Community and Clinician Partnership for Prevention

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the impact of strategies to develop and foster the relationship between primary care practices and community resources to address specific unhealthy behaviors (tobacco use, poor nutrition, and lack of physical activity).

Detailed Description
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Tobacco use, poor diet, and lack of physical activity are associated with the leading causes of significant morbidity and mortality, including coronary heart disease, hypertension, cancer, stroke, diabetes, and respiratory dysfunction. One solution to decreasing unhealthy behaviors would be to better integrate primary care providers with community resources, including community and public health organizations that already have the capacity and expertise to deliver effective interventions. This project is a randomized trial to evaluate different practice-level interventions to link practices to community resources to decrease unhealthy behaviors.

Official Title
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Community and Clinician Partnership for Prevention

Conditions
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Physical Activity, Dietary Habits, Tobacco Use Cessation

Intervention / Treatment
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* Other: Active Intervention
* Other: Passive Intervention
* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Internal medicine and family practices in Durham and Orange counties, North Carolina Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Active Intervention<br>Direct referral to community organizations, with support for practices to do so. These include the North Carolina Tobacco Quitline, public health department dietitians, and the YMCA. | Other: Active Intervention<br>* Quality improvement activities, including monthly teleconferences and chart audit with feedback, to help practices refer to community resources<br>|
| Experimental: Passive Intervention<br>Provision of information about community organizations to patients as above. | Other: Passive Intervention<br>* Provision of tools to help with referrals to community resources<br>|
| Placebo Comparator: Usual Care<br>Usual care | Other: No intervention<br>* No intervention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of referrals from the practices to the community resources |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of referrals received by each resource |  | 6 months | 
| The proportion of patients with unhealthy behaviors who were referred from the practices to community resources |  | 6 months | 
| Practice attitudes and practice regarding referral to community resources |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quality assurance, health care, primary health care, community health services, referral and consultation, exercise, diet, tobacco