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Zittleman L, Westfall JM, Callen D, Herrick AM, Nkouaga C, Simpson M, Dickinson LM, Fernald D, Kaufman A, English AF, Dickinson WP, Nease DE. Does engagement matter? The impact of patient and community engagement on implementation of cardiovascular health materials in primary care settings. BMC PRIMARY CARE 2024; 25:135. [PMID: 38664665 PMCID: PMC11044409 DOI: 10.1186/s12875-024-02365-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Engaging patients and community members in healthcare implementation, research and evaluation has become more popular over the past two decades. Despite the growing interest in patient engagement, there is scant evidence of its impact and importance. Boot Camp Translation (BCT) is one evidence-based method of engaging communities in research. The purpose of this report is to describe the uptake by primary care practices of cardiovascular disease prevention materials produced through four different local community engagement efforts using BCT. METHODS EvidenceNOW Southwest (ENSW) was a randomized trial to increase cardiovascular disease (CVD) prevention in primary care practices. Because of its study design, Four BCTs were conducted, and the materials created were made available to participating practices in the "enhanced" study arm. As a result, ENSW offered one of the first opportunities to explore the impact of the BCT method by describing the uptake by primary care practices of health messages and materials created locally using the BCT process. Analysis compared uptake of locally translated BCT products vs. all other products among practices based on geography, type of practice, and local BCT. RESULTS Within the enhanced arm of the study that included BCT, 69 urban and 13 rural practices participated with 9 being federally qualified community health centers, 14 hospital owned and 59 clinician owned. Sixty-three practices had 5 or fewer clinicians. Two hundred and ten separate orders for materials were placed by 43 of the 82 practices. While practices ordered a wide variety of BCT products, they were more likely to order materials developed by their local BCT. CONCLUSIONS In this study, patients and community members generated common and unique messages and materials for cardiovascular disease prevention relevant to their regional and community culture. Primary care practices preferred the materials created in their region. The greater uptake of locally created materials over non-local materials supports the use of patient engagement methods such as BCT to increase the implementation and delivery of guideline-based care. Yes, patient and community engagement matters. TRIAL REGISTRATION AND IRB Trial registration was prospectively registered on July 31, 2015 at ClinicalTrials.gov (NCT02515578, protocol identifier 15-0403). The project was approved by the Colorado Multiple Institutional Review Board and the University of New Mexico Human Research Protections Office.
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Affiliation(s)
- Linda Zittleman
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - John M Westfall
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Danelle Callen
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Alisha M Herrick
- The Center for Health Innovation, New Mexico's Public Health Institute, Albuquerque, NM, USA
| | - Carolina Nkouaga
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Matthew Simpson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - L Miriam Dickinson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Douglas Fernald
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Arthur Kaufman
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Aimee F English
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - W Perry Dickinson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Donald E Nease
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Woodward EN, Castillo AIM, True G, Willging C, Kirchner JE. Challenges and promising solutions to engaging patients in healthcare implementation in the United States: an environmental scan. BMC Health Serv Res 2024; 24:29. [PMID: 38178131 PMCID: PMC10768202 DOI: 10.1186/s12913-023-10315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND One practice in healthcare implementation is patient engagement in quality improvement and systems redesign. Implementers in healthcare systems include clinical leadership, middle managers, quality improvement personnel, and others facilitating changes or adoption of new interventions. Patients provide input into different aspects of health research. However, there is little attention to involve patients in implementing interventions, especially in the United States (U.S.), and this might be essential to reduce inequities. Implementers need clear strategies to overcome challenges, and might be able to learn from countries outside the U.S. METHODS We wanted to understand existing work about how patients are being included in implementation activities in real world U.S. healthcare settings. We conducted an environmental scan of three data sources: webinars, published articles, and interviews with implementers who engaged patients in implementation activities in U.S. healthcare settings. We extracted, categorized, and triangulated from data sources the key activities, recurring challenges, and promising solutions using a coding template. RESULTS We found 27 examples of patient engagement in U.S. healthcare implementation across four webinars, 11 published articles, and seven interviews, mostly arranging patient engagement through groups and arranging processes for patients that changed how engaged they were able to be. Participants rarely specified if they were engaging a population experiencing healthcare inequities. Participants described eight recurring challenges; the two most frequently identified were: (1) recruiting patients representative of those served in the healthcare system; and (2) ensuring processes for equitable communication among all. We matched recurring challenges to promising solutions, such as logistic solutions on how to arrange meetings to enhance engagement or training in inclusivity and power-sharing. CONCLUSION We clarified how some U.S. implementers are engaging patients in healthcare implementation activities using less and more intensive engagement. It was unclear whether reducing inequities was a goal. Patient engagement in redesigning U.S. healthcare service delivery appears similar to or less intense than in countries with more robust infrastructure for this, such as Canada and the United Kingdom. Challenges were common across jurisdictions, including retaining patients in the design/delivery of implementation activities. Implementers in any region can learn from those in other places.
