Delivery of Preventive Services in Primary Care

描述（由申请人提供）：俄克拉荷马州大学家庭医学研究中心和俄克拉荷马州医生资源/研究网络与医疗数据解决方案公司合作，（一家软件开发公司）将研究一种多组成部分干预措施的有效性，以转化三种办公系统战略，这些战略已知可在一组初级保健实践中增加免疫接种和其他预防服务的提供。翻译干预将包括医疗记录审计与反馈和基准，学术细节由当地意见领袖，包括来自同行范例的建议（“最佳实践研究”的结果），实践增强助理（实践促进者），和计算机应用程序，旨在帮助实践纳入和维护办公室系统战略。有关战略包括护士常规命令、召回和提醒制度以及特别免疫接种和预防服务诊所。实践将被随机分配到多成分干预组或对照组，对照组将仅接受基准测试的反馈。主要成果衡量标准是业务部门采用的办公室系统战略（三项战略中）的数量。将分析背景因素和障碍及其对采用办公系统策略的影响。最后，我们还将比较选定的免疫接种和预防服务的提供率，以确定干预措施对预防服务提供的影响程度。这项为期两年的研究，虽然相对较小，但将有助于我们了解基于实践的研究网络中的多组分翻译干预。

DESCRIPTION (Provided by Applicant): The Center for Family Medicine Research at the University of Oklahoma and the Oklahoma Physicians Resource/Research Network, in collaboration with Medical Data Solutions, Inc., (a software development company) will study the effectiveness of a multi-component intervention to translate three office system strategies known to increase delivery of immunizations and other preventive services in a group of primary care practices. The translational intervention will include medical record audits with feedback and benchmarking, academic detailing by a local opinion leader including suggestions derived from peer exemplars (results of "best practices research"), a practice enhancement assistant (practice facilitator), and a computer application designed to help the practice incorporate and maintain the office system strategies. The strategies of interest include nurse standing orders, a recall and reminder system, and special immunization and preventive services clinics. Practices will be randomized to the multi-component intervention group or to the control group, which will receive feedback with benchmarking alone. The primary outcome measure will be the number of office system strategies (of the three) adopted by the practice. Contextual factors and barriers and their impact on adoption of the office system strategies will analyzed. Finally, we will also compare the rates of delivery of selected immunizations and preventive services to determine the size of the effect of the intervention on preventive services delivery. This two-year study, though relatively small, will contribute to our understanding of multi-component translational interventions within practice-based research networks.