Please select the eligibility criteria that correspond to the clinical trial below.
Title: Personalized and Targeted Feedback in the ACTION-Registry-GWTG
Brief Summary: This project is designed to examine the impact of tailored feedback on site performance.

The investigators' objective is to evaluate whether a 'personalized and targeted' feedback, education and performance improvement intervention has a greater impact on adherence to recommended guidelines than standard feedback.

The investigators hypothesize that a site-specific report with centrally identified targets for improvement paired with target specific interventions will enable sites to quickly identify and prioritize salient problem areas, have ready access to an analysis of factors that underlie problems, and formulate an effective action plan. The investigators also hypothesize that those hospitals randomized to receive intervention will be more likely to improve their overall performance, as well as their target specific performance, during the period of observation in direct response to activated QI processes.

Outcomes:

The primary outcome is improvement in the overall composite of all metrics eligible for intervention regardless of their selection as targets.

The secondary outcome is improvement in the composite of targeted metrics.

Outcomes will be assessed in all participating sites, and in among relevant performance subgroups (low performers, academic centers, full service, and among medication versus process metrics).


Options:
A: Inclusion Criteria:

* Established T1D diagnosis for a minimum of one year (chosen to allow time for adjustment to a new diagnosis and more stable disease control).
* Between the ages of 17 and 20 years. It is left to the clinical judgment of the pediatric endocrinologist to determine individually the appropriate age of the transition for each subject
* At least 1 visit during the previous year with the pediatric endocrinologist at a Diabetes Clinic (aim is to minimize the non-adherence with the intervention).
* Ability to participate in all aspects of this clinical trial.
* Written informed consent/assent must be obtained and documented.
* Resident of Ontario.

Exclusion Criteria:

* Pregnant or lactating females or intent to become pregnant during the next 3 years.
* Conditions which in the opinion of the investigator may interfere with the subject's ability to participate in the study.
* Prior enrollment in the current study.
* Current participation in another clinical trial or participation in another clinical trial in the 6 months prior to enrollment.
B: Inclusion Criteria:

* hospitals participating in the ACTION Registry GWTG

Exclusion Criteria:

* sites with low volume of data submission (\< 10 data forms in the past year)
C: Inclusion Criteria:

* Parents of children will be enrolled in the study if they meet a set of eligibility criteria which includes:

  1. Age 0 - 11 years old
  2. A primary care patient at Boston Medical Center
  3. An English speaking child and parent.

Exclusion Criteria:

* Children will be considered ineligible for the study if they plan to move away from the Boston area in less than 3 months, or are participating in another primary care research project with content that overlaps the content within this study. Currently, there are no studies being conducted that would lead to exclusion.
D: DISEASE CHARACTERISTICS:

* Enrolled in a participating Medicaid Managed Care Organization (MMCO) as a Medicaid patient for ≥ 12 months
* Not up-to-date (UTD) for colorectal cancer screening

  * UTD status defined by any of the following:

    * Home fecal occult blood test within the past 12 months
    * Flexible sigmoidoscopy within the past 5 years
    * Double-contrast barium enema within the past 5 years
    * Colonoscopy within the past 10 years
* Registered to receive primary care from a participating Community/Migrant Health Center, Diagnostic and Treatment Center, or other participating practice in New York City
* Must have a telephone available
* No MMCO claim for any of the following:

  * Colorectal, breast, or cervical cancer
  * Colon polyp removal
  * Total colectomy

PATIENT CHARACTERISTICS:

* Female
* Able to use telephone
* No plans to move for ≥ 1 year

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics

Answer: B