Dissemination of the Cardiovascular Risk Service (CVRS Live)

心血管风险服务传播（CVRS Live）

基本信息

批准号：
10371880
负责人：
KOREY A KENNELTY
金额：
$ 71.71万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-02-01 至 2023-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10371880
关键词：
Achievement Address Adherence Adoption American American Cancer Society American Heart Association Behavior Therapy Cardiovascular Diseases Caring Cessation of life Clinic Clinical Research Clinical Trials Cluster randomized trial Collaborations Complex Data Diabetes Mellitus Disease Disease Management Dissemination and Implementation Effectiveness Evaluation Evidence based intervention Funding Goals Guidelines Health Health system Heart Home Hospitals Individual Infrastructure Intervention Interview Lead Maintenance Managed Care Measures Medical History Medical center Meta-Analysis Methods Minority Modeling Morbidity - disease rate National Heart, Lung, and Blood Institute Patient Care Patients Performance Pharmacists Pharmacy facility Physicians Physicians&apos Offices Policies Primary Health Care Privatization Public Health Randomized Reach Effectiveness Adoption Implementation and Maintenance Research Research Design Research Priority Risk Factors Rural Screening for cancer Secondary Prevention Self Management Service delivery model Services Surveys System Testing Training Translational Research Underserved Population United States Centers for Medicare and Medicaid Services United States National Institutes of Health Vaccination Vulnerable Populations base cardiovascular disorder prevention cardiovascular disorder risk cardiovascular risk factor care delivery care providers design disorder prevention health record implementation barriers implementation facilitators implementation process implementation research improved innovation mortality multiple chronic conditions novel novel strategies patient oriented prevention service programs provider adherence scale up treatment as usual

项目摘要

Project Summary/Abstract Cardiovascular disease (CVD) causes 2,200 deaths in Americans every day. Yet effective implementation of evidence-based interventions that reduce CVD-related morbidity and mortality remains a substantial challenge. The Patient-Centered Medical Home including self-management, personalized health records, and team-based care is a strategy to improve care for patients with multiple chronic conditions. Building upon this framework, we developed an innovative team-based intervention, the Cardiovascular Risk Service (CVRS), which includes a centralized, pharmacist-led cardiovascular risk service and prevention services (e.g., vaccinations, cancer screenings) model to support primary care providers with CVD management and achievement of key performance measures. Results from one of our previous NIH-funded clustered-randomized trials showed a decrease in CVD risk factors in CVRS intervention patients receiving care through private physician offices. However, we discovered many more barriers to adoption of the CVRS in large health centers in another ongoing trial than the major positive support we received in small rural private clinics. Our long-term goal is to improve CVD management through team-based primary care. The application objective is to test the scalability of the CVRS in 12 large, organizationally and culturally diverse (diverse) hospitals and health- systems, many with high proportions of minority and underserved patients, using a pragmatic cluster- randomized design. Scaling-up the CVRS will require an assessment of adoption, implementation, and maintenance for broader dissemination and implementation. Our central hypothesis is that barriers and facilitators to CVRS implementation will vary across diverse primary care offices. We will use a transdisciplinary approach in collaboration with national experts in educational policy to measure these variances by means of mixed methods including interviews, observations, and surveys. The proposed study rationale is a novel implementation approach to improve CVD management and prevention services in patients with complex medical histories and will lead to innovative strategies for broader adoption by US health systems. Grounded in the RE-AIM framework, we will accomplish our objective and test our central hypothesis with these specific aims: Aim 1: Identify, understand, and develop strategies for overcoming barriers to the adoption, implementation, and maintenance of the CVRS in diverse primary care offices. Aim 2: Determine the real-world reach and effectiveness of the CVRS in diverse primary care offices. Aim 3: Determine CVRS sustainability and adaptation in diverse primary care offices. Our approach is innovative because it will ask: “How can implementation processes be improved and maintained?” as well as “Can implementation and maintenance be ‘tailored’ to real-world primary care providers so that they desire expansion to underserved patients?” This study design is novel because it will be the first to evaluate the adoption, implementation, and maintenance of a behavioral intervention using the comprehensive model in large, complex health systems.