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Affiliation(s)
- Eva N Woodward
- VA Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Drive, Building 11, North Little Rock, AR, 72114, USA.
- Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA.
| | - Andrea Isabel Melgar Castillo
- VA Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Drive, Building 11, North Little Rock, AR, 72114, USA
- Graduate School, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA
| | - Gala True
- South Central Mental Illness Research Education and Clinical Center, Southeast Louisiana Veterans Health Care System, 2400 Canal St, New Orleans, LA, 70119, USA
- Section on Community and Population Medicine, School of Medicine, Louisiana State University, 2400 Canal St (11F), New Orleans, LA, USA
| | - Cathleen Willging
- Pacific Institute for Research and Evaluation, 851 University Boulevard, Suite 101, Albuquerque, NM, 87106, USA
| | - JoAnn E Kirchner
- Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA
- Behavioral Health Quality Enhancement Research Initiative (QUERI), Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, Building 11, North Little Rock, AR, 72114, USA
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Coury J, Coronado GD, Myers E, Patzel M, Thompson J, Whidden-Rivera C, Davis MM. Engaging with Rural Communities for Colorectal Cancer Screening Outreach Using Modified Boot Camp Translation. Prog Community Health Partnersh 2024; 18:47-59. [PMID: 38661826 PMCID: PMC11047025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Colorectal cancer (CRC) incidence and mortality are disproportionately high among rural residents and Medicaid enrollees. OBJECTIVES To address disparities, we used a modified community engagement approach, Boot Camp Translation (BCT). Research partners, an advisory board, and the rural community informed messaging about CRC outreach and a mailed fecal immunochemical test program. METHODS Eligible rural patients (English-speaking and ages 50-74) and clinic staff involved in patient outreach participated in a BCT conducted virtually over two months. We applied qualitative analysis to BCT transcripts and field notes. RESULTS Key themes included: the importance of directly communicating about the seriousness of cancer, leveraging close clinic-patient relationships, and communicating the test safety, ease, and low cost. CONCLUSIONS Using a modified version of BCT delivered in a virtual format, we were able to successfully capture community input to adapt a CRC outreach program for use in rural settings. Program materials will be tested during a pragmatic trial to address rural CRC screening disparities.
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McDonald IR, Blocker ES, Weyman EA, Smith N, Dwyer AA. What Are the Best Practices for Co-Creating Patient-Facing Educational Materials? A Scoping Review of the Literature. Healthcare (Basel) 2023; 11:2615. [PMID: 37830651 PMCID: PMC10572900 DOI: 10.3390/healthcare11192615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
Co-creating patient-facing educational materials (PEMs) can enhance person-centered care by responding to patient priorities and unmet needs. Little data exist on 'best practices' for co-creation. We followed the Arksey and O'Malley framework to conduct a systematic literature search of nine databases (MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, Joanna Briggs Institute, TRIP-April, 2022) to identify empirical studies published in English on PEM co-creation to distill 'best practices'. Following an independent dual review of articles, data were collated into tables, and thematic analysis was employed to synthesize 'best practices' that were validated by a patient experienced in co-creating PEMs. Bias was not assessed, given the study heterogeneity. Of 6998 retrieved articles, 44 were included for data extraction/synthesis. Studies utilized heterogeneous methods spanning a range of health conditions/populations. Only 5/45 (11%) studies defined co-creation, 14 (32%) used a guiding framework, and 18 (41%) used validated evaluation tools. Six 'best practices' were identified: (1) begin with a review of the literature, (2) utilize a framework to inform the process, (3) involve clinical and patient experts from the beginning, (4) engage diverse perspectives, (5) ensure patients have the final decision, and (6) employ validated evaluation tools. This scoping review highlights the need for clear definitions and validated evaluation measures to guide and assess the co-creation process. Identified 'best practices' are relevant for use with diverse patient populations and health issues to enhance person-centered care.
