Empowering Women and Providers for Improved Care of Urinary Incontinence : EMPOWER Study

赋予妇女和医疗服务提供者权力，改善尿失禁护理：EMPOWER 研究

• 批准号: 10559564
• 负责人: Adonis K Hijaz
• 金额: $ 104.07万
• 依托单位: UNIVERSITY HOSPITALS OF CLEVELAND
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10559564
• 关键词: Empowering; Women; Providers; Improved; Care

Empowering patients and providers to improve care for urinary incontinence: EMPOWER Study Urinary incontinence (UI) affects over 50% of women. Non-surgical treatment, including behavioral interventions or pharmacotherapy, is usually effective, but recognition and evidence-based care for this condition remains suboptimal. Frontline treatment in primary care, with system support and specialty backup, has great potential, but a variety of patient-, provider-, and system-level barriers result in under-diagnosis and suboptimal management. Therefore, using established patient-centered outcomes research evidence for nonsurgical treatments for urinary incontinence in women, we propose an integrated, multilevel (patient, provide, and system) approach that addresses key barriers to diagnosing and managing UI in the primary care setting. Implementation strategies include large-scale screening, empowering patients to discuss UI with their providers, provider education and training, practice facilitation through nurse navigation, and a novel mobile platform “chatbot” to engage patients in self-management of their UI. A system-based strategy for streamlined referral and treatment will also be implemented. The implementation plan is fully aligned with AHRQ's EvidenceNow framework: practice facilitation, expert consultation, shared learning collaborative, data feedback and benchmarking, and health-information technology support. Over the course of 3 years, we aim to 1) Implement the “Empowerment for Improving UI” program across a large network of primary care practices. The program will involve systematic screening and identification of UI, patient empowerment, provider training and empowerment, nurse navigation, and simple and practical evidence-based technology. We hypothesize that the program will be implemented with fidelity to all planned elements and with local tailoring in all recruited practices. 2) Create an evidence-based patient-centered care pathway that minimizes burden on primary care while optimizing health-information systems, including an embedded electronic screening tool, that lead to sustainable improvement in quality of care. 3) Assess the impact of the Empowering for Improving UI intervention on outcomes important to patients and on provider knowledge and confidence, practice workflow and satisfaction among practice providers and staff. Through a systemic intervention that is multilevel, patient-oriented and supportive of primary care practice, and a rigorous mixed methods analysis, the proposed research has great potential to improve practice and patient outcomes and to generate transportable new knowledge to improve care for women with urinary incontinence.

赋予患者和医疗服务提供者改善尿失禁护理的能力：EMPOWER 研究 超过 50% 的女性患有尿失禁 (UI)。非手术治疗，包括行为治疗 干预或药物治疗通常是有效的，但对此的认识和基于证据的护理 状况仍然不理想。初级保健一线治疗，有系统支持和专业后备， 具有巨大潜力，但患者、提供者和系统层面的各种障碍导致诊断不足和 管理欠佳。 因此，利用已建立的以患者为中心的结果研究证据来进行非手术治疗 针对女性尿失禁，我们提出了一种综合的、多层次的（患者、供应商和系统）方法 解决了初级保健机构中诊断和管理 UI 的主要障碍。执行 策略包括大规模筛查、让患者能够与其提供者讨论 UI、提供者 教育和培训、通过护士导航进行实践促进以及新颖的移动平台“聊天机器人” 让患者参与其 UI 的自我管理。基于系统的策略，用于简化转介和 也将实施治疗。该实施计划与 AHRQ 的 EvidenceNow 完全一致 框架：实践促进、专家咨询、共享学习协作、数据反馈和 基准测试和卫生信息技术支持。 在 3 年的时间里，我们的目标是 1) 在整个领域实施“赋能改善用户界面”计划 初级保健实践的大型网络。该计划将涉及 UI 的系统筛查和识别， 患者赋权、提供者培训与赋权、护士导航，简单实用 基于证据的技术。我们假设该计划将忠实于所有计划的实施 元素并在所有招募的实践中进行本地定制。 2）创建以证据为基础、以患者为中心的护理 最大限度地减少初级保健负担的途径，同时优化卫生信息系统，包括 嵌入式电子筛查工具，可实现护理质量的可持续提高。 3）评估 增强 UI 干预对患者和提供者重要结果的影响 实践提供者和员工的知识和信心、实践工作流程和满意度。通过一个 多层次、以患者为导向、支持初级保健实践的系统性干预，以及严格的 混合方法分析表明，拟议的研究具有改善实践和患者治疗结果的巨大潜力 并产生可传播的新知识，以改善对尿失禁妇女的护理。