Southwest Health Extension Partnership to Enhance Research Dissemination
Condition: Cardiovascular Diseases
MeSH terms: Cardiovascular Diseases
Study type: Interventional

Summary: 
      Heart disease and strokes cause one in three deaths reported each year in the United States.
      Primary care practices need to implement new research findings that help decrease patients'
      risk for heart disease and stroke. This project will help to build primary care practice
      capacity for quality improvement and change management in small and medium size primary care
      practices in Colorado and New Mexico. This project will also help practices implement
      patient-centered outcomes research findings.
    

Detailed description: 
      Cardiovascular disease (CVD) causes one in three deaths reported each year in the United
      States. Strategies derived from patient-centered outcomes research (PCOR) that address CVD
      risk factors can greatly reduce the burden of CVD. Primary care practices must transform to
      deliver a higher level of PCOR evidence-based prevention to decrease cardiovascular risk.
      PCOR interventions that emphasize patient-centered care including self-management support,
      team-based care, improved information systems, and active quality improvement have been shown
      to be effective. Practices often require assistance integrating new programs into clinical
      operations. Practice facilitation has been shown to enhance implementation of new programs
      for patients with chronic disease in primary care. Other methods of practice support,
      including academic detailing, collaborative learning sessions, and health information
      technology assistance, have also been shown to be effective, by themselves and in combination
      with practice facilitation. Patient involvement may also aid practice transformation.
      Increasingly, practices are actively including patients as part of the change process through
      the creation of patient advisory councils and including patients in practice quality
      improvement teams. Another method of patient involvement to inform implementation of
      evidence-based care is the Boot Camp Translation process, in which patients collaborate with
      primary care clinicians, staff members, and community members to translate best practices
      into culturally and community relevant implementation at the local level. However, while
      these efforts have had considerable success, no study has looked at the incremental value of
      adding patient engagement strategies to the more standard approaches to practice
      transformation listed above. This project would implement the Southwest Health Extension
      Program to Enhance Research Dissemination (SHEPERD) as a cooperative program to build primary
      care practice capacity for quality improvement, change management, and implementation of PCOR
      findings in small and medium size primary care practices in Colorado and New Mexico, with an
      initial focus on cardiovascular care. It also would conduct a cluster randomized trial with
      an external matched cohort control group to examine the Reach, Effectiveness, Adoption,
      Implementation, and Maintenance of two approaches to practice transformation to implement
      PCOR interventions for reducing cardiovascular risks in primary care practices, comparing the
      impact of 1) a standard practice transformation support intervention (including practice
      facilitation, practice assessment with feedback, HIT assistance, academic detailing, and
      collaborative learning sessions) to 2) an approach that adds patient engagement activities
      (including patient advisory councils and boot camp translation) as part of the practice
      transformation support. This project will provide critical information regarding the added
      value of patient engagement in practice transformation efforts and will also result in a
      network of practices across the region with increased capacity for practice transformation
      and implementation of PCOR findings.
    

Intervention name(s): Enhanced practice transformation support; Standard practice transformation support
Intervention type(s): Other; Other
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Primary Health Care; Cardiovascular Diseases; Quality Improvement