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Affiliation(s)
- Isabella R. McDonald
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
| | - Elizabeth S. Blocker
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
| | - Elizabeth A. Weyman
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
| | - Neil Smith
- “I Am HH” Patient Organization, Dallas, TX 75238, USA;
| | - Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
- Massachusetts General Hospital—Harvard Center for Reproductive Medicine, Boston, MA 02114, USA
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Litchman ML, Kwan BM, Zittleman L, Simonetti J, Iacob E, Curcija K, Neuberger J, Latendress G, Oser TK. A Telehealth Diabetes Intervention for Rural Populations: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34255. [PMID: 35700026 PMCID: PMC9240926 DOI: 10.2196/34255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 01/08/2023] Open
Abstract
Background Diabetes self-management education and support (DSMES) is a crucial component of diabetes care associated with improved clinical, psychosocial, and behavioral outcomes. The American Association of Diabetes Care and Education Specialists, the American Diabetes Association, and the American Academy of Family Physicians all recommend DSMES yet accessing linguistically and culturally appropriate DSMES is challenging in rural areas. The Diabetes One-Day (D1D) program is an established DSMES group intervention that has not been adapted or evaluated in rural communities. Objective The specific aims of this paper are (1) to adapt the existing D1D program for use in rural communities, called rural D1D (R-D1D); and (2) to conduct a patient-level randomized controlled trial to examine the effects of R-D1D and standard patient education, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Methods This is a protocol for a pilot type II hybrid implementation-effectiveness trial of a culturally adapted virtual DSMES program for rural populations, R-D1D. We will use Boot Camp Translation, a process grounded in the principles of community-based participatory research, to adapt an existing DSMES program for rural populations, in both English and Spanish. Participants at 2 rural primary care clinics (4 cohorts of N=16 plus care partners, 2 in English and 2 in Spanish) will be randomized to the intervention or standard education control. The evaluation is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Patient-level effectiveness outcomes (hemoglobin A1c, diabetes distress, and diabetes self-care behaviors) will be assessed using patient-reported outcomes measures and a home A1c test kit. Practice-level and patient-level acceptability and feasibility will be assessed using surveys and interviews. Results This study is supported by the National Institute of Nursing. The study procedures were approved, and the adaptation processes have been completed. Recruitment and enrollment started in July 2021. Conclusions To our knowledge, this will be the first study to evaluate both effectiveness and implementation outcomes for virtually delivered DSMES, culturally adapted for rural populations. This research has implications for delivery to other rural locations where access to specialty diabetes care is limited. Trial Registration ClinicalTrials.gov NCT04600622; https://clinicaltrials.gov/ct2/show/NCT04600622 International Registered Report Identifier (IRRID) DERR1-10.2196/34255
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Affiliation(s)
- Michelle L Litchman
- College of Nursing, University of Utah, Salt Lake City, UT, United States.,Utah Diabetes and Endocrinology Center, University of Utah, Salt Lake City, UT, United States
| | - Bethany M Kwan
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Linda Zittleman
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Juliana Simonetti
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Kristen Curcija
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Julie Neuberger
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - Gwen Latendress
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Tamara K Oser
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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Oser TK, Zittleman L, Curcija K, Kwan B, Burke S, Gonzalez S, Huss K, Johnson M, Sanchez N, Neuberger J, Iacob E, Simonetti J, Litchman M. Informing a Randomized Control Trial in Rural Populations: Adaptation of a Diabetes Self-Management Education and Support Intervention. JMIR Diabetes 2022; 7:e35664. [PMID: 35687385 PMCID: PMC9233250 DOI: 10.2196/35664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/12/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over 34 million people in the United States have diabetes, with 1.5 million diagnosed every year. Diabetes self-management education and support (DSMES) is a crucial component of treatment to delay or prevent complications. Rural communities face many unique challenges in accessing DSMES, including geographic barriers and availability of DSMES programs that are culturally adapted to rural context. OBJECTIVE Boot Camp Translation (BCT) is an established approach to community-based participatory research used to translate complex clinical and scientific information into concepts, messages, and materials that are understandable, meaningful, and relevant to community members and patients. This study aimed to utilize BCT to adapt an existing DSMES program for delivery in rural primary care for English- and Spanish-speaking people with diabetes. METHODS The High Plains Research Network (HPRN) Community Advisory Council (C.A.C.) partnered with researchers at the University of Colorado and University of Utah to use BCT to aid in translating medical jargon and materials from an existing DSMES program, called "Diabetes One Day (D1D)." BCT consisted of 10 virtual meetings over a 6-month period among the C.A.C., which included 15 diverse community stakeholders. Both English-speaking and bilingual Spanish-English-speaking C.A.C. members were recruited to reflect the diversity of the rural communities in which the adapted program would be delivered. RESULTS The BCT process guided adaptations to D1D for use in rural settings (R-D1D). R-D1D adaptations reflect both content and delivery to assure that the intervention is appropriate and likely to be accepted by rural English- and Spanish-speaking people with diabetes. Additionally, BCT informed the design of recruitment and program materials and identification of recruitment venues. During the BCT process, the importance of tailoring materials to reflect culture differences in English- and Spanish-speaking patients was identified. CONCLUSIONS BCT was an effective strategy for academic researchers to partner with rural community members to adapt an existing DSMES intervention for delivery in rural areas to both English- and Spanish-speaking patients with diabetes. Through BCT, adaptations to recruitment materials and methods, program content and delivery, and supplemental materials were developed. The need to culturally adapt Spanish materials with input from stakeholders rather than simply translate materials into Spanish was highlighted. The importance of increasing awareness of the connection between diabetes and depression or diabetes distress, adaptations to include local foods, and the importance of the relationship between people with diabetes and their primary care practices were identified.
