Clinical trial NCT03211832: Disseminating Public Health Evidence to Support Prevention and Control of Diabetes Among Local Health Departments
Official title: Enhancing Evidence-based Diabetes Control Among Local Health Departments
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Organizational Support for Evidence-based Public Health
Keywords: Dissemination research
Public health workforce
Evidence-based public health
Public health accreditation
Lead sponsor: Washington University School of Medicine
Sponsor class: OTHER
Collaborators: name: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
First posted: 2017-07-07
Enrollment: 331
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: OTHER

Brief summary: The purpose of this study is to identify and evaluate dissemination strategies to support the uptake of evidence-based programs and policies (EBPPs) for diabetes prevention and control among local-level public health practitioners. Dissemination strategies such as multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance are hypothesized to associate with improved access and use of public health evidence and organizational supports for program and policy decision making based on evidence-based public health.

Detailed description: Evidence-based public health approaches to prevent and control diabetes and other chronic diseases have been identified in recent decades, and could have a profound effect on diabetes incidence and quality and length of life of those diagnosed. However, barriers to implement approaches continue because of lack of organizational support, limited resources, competing priorities, and limited skill among the public health workforce. The purpose of this study is to determine effective ways to promote the adoption of evidence based public health practice related to diabetes and chronic disease prevention and control among local health departments (LHDs). This stepped-wedge cluster randomized trial aims to evaluate active dissemination strategies on local-level public health practitioners to increase adoption and use of evidence-based programs and policies for diabetes and chronic disease prevention and control among LHDs in Missouri. Twelve LHDs will be recruited and randomly assigned to one of three groups that cross over from usual practice to receive the intervention (dissemination) strategies at 8-month intervals; the intervention duration for groups ranges from 8 to 24 months. LHD staff and the university-based study team are jointly identifying, refining and selecting dissemination strategies. Intervention strategies may include multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance. Evaluation methods include surveys at baseline and at each 8-month interval, abstraction of LHD chronic disease prevention program plans and progress reports, and social network analysis.

Eligibility criteria: Inclusion Criteria:

* Local Health Departments (LHDs, cluster) in the state of Missouri and corresponding public health workforce (individuals within cluster); screenings.

Exclusion Criteria:

* LHDs that have less than 5 employees working in or supporting diabetes or chronic disease control, which includes program areas of diabetes prevention and management, obesity prevention, physical activity, nutrition, cardiovascular health, and cancer

Primary outcomes:
measure: Evidence-based Decision Making (EBDM) Competencies
timeFrame: 24 months post baseline
measure: Evidence-based Intervention Score
timeFrame: 24 months post baseline
measure: Awareness of Culture Supportive of EBDM
timeFrame: 24 months post baseline
measure: Capacity and Expectations for Evidence-based Decision Making (EBDM)
timeFrame: 24 months post baseline
measure: Resource Availability
timeFrame: 24 months post baseline
measure: Evaluation Capacity of Work Unit
timeFrame: 24 months post baseline
measure: EBDM Climate Cultivation
timeFrame: 24 months post baseline
measure: Partnerships to Support EBDM
timeFrame: 24 months post baseline
Secondary outcomes:
measure: Inter-agency Connectedness
timeFrame: 24 months post baseline
Other outcomes:
Locations:
city: Saint Louis
country: United States
facility: Prevention Research Center, Brown School, Washington University in St. Louis
state: Missouri
Study officials:
affiliation: Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Division of Public Health Sciences, Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine
name: Ross C Brownson, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Parks RG, Tabak RG, Allen P, Baker EA, Stamatakis KA, Poehler AR, Yan Y, Chin MH, Harris JK, Dobbins M, Brownson RC. Enhancing evidence-based diabetes and chronic disease control among local health departments: a multi-phase dissemination study with a stepped-wedge cluster randomized trial component. Implement Sci. 2017 Oct 18;12(1):122. doi: 10.1186/s13012-017-0650-4.
citation: Jacob RR, Parks RG, Allen P, Mazzucca S, Yan Y, Kang S, Dekker D, Brownson RC. How to "Start Small and Just Keep Moving Forward": Mixed Methods Results From a Stepped-Wedge Trial to Support Evidence-Based Processes in Local Health Departments. Front Public Health. 2022 Apr 28;10:853791. doi: 10.3389/fpubh.2022.853791. eCollection 2022.