项目摘要/摘要心血管疾病（CVD）每天在美国人中导致2200例死亡。然而有效的实施减少与CVD相关的发病率和死亡率的基于证据的干预措施仍然是一个重大挑战。以患者为中心的医疗之家，包括自我管理，个性化的健康记录和基于团队护理是改善多种慢性病患者护理的策略。在此框架的基础上，我们开发了一种创新的基于团队的干预措施，即心血管风险服务（CVRS），其中包括集中式药剂师领导的心血管风险服务和预防服务（例如，疫苗，癌症筛选）模型以支持CVD管理和关键实现的初级保健提供者绩效指标。我们以前一项NIH资助的聚类随机试验的结果显示了一个 CVRS干预患者通过私人物理办公室接受护理的CVD危险因素的减少。但是，我们发现了在另一个大型健康中心采用CVR的更多障碍正在进行的试验比我们在小型农村私人诊所获得的主要积极支持。我们的长期目标是通过基于团队的初级保健改善CVD管理。应用程序的目标是测试 CVR在12个大型，组织和文化上多样化（多元化）医院的可伸缩性和健康许多具有少数族裔和服务不足的患者的系统，使用务实的簇 - 随机设计。扩展CVR将需要评估采用，实施和维护更广泛的传播和实施。我们的中心假设是障碍和 CVRS实施的促进者将在潜水员的初级保健办公室中有所不同。我们将使用一个跨学科方法与国家教育政策专家合作，以衡量这些方法通过混合方法在内的差异，包括访谈，观察和调查。拟议的研究理由是一种新的实施方法，用于改善CVD管理和预防服务具有复杂病史的患者，将导致美国健康健康采用更广泛采用的创新策略系统。基于Re-Aim框架，我们将实现我们的目标并检验中心假设以这些具体目的：目标1：确定，理解和制定克服障碍的策略在潜水员初级保健办公室中采用，实施和维护CVR。目标2：确定 CVR在潜水员初级保健办公室中的现实世界范围和有效性。目标3：确定CVRS 潜水员初级保健办公室的可持续性和适应。我们的方法是创新的，因为它会问： “如何改善和维护实施过程？”以及“可以实施和维护对现实世界中的初级保健提供商“量身定制”，以便他们希望扩展到服务不足病人？”这项研究设计是新颖的，因为它将是第一个评估采用，实施和使用大型复杂卫生系统中的综合模型维护行为干预。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The Initial Use of the Home Medication Experience Questionnaire (HOME-Q) in Community-Based Pharmacy.

DOI：
10.1177/2374373520916015
发表时间：
2020-12
期刊：
Journal of patient experience
影响因子：
1.5
作者：
Witry MJ;Pham K;Viyyuri B;Doucette W;Kennelty K
通讯作者：
Kennelty K

Dissemination of a telehealth cardiovascular risk service: The CVRS live protocol.

DOI：
10.1016/j.cct.2021.106282
发表时间：
2021-03
期刊：
Contemporary clinical trials
影响因子：
2.2
作者：
Kennelty KA;Engblom NJ;Carter BL;Hollingworth L;Levy BT;Finkelstein RJ;Parker CP;Xu Y;Jackson KL;Dawson JD;Dorsey KK
通讯作者：
Dorsey KK

Incorporation of an Efficient Pharmacist Workflow During the Transition From In-Person to Telemedicine Geriatric Clinics in Response to the COVID-19 Pandemic.

为了应对 COVID-19 大流行，在从面对面老年诊所向远程医疗老年诊所过渡的过程中纳入高效的药剂师工作流程。

DOI：
10.1177/08971900221109982
发表时间：
2023
期刊：
Journal of pharmacy practice
影响因子：
1.3
作者：
Reist,JeffreyC;Zahn,Brent;Oche,Onyeche;Shannon,ZacariahK;Casteel,Carri;Dobyns,RichardC;Kennelty,KoreyA
通讯作者：
Kennelty,KoreyA

Heterotrimeric G protein-mediated signaling and its non-canonical regulation in the heart.