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Affiliation(s)
- Tamara K Oser
- Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United States
| | - Linda Zittleman
- Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United States
| | - Kristen Curcija
- Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United States
| | - Bethany Kwan
- Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United States
| | - Shawnecca Burke
- Community Advisory Council, High Plains Research Network, Aurora, CO, United States
| | - Sindy Gonzalez
- Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United States
| | - Kelsey Huss
- Community Advisory Council, High Plains Research Network, Aurora, CO, United States
| | - Marilee Johnson
- Community Advisory Council, High Plains Research Network, Aurora, CO, United States
| | - Norah Sanchez
- Community Advisory Council, High Plains Research Network, Aurora, CO, United States
| | - Julie Neuberger
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Juliana Simonetti
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - Michelle Litchman
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States.,College of Nursing, University of Utah, Salt Lake City, UT, United States
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Fernald DH, Zittleman L, Gilchrist EC, Brou LI, Brou LI, Niebauer L, Ledonne C, Sutter C, Felzien M, Westfall JM, Green LA. UPSTREAM! Together evaluation results from community efforts to prevent mental, emotional, and behavioral health problems. EVALUATION AND PROGRAM PLANNING 2021; 89:102000. [PMID: 34555734 DOI: 10.1016/j.evalprogplan.2021.102000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/08/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.
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Affiliation(s)
- Douglas H Fernald
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States.
| | - Linda Zittleman
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Emma C Gilchrist
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
| | - Lina I Brou
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lina I Brou
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Linda Niebauer
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
| | - Charlotte Ledonne
- San Luis Valley Area Health Education Center, Alamosa, CO, United States
| | - Christin Sutter
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; High Plains Research Network Community Advisory Council, Sterling, CO, United States
| | - Maret Felzien
- High Plains Research Network Community Advisory Council, Sterling, CO, United States
| | - John M Westfall
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
| | - Larry A Green
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
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Lowe D, Ryan R, Schonfeld L, Merner B, Walsh L, Graham-Wisener L, Hill S. Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. Cochrane Database Syst Rev 2021; 9:CD013373. [PMID: 34523117 PMCID: PMC8440158 DOI: 10.1002/14651858.cd013373.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Health services have traditionally been developed to focus on specific diseases or medical specialties. Involving consumers as partners in planning, delivering and evaluating health services may lead to services that are person-centred and so better able to meet the needs of and provide care for individuals. Globally, governments recommend consumer involvement in healthcare decision-making at the systems level, as a strategy for promoting person-centred health services. However, the effects of this 'working in partnership' approach to healthcare decision-making are unclear. Working in partnership is defined here as collaborative relationships between at least one consumer and health provider, meeting jointly and regularly in formal group formats, to equally contribute to and collaborate on health service-related decision-making in real time. In this review, the terms 'consumer' and 'health provider' refer to partnership participants, and 'health service user' and 'health service provider' refer to trial participants. This review of effects of partnership interventions was undertaken concurrently with a Cochrane Qualitative Evidence Synthesis (QES) entitled Consumers and health providers working in partnership for the promotion of person-centred health services: a co-produced qualitative evidence synthesis. OBJECTIVES To assess the effects of consumers and health providers working in partnership, as an intervention to promote person-centred health services. SEARCH METHODS We searched the CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL databases from 2000 to April 2019; PROQUEST Dissertations and Theses Global from 2016 to April 2019; and grey literature and online trial registries from 2000 until September 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs of 'working in partnership' interventions meeting these three criteria: both consumer and provider participants meet; they meet jointly and regularly in formal group formats; and they make actual decisions that relate to the person-centredness of health service(s). DATA COLLECTION AND ANALYSIS Two review authors independently screened most titles and abstracts. One review author screened a subset of titles and abstracts (i.e. those identified through clinical trials registries searches, those classified by the Cochrane RCT Classifier as unlikely to be an RCT, and those identified through other sources). Two review authors independently screened all full texts of potentially eligible articles for inclusion. In case of disagreement, they consulted a third review author to reach consensus. One review author extracted data and assessed risk of bias