviationsAddressAdoptedAdoptionAdvisory CommitteesAfrican AmericanAmbulatory Blood Pressure MonitoringAttitudeCardiovascular DiseasesCaringClinicalCluster randomized trialCodeCost AnalysisDataDiagnosisEffectivenessElementsEvaluationEvidence based practiceGlossaryGoalsHome Blood Pressure MonitoringHybridsHypertensionInfrastructureKnowledgeLeadershipLearningLengthLow incomeMaintenanceManualsMeasuresMedicalMethodsMinorityModelingMotivationOffice VisitsOutcomePatient EducationPatientsPerformancePersonal GrowthPhasePractical, Robust Implementation and Sustainability ModelPrimary Health CareProblem SolvingProceduresProcessProgress ReportsPublishingQuality of lifeReach, Effectiveness, Adoption, Implementation, and MaintenanceReadinessReadingReportingResearch PersonnelResourcesRisk FactorsRoleScienceSiteTestingTimeTimeLineTrainingUnited StatesWorkbasecardiovascular disorder preventionfollow-upformative assessmenthypertension controlimplementation costimplementation processimplementation strategyimprovedimproved functioningmeetingsmodifiable riskpatient orientedprimary outcomeracial disparityrecruitsecondary outcomeskills
项目摘要
Hypertension is the single most important, medically modifiable risk factor for the prevention of cardiovascular
disease in the United States. Control of hypertension is critical to improving the length and quality of life in the
United States and for addressing racial disparities in cardiovascular disease. Yet, national progress in
controlling hypertension has stalled. The current model for hypertension care in the United States, which relies
nearly exclusively on clinician-driven office visits, has proven inadequate. There is an urgent need for team-
based, patient-centered models of care. Team-based home blood pressure monitoring (TB-HBPM)
represents an evidence-based practice that is widely underused in primary care. Strategies are needed
to promote its adoption in primary care. Based on published barriers to adoption of TB-HBPM, successful
strategies must engage patients and clinicians in the implementation process, and provide patients and their
care teams with the knowledge, skills, resources, and data needed to implement and sustain TB-HBPM.
Notably, strategies must address financial sustainability. The primary goal of this proposal is to identify
and rigorously evaluate translatable strategies for implementing and sustaining TB-HBPM within
primary care. To accomplish this aim, we will recruit seven practices from a single site where hypertension
control is suboptimal. These practices serve predominately low-income and minority patients. In phase1 (R61),
we will convene a steering committee that includes patients, practice staff, and clinicians to guide planning,
implementation, sustainability, and evaluation (Aim 1). During phase 1, we will assess the specific barriers and
facilitators to implementing TB-HPBM within these practices. Based on these practice-specific barriers, we will
operationalize strategies using the Practical, Robust, Implementation, and Sustainability Model (PRISM). In
phase 2 (R33), we will deploy these implementation strategies using a hybrid type-2, stepped wedge cluster
randomized trial (Aim 2). Implementation strategies will include patient and team training, actionable data
provided to the teams, and adoption of new billing codes. We will assess the impact of implementation
strategies using the Reach, Effectiveness, Adoption, Maintenance (RE-AIM) framework (Aim 3). Our primary
outcomes will be HTN control and patient use of HBPM. Secondary outcomes will include the proportion of
patients with uncontrolled BP who are seen within 60 days, establishment of team charters by teams
(adoption), and financial sustainability based on a cost analyses (maintenance). We will use realist evaluation
to test theoretical assumptions underlying the implementation strategies (Aim 4). This mixed-methods
approach will allow us to develop transferable lessons for other settings. Our findings will advance the science
on implementation of successful HTN management models and provide a roadmap towards broader
implementation of TB-HBPM in primary care.
高血压是预防心血管疾病的唯一最重要的、医学上可改变的危险因素
美国的疾病。控制高血压对改善老年人的生活时间和质量至关重要
在美国和解决心血管疾病方面的种族不平等问题上取得了重大成就。然而,国家在以下方面取得了进展
控制高血压已经停滞不前。美国目前的高血压护理模式依赖于
几乎完全由临床医生驱动的办公室访问,已被证明是不够的。迫切需要一支团队-
以病人为中心的护理模式。团队家庭血压监测(TB-HBPM)
代表了一种循证做法,这种做法在初级保健中普遍未得到充分利用。战略是必要的
以促进其在初级保健中的采用。根据已公布的采用TB-HBPM的障碍,成功
战略必须让患者和临床医生参与实施过程,并为患者和他们提供
拥有实施和维持结核病-HBPM所需的知识、技能、资源和数据的护理团队。
