Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES)
Condition: Program Evaluation
Study type: Observational

Summary: 
      The purpose of this study is to evaluate approximately eight grants that will test
      interventions to improve cardiovascular disease prevention. The investigators will collect
      and analyze qualitative data to identify the most effective combinations of intervention
      strategies. The investigators will observe grantees and selected practices to understand why
      and how those combinations are effective. The investigators will also gather data from the
      grantees to assess how effective the interventions are.
    

Detailed description: 
      The purpose of this study is to evaluate approximately eight different R18 grants that will
      test practice change interventions to improve cardiovascular disease (CVD) prevention
      screening. The investigators will collect and analyze quantitative data (context, process,
      and outcomes) to identify the most effective combinations of intervention strategies for
      various practice types in relation to practice structure, context, and organizational
      characteristics associated with change in outcomes. The investigators will collect
      qualitative data (observation, interviews, online diaries) from grantees and selected
      practices to understand why and how those combinations are effective. The investigators will
      also gather documents and de-identified quantitative data from grantees.

      Evidence clearly shows that many people do not receive guideline-concordant health care; this
      is true even for low cost treatments such as Aspirin prescribing, Blood pressure and
      Cholesterol control and Smoking cessation (the ABCS) known to prevent cardiovascular disease
      (CVD). In hospitals and integrated care systems with substantial resources, large quality
      improvement campaigns have been shown to increase adherence to guidelines by creating
      communities of learning that change behavior on a large scale. Agency for Healthcare Research
      and Quality (AHRQ) and the Patient Centered Outcomes Research Institute (PCORI) are
      partnering to launch a campaign to promote the improvement of guideline-based CVD preventive
      care in small primary care practices with limited resources and experience with quality
      improvement ("Implementation" RFA-HS-14-008). The practices for each of these R18 grants will
      be in a contiguous geographic region. This study will evaluate each of these R18
      implementation grants.

      The investigators' strategy is to conduct a prospective observational analysis to evaluate
      the effectiveness of the R18s ABCS quality improvement initiatives. To do this, the
      investigators will collect and analyze qualitative data to identify the most effective
      combinations of intervention strategies for various practice types, contexts, and
      organizational characteristics, and to understand why and how those combinations are
      effective. The investigators will also gather de-identified quantitative data that the R18s
      collected.
    

Intervention name(s): ESCALATES
Intervention type(s): Behavioral
Intervention description(s): The investigators collect and analyze qualitative data to identify the most effective combinations of intervention strategies for various practice types, contexts, and organizational characteristics, and to understand why and how those combinations are effective. The investigators also gather de-identified quantitative data that the R18s collected.
Other intervention name(s): EvidenceNOW
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        This study will include all R18 grantees
      
Keywords: Mixed Methods; Cardiovascular Health; Implementation Evaluation; Cardiovascular Prevention Screening