for all included studies and a second review author independently cross-checked all data and assessments. Any discrepancies were resolved by discussion, or by consulting a third review author to reach consensus. Meta-analysis was not possible due to the small number of included trials and their heterogeneity; we synthesised results descriptively by comparison and outcome. We reported the following outcomes in GRADE 'Summary of findings' tables: health service alterations; the degree to which changed service reflects health service user priorities; health service users' ratings of health service performance; health service users' health service utilisation patterns; resources associated with the decision-making process; resources associated with implementing decisions; and adverse events. MAIN RESULTS We included five trials (one RCT and four cluster-RCTs), with 16,257 health service users and more than 469 health service providers as trial participants. For two trials, the aims of the partnerships were to directly improve the person-centredness of health services (via health service planning, and discharge co-ordination). In the remaining trials, the aims were indirect (training first-year medical doctors on patient safety) or broader in focus (which could include person-centredness of health services that targeted the public/community, households or health service delivery to improve maternal and neonatal mortality). Three trials were conducted in high income-countries, one was in a middle-income country and one was in a low-income country. Two studies evaluated working in partnership interventions, compared to usual practice without partnership (Comparison 1); and three studies evaluated working in partnership as part of a multi-component intervention, compared to the same intervention without partnership (Comparison 2). No studies evaluated one form of working in partnership compared to another (Comparison 3). The effects of consumers and health providers working in partnership compared to usual practice without partnership are uncertain: only one of the two studies that assessed this comparison measured health service alteration outcomes, and data were not usable, as only intervention group data were reported. Additionally, none of the included studies evaluating this comparison measured the other primary or secondary outcomes we sought for the 'Summary of findings' table. We are also unsure about the effects of consumers and health providers working in partnership as part of a multi-component intervention compared to the same intervention without partnership. Very low-certainty evidence indicated there may be little or no difference on health service alterations or health service user health service performance ratings (two studies); or on health service user health service utilisation patterns and adverse events (one study each). No studies evaluating this comparison reported the degree to which health service alterations reflect health service user priorities, or resource use. Overall, our confidence in the findings about the effects of working in partnership interventions was very low due to indirectness, imprecision and publication bias, and serious concerns about risk of selection bias; performance bias, detection bias and reporting bias in most studies. AUTHORS' CONCLUSIONS The effects of consumers and providers working in partnership as an intervention, or as part of a multi-component intervention, are uncertain, due to a lack of high-quality evidence and/or due to a lack of studies. Further well-designed RCTs with a clear focus on assessing outcomes directly related to partnerships for patient-centred health services are needed in this area, which may also benefit from mixed-methods and qualitative research to build the evidence base.
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Affiliation(s)
- Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | | | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Apatu E, Stallings-Smith S, Alvarez E, Anderson L, Spaulding A. Does community engaged Carnegie status matter for county health rankings in the United States? J Public Health (Oxf) 2021; 43:164-171. [PMID: 31211380 DOI: 10.1093/pubmed/fdz066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/23/2019] [Accepted: 05/21/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Community engagement is commonly used to address social inequities. The Carnegie Foundation offers an optional designation for which U.S. colleges and universities may apply to facilitate better educational outcomes through the institutionalization of community engagement. This study is the first to examine the relationship between Carnegie community engaged status and community health outcomes. METHODS Ordinal logistic regression was conducted to investigate the association between the presence of a community engaged institution and county health outcomes, including health behaviors, clinical care relating to access and quality, social and economic factors, and physical environment from the 2016 Robert Wood Johnson County Health Rankings and 2015 New England Resource Center for Higher Education Community engaged list. We examined 820 U.S. counties containing a university or college, 240 of which had a community engaged designation. RESULTS Findings indicated that the presence of a community-engaged institution was positively associated with Clinical Care (OR = 1.99; 95% CI: 1.09, 3.64). Other county health factors were not similarly associated. CONCLUSIONS Our findings suggest that community engagement status may be most relevant for achieving better access and quality of clinical care. More research is needed to explore this association in the U.S. and internationally.
