Improving Primary Care Understanding of Resources and Screening for Urinary Incontinence to Enhance Treatment (PURSUIT)

提高初级保健对资源的了解和尿失禁筛查以加强治疗 (PURSUIT)

• 批准号: 10559574
• 负责人: Alayne Denise Markland
• 金额: $ 82.44万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 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/10559574
• 关键词: Improving; Primary; Care; Understanding; Resources

The Department of Veterans Affairs Integrated Service Network (VISN-7) is our targeted region for this proposal, named “Improving Primary Care Understanding of Resources and Screening for Urinary Incontinence to Enhance Treatment (PURSUIT)” as part of the Improving Nonsurgical Treatment of Urinary Incontinence among women in Primary Care (INTUIT-PC). Our overarching goal is to improve access to evidence-based nonsurgical UI treatment for women Veterans using the most effective remote delivery modality in the Southeast region of the U.S. In our first aim, we will compare two models: our mHealth UI modality alone and our mHealth UI model combined with clinician expertise delivered via clinical video telehealth (CVT) to improve UI symptoms at the patient level. With leverage from our current clinical trial infrastructure that utilizes these two models, our proposed study will incorporate a sequential, multiple assignment, randomized trial (SMART) design to determine the optimal model for remote delivery of nonsurgical UI treatment for UI symptom improvement. In our second aim, we propose an implementation strategy of practice facilitation, to improve awareness and adherence to evidence-based guidelines on nonsurgical UI treatments at the practice level. We will employ a Type 1 Hybrid Effectiveness-Implementation design to assess the effectiveness of our mHealth intervention, while using the Reach, Efficacy/effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to guide our practice level implementation approach. For our third mixed-methodology aim, we seek to explore women Veterans’ and providers’ perceptions of key factors that may influence future remote UI treatment scalability for local, regional, and national dissemination. PURSUIT aims to target 62 primary care practices that treat over 50,000 women Veterans. Practices will be randomized in clusters to receive the interactive mHealth UI application non- surgical UI treatment modality with or without additional clinical UI expertise delivered via telehealth. All primary care practices will receive practice facilitation with a PURSUIT toolkit that includes (1) 1-2 visits with a practice facilitator engaging practices through virtual group sessions and one on-site visit (if allowed); (2) Mobile-health or mHealth Application Training (MAT) training: MAT training will be offered through in-person academic detailing, online resources, and ongoing support via email or office hours with project staff and experts; 3) Online Resource Hub: The online resource hub will be available throughout project implementation, and e-learning modules will serve as the structural base for virtual practice facilitation sessions; and (4) Health information technology (HIT) assistance: Project staff will offer support in developing UI registries for population management, quality improvement, and data reporting through the mHealth nonsurgical UI application. Our future goal is to disseminate the most effective modality for delivering nonsurgical UI treatment for women Veterans nationally within the Veterans Healthcare Administration.

退伍军人事务部综合服务网络（VISN-7）是我们的目标地区 提案，命名为“改善对资源的理解和尿筛查的理解 尿失禁增强治疗（追捕）”，作为改进的非手术治疗的一部分 初级保健中妇女的尿失禁（Intuit-PC）。我们的总体目标是提高访问权限 使用最有效的远程交付的女性退伍军人的循证非手术UI治疗 在我们的第一个目标中，美国东南地区的方式，我们将比较两种模型：我们的MHealth UI 仅模态和我们的MHealth UI模型与通过临床视频交付的临床专业知识相结合 远程医疗（CVT）在患者级别上改善UI符号。通过我们当前临床试验的杠杆作用 利用这两个模型的基础架构，我们提出的研究将结合一个顺序的多个 分配，随机试验（智能）设计，以确定用于远程交付的最佳模型 非外科UI治疗UI症状改善。在我们的第二个目标中，我们建议实施 实践设施的策略，以提高认识和遵守基于证据的准则 非手术UI治疗在实践层面。我们将采用1型混合有效性实施 设计以评估MHealth干预措施的有效性，同时使用覆盖范围，有效性/有效性， 采用，实施和维护（RE-AIM）框架以指导我们的实践水平实施 方法。对于我们的第三个混合方法，我们寻求探索妇女退伍军人和提供者 对可能影响未来远程UI治疗可伸缩性的关键因素的看法 民族传播。追求旨在针对62种治疗50,000多名妇女的初级保健实践 退伍军人。实践将在群集中随机分配，以接收交互式MHealth UI应用程序非 - 通过有或没有其他临床UI专业知识的手术UI治疗方式通过远程医疗提供。全部 初级保健实践将通过追踪工具包接收练习设施，其中包括（1）1-2访问 通过虚拟小组会议和一次现场访问（如果允许）来实践促进者参与实践； （2） 移动健康或MHealth应用程序培训（MAT）培训：将通过面对面提供垫子培训 学术详细信息，在线资源和通过电子邮件或办公时间与项目人员和办公时间的支持以及 专家； 3）在线资源中心：在线资源中心将在整个项目实施中可用， 电子学习模块将成为虚拟实践设施会议的结构基础； （4）健康 信息技术（HIT）协助：项目工作人员将为开发UI注册机构提供支持 通过MHealth非外科UI的人口管理，质量改进和数据报告 应用。我们未来的目标是传播提供非外科UI处理的最有效方式 在退伍军人医疗保健管理局内的全国范围内的妇女退伍军人。