值得注意的是,战略必须解决财务可持续性问题。这项提案的主要目标是确定
并严格评估实施和维持结核病-HBPM的可翻译战略
初级保健。为了实现这一目标,我们将从高血压的一个地点招募七名医生
控制不是最优的。这些做法主要服务于低收入和少数族裔患者。在阶段1(R61)中,
我们将召集一个由患者、执业人员和临床医生组成的指导委员会来指导规划,
执行、可持续性和评价(目标1)。在第一阶段,我们将评估具体的障碍和
在这些做法中实施结核病--氟氯烃管理的促进者。基于这些特定于实践的障碍,我们将
使用实用、稳健、实施和可持续发展模式(PRISM)实施战略。在……里面
第2阶段(R33),我们将使用混合型2阶梯楔形群集部署这些实施战略
随机试验(目标2)。实施战略将包括患者和团队培训、可操作的数据
提供给团队,并采用新的计费代码。我们将评估实施的影响
使用REACH、有效性、采用、维护(RE-AIM)框架的战略(目标3)。我们的初选
结果将是HTN的控制和患者使用HBPM。次要结果将包括
60天内就诊的血压失控患者,按团队建立团队章程
(采用)和基于成本分析的财务可持续性(维护)。我们将使用现实主义的评估
检验作为实施战略基础的理论假设(目标4)。这种混合方法
这种方法将使我们能够为其他环境开发可转移的经验教训。我们的发现将推动科学的发展
关于实施成功的HTN管理模式,并提供走向更广泛的路线图
在初级保健中实施结核病-HBPM。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Kevin Fiscella其他文献
Kevin Fiscella的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Kevin Fiscella', 18)}}的其他基金
Identifying Successful Strategies for Implementing Team-Based Home Blood Pressure Monitoring in Primary Care
确定在初级保健中实施基于团队的家庭血压监测的成功策略
- 批准号:
10701721 - 财政年份:2022
- 资助金额:
$ 69.46万 - 项目类别:
Identifying Successful Strategies for Implementing Team-Based Home Blood Pressure Monitoring in Primary Care
确定在初级保健中实施基于团队的家庭血压监测的成功策略
- 批准号:
10474081 - 财政年份:2022
- 资助金额:
$ 69.46万 - 项目类别:
Develop an Artificial Intelligence-powered Smartphone App AICaries for Caries Detection in Children
开发人工智能驱动的智能手机应用程序 AICaries,用于儿童龋齿检测
- 批准号:
10331877 - 财政年份:2021
- 资助金额:
$ 69.46万 - 项目类别:
Implementation Research: Translating the ABC's into HIV Care
实施研究:将 ABC 转化为艾滋病毒护理
- 批准号:
9978087 - 财政年份:2018
- 资助金额:
$ 69.46万 - 项目类别:
Blood Pressure-Visit Intensification for Successful Improvement of Treatment
加强血压就诊以成功改善治疗
- 批准号:
8474980 - 财政年份:2013
- 资助金额:
$ 69.46万 - 项目类别:
Translating Team Science into Primary Care: PCOR on teamwork in FQHCs
将团队科学转化为初级保健:PCOR 关于 FQHC 中的团队合作
- 批准号:
8706795 - 财政年份:2013
- 资助金额:
$ 69.46万 - 项目类别:
Addressing Disparities in Health Information through an FQHC-Library Partnership
通过 FQHC-图书馆合作伙伴关系解决健康信息的差异
- 批准号:
8729008 - 财政年份:2013
- 资助金额:
$ 69.46万 - 项目类别:
Blood Pressure-Visit Intensification for Successful Improvement of Treatment
加强血压就诊以成功改善治疗
- 批准号:
8889719 - 财政年份:2013
- 资助金额:
$ 69.46万 - 项目类别:
Blood Pressure-Visit Intensification for Successful Improvement of Treatment
加强血压就诊以成功改善治疗
- 批准号:
8725734 - 财政年份:2013
- 资助金额:
$ 69.46万 - 项目类别:
Blood Pressure-Visit Intensification for Successful Improvement of Treatment
加强血压就诊以成功改善治疗
- 批准号:
9312862 - 财政年份:2013
- 资助金额:
$ 69.46万 - 项目类别:
相似海外基金
Rational design of rapidly translatable, highly antigenic and novel recombinant immunogens to address deficiencies of current snakebite treatments
合理设计可快速翻译、高抗原性和新型重组免疫原,以解决当前蛇咬伤治疗的缺陷
- 批准号:
MR/S03398X/2 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Fellowship
CAREER: FEAST (Food Ecosystems And circularity for Sustainable Transformation) framework to address Hidden Hunger
职业:FEAST(食品生态系统和可持续转型循环)框架解决隐性饥饿
- 批准号:
2338423 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Continuing Grant
Re-thinking drug nanocrystals as highly loaded vectors to address key unmet therapeutic challenges
重新思考药物纳米晶体作为高负载载体以解决关键的未满足的治疗挑战
- 批准号:
EP/Y001486/1 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Research Grant
Metrology to address ion suppression in multimodal mass spectrometry imaging with application in oncology
计量学解决多模态质谱成像中的离子抑制问题及其在肿瘤学中的应用
- 批准号:
MR/X03657X/1 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Fellowship
CRII: SHF: A Novel Address Translation Architecture for Virtualized Clouds
CRII:SHF:一种用于虚拟化云的新型地址转换架构
- 批准号:
2348066 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Standard Grant
The Abundance Project: Enhancing Cultural & Green Inclusion in Social Prescribing in Southwest London to Address Ethnic Inequalities in Mental Health
丰富项目:增强文化
- 批准号:
AH/Z505481/1 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Research Grant
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
- 批准号:
10107647 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
EU-Funded
BIORETS: Convergence Research Experiences for Teachers in Synthetic and Systems Biology to Address Challenges in Food, Health, Energy, and Environment
BIORETS:合成和系统生物学教师的融合研究经验,以应对食品、健康、能源和环境方面的挑战
- 批准号:
2341402 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Standard Grant
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
- 批准号:
10106221 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
EU-Funded
Recite: Building Research by Communities to Address Inequities through Expression
背诵:社区开展研究,通过表达解决不平等问题
- 批准号:
AH/Z505341/1 - 财政年份:2024
- 资助金额:
$ 69.46万 - 项目类别:
Research Grant