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Affiliation(s)
- Emma Apatu
- Department of Health Research Methodology, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, USA
| | - Sericea Stallings-Smith
- Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Elizabeth Alvarez
- Department of Health Research Methodology, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, USA
| | - Laura Anderson
- Department of Health Research Methodology, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, USA
| | - Aaron Spaulding
- Department of Health Sciences Research, Division of Health Care Policy and Research, Mayo Clinic Robert D. and Patricia E. Kern, Center for the Science of Health Care Delivery, 4500 San Pablo Rd., Jacksonville, FL, USA
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Brewer SE, Simpson MJ, Rice JD, Skenadore A, O'Leary ST. Engaging practices and communities in the development of interventions to promote HPV vaccine uptake: a protocol for implementing Boot Camp Translation in the private practice setting. BMJ Open 2020; 10:e041685. [PMID: 33310806 PMCID: PMC7735122 DOI: 10.1136/bmjopen-2020-041685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The Healthy People 2020 report states a goal of 80% uptake of recommended vaccines among adolescents, including the human papillomavirus (HPV) vaccine. However, the rate of uptake of the HPV vaccine is estimated at 51% in 2018, which leaves young people vulnerable to morbidity and mortality from preventable, HPV-related cancers. Reasons for this are multifactorial and include factors at the level of the provider, primary care practice, patient and family, and community. The development of interventions that are responsive to these multifactorial barriers in real-world settings is a priority. Boot Camp Translation (BCT) is a community-engaged approach to message development for translating evidence-based practices into clinics and communities. This project aims to (1) Engage practices and communities in the development of interventions to promote HPV vaccine uptake and (2) Evaluate the impact of the BCT-designed intervention on practice-level HPV vaccine initiation rates. We hypothesise that the BCT-designed intervention will increase the rate of HPV vaccine initiation in the practices. METHODS AND ANALYSIS This study will implement HPV-focused BCT in three counties in Colorado with a below average county-level vaccination rate. Each BCT group will design a multipronged intervention targeted at patients, parents, providers and the general community to then be disseminated in the participating practices and communities over the subsequent 6-month period. The long-term goal is to develop a replicable approach and low-cost method of increasing HPV vaccine uptake that is easily adaptable to different settings and sociodemographic contexts. ETHICS AND DISSEMINATION This study is approved by the Colorado Multiple Institutional Review Board. Results will be disseminated through peer-reviewed manuscripts and conference presentations, as well as within Colorado practice-based research networks. TRIAL REGISTRATION NUMBER NCT04279964.
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Affiliation(s)
- Sarah E Brewer
- Adult and Child Consortium for Health Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew J Simpson
- Adult and Child Consortium for Health Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John D Rice
- Adult and Child Consortium for Health Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Amanda Skenadore
- Adult and Child Consortium for Health Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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11
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Fernald DH, Mullen R, Hall T, Bienstock A, Kirchner S, Knierim K, de la Cerda D, Callan D, Rhyne RL, Dickinson LM, Dickinson WP. Exemplary Practices in Cardiovascular Care: Results on Clinical Quality Measures from the EvidenceNOW Southwest Cooperative. J Gen Intern Med 2020; 35:3197-3204. [PMID: 32808208 PMCID: PMC7661662 DOI: 10.1007/s11606-020-06094-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 07/30/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Identifying characteristics of primary care practices that perform well on cardiovascular clinical quality measures (CQMs) may point to important practice improvement strategies. OBJECTIVE To identify practice characteristics associated with high performance on four cardiovascular disease CQMs. DESIGN Longitudinal cohort study among 211 primary care practices in Colorado and New Mexico. Quarterly CQM reports were obtained from 178 (84.4%) practices. There was 100% response rate for baseline practice characteristics and implementation tracking surveys. Follow-up implementation tracking surveys were completed for 80.6% of practices. PARTICIPANTS Adult patients, staff, and clinicians in family medicine, general internal medicine, and mixed-specialty practices. INTERVENTION Practices received 9 months of practice facilitation and health information technology support, plus biannual collaborative learning sessions. MAIN MEASURES This study identified practice characteristics associated with overall highest performance using area under the curve (AUC) analysis on aspirin therapy, blood pressure management, and smoking cessation CQMs. RESULTS Among 178 practices, 39 were exemplars. Exemplars were more likely to be a Federally Qualified Health Center (69.2% vs 35.3%, p = 0.0006), have an underserved designation (69.2% vs 45.3%, p = 0.0083), and have higher percentage of patients with Medicaid (p < 0.0001). Exemplars reported greater use of cardiovascular disease registries (61.5% vs 29.5%,), standing orders (38.5 vs 22.3%) or electronic health record prompts (84.6% vs 49.6%) (all p < 0.05), were more likely to have medical home recognition (74.4% vs 43.2%, p = 0.0006), and reported greater implementation of building blocks of high-performing primary care: regular quality improvement team meetings (3.0 vs 2.2), patient experience survey (3.1 vs 2.2), and resources for patients to manage their health (3.0 vs 2.3). High improvers (n = 45) showed greater improvement implementing team-based care (32.8 vs 11.7, p = 0.0004) and population management (37.4 vs 20.5, p = 0.0057). CONCLUSIONS Multiple strategies-registries, prompts and protocols, patient self-management support, and patient-team partnership activities-were associated with delivering high-quality cardiovascular care over time, measured by CQMs. TRIAL REGISTRATION ClinicalTrials.gov registration: NCT02515578.
