Implementing Networks Self-management Tools Through Engaging Patients and Practic

项目摘要/摘要 由初级保健实践团队提供的自我管理支持(SMS)被认为是重要的 护理模式的组成部分和以患者为中心的医疗之家。慢性病的负担呼唤团队-- 以初级保健为基础，与活跃的知情患者合作。人们认识到，很少有患者 精通自我管理技能，缺乏知识和信心。主要实践越来越多地 将资源用于护理协调-在实践中确定和培训护理经理以帮助 管理日益复杂的患者小组。医疗研究和质量机构(AHRQ) 开发了一套基于Web的资源和工具，以帮助繁忙的实践进行推广和交付 病人的自我管理能力，能应付慢性病的负担。来自Meta-LARC的这项建议 基于实践的研究网络联盟(PBRN)将利用创新的社区参与式 实施干预，训练营翻译(BCT)促进和研究实施 ARHQ的SMS库/工具包涵盖四个PBRN中的16个中小型初级实践。这个 通过参与患者和实践实施网络的自我管理工具(INSTTEPP) 该项目将实现三个具体目标：1)在四个参与方实施AHRQ短信图书馆/工具包 在阶梯式楔形设计中使用Boot Camp转换的网络和16项实践~2)评估 对从事慢性病管理的实习人员和患者的实施情况；3)确定 与成功实施相关的因素。 INSTTEPP描述了四个假设：1)训练营翻译将对态度产生积极影响 和实习人员关于患者自我管理技能的行为~2)BCT将积极影响 AHRQ管理信息库/TOOLKIT~3)BCT的采用和AHRQ管理信息库的使用将产生积极影响 参与实践护理管理项目的患者对自我管理的态度 计划行为理论(TPB)中的可识别因素和综合框架 执行研究将通过实践影响AHRQ图书馆/工具包的采用。 研训所将提供一个与PBRN合作的模式，以有效地利用BCT，以有效地 临床医生、诊所工作人员和患者使用AHRQ短信资料库/工具包来增加知识和使用 慢性病护理的自我管理技能。TPB和TPB确定的SMS效用因素的评估 CFIR和定性比较分析将为以下方面的进一步研究提供路线图 慢性病护理。

Project Summary/Abstract Self-management support (SMS) provided by primary care practice teams is recognized as an important component of the care model and patient centered medical home. The burden of chronic illness calls for team- based primary care working in partnership with activated informed patients. It is recognized that few patients are proficient in self-management skills, lacking knowledge and confidence. Primary practices are increasingly dedicating resources to care coordination-identifying and training care managers within the practice to help manage an increasingly complex panel of patients. The Agency for Healthcare Research and Quality (AHRQ) has developed a web-based set of resources and tools to assist busy practices with promoting and delivering patient self-management skills coping with the burden of chronic illness. This proposal from the Meta-LARC consortium of practice-based research networks (PBRNs) will utilize an innovative community participatory implementation intervention, Boot Camp Translation (BCT) to promote and study the implementation of ARHQ's SMS Library/Toolkit across 16 small- and medium-sized primary practices in four PBRNs. The Implementing Networks' Self-management Tools Through Engaging Patients and Practice (INSTTEPP) project will address three specific aims: 1) Implement the AHRQ SMS Library/Toolkit across four participating networks and 16 practices using Boot Camp Translation in a stepped-wedge design~ 2) Assess the impact of implementation on practice staff and patients engaged in chronic illness management~ and, 3) Identify the factors related to successful implementation. INSTTEPP describes four hypotheses: 1) Boot Camp Translation will have positive influences on the attitudes and behaviors of practice staff regarding patient self-management skills~ 2) BCT will positively influence the adoption of the AHRQ SMS Library/Toolkit~ 3) BCT and use of the AHRQ SMS Library will positively influence the attitudes of patients engaged in practice care management programs toward self-management~ and, 4) Identifiable factors within the Theory of Planned Behavior (TPB) and the Consolidated Framework for Implementation Research (CFIR) will impact the adoption of the AHRQ Library/Toolkit by practices. INSTTEPP will provide a model of working in partnership with PBRNs to effectively use BCT to effectively clinicians, clinic staff, and patients in using the AHRQ SMS Library/Toolkit to increase knowledge and use of self-management skills for chronic illness care. The assessment of SMS utility factors identified by TPB and CFIR and informed by qualitative comparative analysis will provide a roadmap for additional research in chronic illness care.