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Affiliation(s)
- Douglas H Fernald
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Rebecca Mullen
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Tristen Hall
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Andrew Bienstock
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Stephanie Kirchner
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kyle Knierim
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Dionisia de la Cerda
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Danelle Callan
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Robert L Rhyne
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - L Miriam Dickinson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - W Perry Dickinson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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12
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Dickinson WP, Nease DE, Rhyne RL, Knierim KE, Fernald DH, de la Cerda DR, Dickinson LM. Practice Transformation Support and Patient Engagement to Improve Cardiovascular Care: From EvidenceNOW Southwest (ENSW). J Am Board Fam Med 2020; 33:675-686. [PMID: 32989062 PMCID: PMC7789932 DOI: 10.3122/jabfm.2020.05.190395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To improve cardiovascular care through supporting primary care practices' adoption of evidence-based guidelines. STUDY DESIGN A cluster randomized trial compared two approaches: (1) standard practice support (practice facilitation, practice assessment with feedback, health information technology assistance, and collaborative learning sessions) and (2) standard support plus patient engagement support. METHODS Primary outcomes were cardiovascular clinical quality measures (CQMs) collected at baseline, 9 months, and 15 months. Implementation of the first 6 "Building Blocks of High-Performing Primary Care" was assessed by practice facilitators at baseline and 3, 6, and 9 months. CQMs from practices not involved in the study served as an external comparison. RESULTS A total of 211 practices completed baseline surveys. There were no differences by study arm (odds ratio [95% confidence interval]) for aspirin use (1.03 [0.99, 1.06]), blood pressure (0.98 [0.95, 1.01]), cholesterol (0.96 [0.92, 1.00]), and smoking (1.01 [0.96, 1.07]); however, there were significant improvements over time in aspirin use (1.04 [1.01, 1.07]), cholesterol (1.05 [1.03, 1.08]), and smoking (1.03 [1.01, 1.06]), but not blood pressure (1.01 [0.998, 1.03]). Improvement in enrolled practices was greater than external comparison practices across all 4 measures (all P < .05). Implementation improved in both arms for Team-Based Care, Patient-Team Partnership, and Population Management, and improvement was greater in enhanced intervention practices (all P < .05). Leadership and Data-Driven Improvement (P < .05) improved significantly, with no difference by arm. A greater improvement in Building Block implementation was associated with a greater improvement in blood pressure measures (P < .05). CONCLUSIONS Practice transformation support can assist practices with improving quality of care. Patient engagement in practice transformation can further enhance practices' implementation of aspects of new models of care.
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Affiliation(s)
- W Perry Dickinson
- From the Department of Family Medicine, University of Colorado School of Medicine, Aurora (WPD, DEN, KEK, DHF, DRdlC, LMD); Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque (RLR).
| | - Donald E Nease
- From the Department of Family Medicine, University of Colorado School of Medicine, Aurora (WPD, DEN, KEK, DHF, DRdlC, LMD); Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque (RLR)
| | - Robert L Rhyne
- From the Department of Family Medicine, University of Colorado School of Medicine, Aurora (WPD, DEN, KEK, DHF, DRdlC, LMD); Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque (RLR)
| | - Kyle E Knierim
- From the Department of Family Medicine, University of Colorado School of Medicine, Aurora (WPD, DEN, KEK, DHF, DRdlC, LMD); Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque (RLR)
| | - Douglas H Fernald
- From the Department of Family Medicine, University of Colorado School of Medicine, Aurora (WPD, DEN, KEK, DHF, DRdlC, LMD); Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque (RLR)
| | - Dionisia R de la Cerda
- From the Department of Family Medicine, University of Colorado School of Medicine, Aurora (WPD, DEN, KEK, DHF, DRdlC, LMD); Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque (RLR)
| | - L Miriam Dickinson
- From the Department of Family Medicine, University of Colorado School of Medicine, Aurora (WPD, DEN, KEK, DHF, DRdlC, LMD); Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque (RLR)
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13
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Knierim KE, Hall TL, Dickinson LM, Nease DE, de la Cerda DR, Fernald D, Bleecker MJ, Rhyne RL, Dickinson WP. Primary Care Practices' Ability to Report Electronic Clinical Quality Measures in the EvidenceNOW Southwest Initiative to Improve Heart Health. JAMA Netw Open 2019; 2:e198569. [PMID: 31390033 PMCID: PMC6687038 DOI: 10.1001/jamanetworkopen.2019.8569] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
IMPORTANCE The capability and capacity of primary care practices to report electronic clinical quality measures (eCQMs) are questionable. OBJECTIVE To determine how quickly primary care practices can report eCQMs and the practice characteristics associated with faster reporting. DESIGN, SETTING, AND PARTICIPANTS This quality improvement study examined an initiative (EvidenceNOW Southwest) to enhance primary care practices' ability to adopt evidence-based cardiovascular care approaches: aspirin prescribing, blood pressure control, cholesterol management, and smoking cessation (ABCS). A total of 211 primary care practices in Colorado and New Mexico participating in EvidenceNOW Southwest between February 2015 and December 2017 were included. INTERVENTIONS Practices were instructed on eCQM specifications that could be produced by an electronic health record, a registry, or a third-party platform. Practices received 9 months of support from a practice facilitator, a clinical health information technology advisor, and the research team. Practices were instructed to report their baseline ABCS eCQMs as soon as possible. MAIN OUTCOMES AND MEASURES The main outcome was time to report the ABCS eCQMs. Cox proportional hazards models were used to examine practice characteristics associated with time to reporting. RESULTS Practices were predominantly clinician owned (48%) and in urban or suburban areas (71%). Practices required a median (interquartile range) of 8.2 (4.6-11.9) months to report any ABCS eCQM. Time to report differed by eCQM: practices reported blood pressure management the fastest (median [interquartile range], 7.8 [3.5-10.4] months) and cholesterol management the slowest (median [interquartile range], 10.5 [6.6 to >12] months) (log-rank P < .001). In multivariable models, the blood pressure eCQM was reported more quickly by practices that participated in accountable care organizations (hazard ratio [HR], 1.88; 95% CI, 1.40-2.53; P < .001) or participated in a quality demonstration program (HR, 1.58; 95% CI, 1.14-2.18; P = .006). The cholesterol eCQM was reported more quickly by practices that used clinical guidelines for cardiovascular disease management (HR, 1.35; 95% CI, 1.18-1.53; P < .001). Compared with Federally Qualified Health Centers, hospital-owned practices had greater ability to report blood pressure eCQMs (HR, 2.66; 95% CI, 95% CI, 1.73-4.09; P < .001), and clinician-owned practices had less ability to report cholesterol eCQMs (HR, 0.52; 95% CI, 0.35-0.76; P < .001). CONCLUSIONS AND RELEVANCE In this study, time to report eCQMs varied by measure and practice type, with very few practices reporting quickly. Practices took longer to report a new cholesterol measure than other measures. Programs that require eCQM reporting should consider the time and effort practices must exert to produce reports. Practices may benefit from additional support to succeed in new programs that require eCQM reporting.
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Affiliation(s)
- Kyle E. Knierim
- University of Colorado School of Medicine, Department of Family Medicine, Aurora
| | - Tristen L. Hall
- University of Colorado School of Medicine, Department of Family Medicine, Aurora
| | - L. Miriam Dickinson
- University of Colorado School of Medicine, Department of Family Medicine, Aurora
| | - Donald E. Nease
- University of Colorado School of Medicine, Department of Family Medicine, Aurora
| | | | - Douglas Fernald
- University of Colorado School of Medicine, Department of Family Medicine, Aurora
| | - Molly J. Bleecker
- University of New Mexico School of Medicine, Department of Family and Community Medicine, Albuquerque
| | - Robert L. Rhyne
- University of New Mexico School of Medicine, Department of Family and Community Medicine, Albuquerque
| | - W. Perry Dickinson
- University of Colorado School of Medicine, Department of Family Medicine, Aurora
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Moody EJ, Harris B, Zittleman L, Nease DE, Westfall JM. It's time for a change!: The appreciative inquiry/bootcamp translation to address disparities in the Latino community with autism spectrum disorders. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2019; 25:113-122. [PMID: 30714773 PMCID: PMC6686679 DOI: 10.1037/cdp0000242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Autism spectrum disorder (ASD) is underidentified and misidentified in the Latino community, and numerous barriers limit this community's ability to access quality health care for ASD. Appreciative inquiry/boot camp translation (AI/BCT) is a novel method of community engagement that can be used within community-based participatory research partnerships. AI/BCT uses qualitative methods to uncover strategies that the community is already successfully using and develops actionable messages to increase the use of those strategies throughout the community. We describe this method and outline how it is likely to be more effective at reducing disparities related to ASDs in the Latino community than traditional methods. CONCLUSION AI/BCT is a promising method of community engagement that is responsive to cultural differences. It is a strength-based approach focused on increasing the use of strategies that already work within the community. Therefore, it has the potential to reduce health disparities in the Latino community who have loved ones with autism ASD much more rapidly than traditional methods of inquiry. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Eric J Moody
- Department of Psychiatry, University of Colorado School of Medicine
| | - Bryn Harris
- School of Psychology, University of Colorado
| | - Linda Zittleman
- Department of Family Medicine, University of Colorado School of Medicine
| | - Donald E Nease
- Department of Family Medicine, University of Colorado School of Medicine
| | - John M Westfall
- Department of Family Medicine, University of Colorado School of Medicine
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15
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Affiliation(s)
- John M Westfall
- From the Department of Family Medicine, High Plains Research Network, Farley Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora (J.M.W.); and Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland (G.A.M.).
| | - George A Mensah
- From the Department of Family Medicine, High Plains Research Network, Farley Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora (J.M.W.); and Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland (G.A.M.)
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