Literature DB >> 31068398

A Cluster Randomized Trial Comparing Strategies for Translating Self-Management Support into Primary Care Practices.

W Perry Dickinson1, L Miriam Dickinson2, Bonnie T Jortberg2, Danielle M Hessler2, Douglas H Fernald2, Michael Cuffney2, Lawrence Fisher2.   

Abstract

INTRODUCTION: Self-management support (SMS) is a key factor in diabetes care, but true SMS has not been widely adopted by primary care practices. Interactive behavior-change technology (IBCT) can provide efficient methods for adoption of SMS in primary care. Practice facilitation has been effective in assisting practices in implementing complex evidence-based interventions, such as SMS. This study was designed to study the incremental impact of practice education, the Connection to Health (CTH) IBCT tool, and practice facilitation as approaches to enhance the translation of SMS for patients with diabetes in primary care practices.
METHODS: A cluster-randomized trial compared the effectiveness of 3 implementation strategies for enhancing SMS for patients with diabetes in 36 primary care practices: 1) SMS education (SMS-ED); 2) SMS-ED plus CTH availability (CTH); and 3) SMS-ED, CTH availability, plus brief practice facilitation (CTH + PF). Outcomes including hemoglobin A1c (HbA1c) levels and SMS activities were assessed at 18 months post study initiation in a random sample of patients through medical record reviews.
RESULTS: A total of 488 patients enrolled in the CTH system (141 CTH, 347 CTH + PF). In the intent-to-treat analysis of patients with medical record reviews, HbA1c slopes did not differ between study arms (CTH vs SMS-ED: P = .2243, CTH + PF vs SMS-ED: P = .8601). However, patients from practices in the CTH + PF arm who used CTH showed significantly improved HbA1c trajectories over time compared with patients from SMS-ED practices (P = .0422). SMS activities were significantly increased in CTH and CTH + PF study arms compared with SMS-ED (CTH vs SMS-ED: P = .0223, CTH + PF vs SMS-ED: P = .0013). The impact of CTH on SMS activities was a significant mediator of the impact of the CTH and CTH + PF interventions on HbA1c.
CONCLUSION: An interactive behavior change technology tool such as CTH can increase primary care practice SMS activities and improve patient HbA1c levels. Even brief practice facilitation assists practices in implementing SMS. © Copyright 2019 by the American Board of Family Medicine.

Entities:  

Keywords:  Behavior Therapy; Behavioral Medicine; Chronic Disease; Counseling; Disease Management; Glycated Hemoglobin A; Health Promotion; Life Style; Obesity; Patient-Centered Care; Primary Health Care; Self Care; Self-Management; Type 2 Diabetes Mellitus

Mesh：

Year:  2019        PMID： 31068398      PMCID： PMC6599532          DOI： 10.3122/jabfm.2019.03.180254

Source DB:  PubMed          Journal:  J Am Board Fam Med        ISSN： 1557-2625            Impact factor:   2.657


  47 in total

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Authors:  Susan L Norris; Phyllis J Nichols; Carl J Caspersen; Russell E Glasgow; Michael M Engelgau; Leonard Jack; Susan R Snyder; Vilma G Carande-Kulis; George Isham; Sanford Garfield; Peter Briss; David McCulloch
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Authors:  Zsolt Nagykaldi; James W Mold; Cheryl B Aspy
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Journal:  J Health Psychol       Date:  2006-05

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8.  Pragmatic Cluster Randomized Trials Using Covariate Constrained Randomization: A Method for Practice-based Research Networks (PBRNs).

Authors:  L Miriam Dickinson; Brenda Beaty; Chet Fox; Wilson Pace; W Perry Dickinson; Caroline Emsermann; Allison Kempe
Journal:  J Am Board Fam Med       Date:  2015 Sep-Oct       Impact factor: 2.657

9.  Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms.

Authors:  James O Prochaska; Wayne F Velicer; Colleen Redding; Joseph S Rossi; Michael Goldstein; Judith DePue; Geoffrey W Greene; Susan R Rossi; Xiaowu Sun; Joseph L Fava; Robert Laforge; William Rakowski; Brett A Plummer
Journal:  Prev Med       Date:  2005-08       Impact factor: 4.018

10.  Two-year follow-up of sequential and simultaneous interactive computer-tailored interventions for increasing physical activity and decreasing fat intake.

Authors:  Corneel Vandelanotte; Ilse De Bourdeaudhuij; Johannes Brug
Journal:  Ann Behav Med       Date:  2007-04
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  5 in total

Review 1.  Can the Routine Use of Patient-Reported Outcome Measures Improve the Delivery of Person-Centered Diabetes Care? A Review of Recent Developments and a Case Study.

Authors:  Soren E Skovlund; T H Lichtenberg; D Hessler; N Ejskjaer
Journal:  Curr Diab Rep       Date:  2019-08-16       Impact factor: 4.810

2.  Effectiveness of Quality Improvement Coaching on Process Outcomes in Health Care Settings: A Systematic Review.

Authors:  Lindsay A Ballengee; Sharron Rushton; Allison A Lewinski; Soohyun Hwang; Leah L Zullig; Katharine A Ball Ricks; Katherine Ramos; Mulugu V Brahmajothi; Thomasena S Moore; Dan V Blalock; Sarah Cantrell; Andrzej S Kosinski; Adelaide Gordon; Belinda Ear; John W Williams; Jennifer M Gierisch; Karen M Goldstein
Journal:  J Gen Intern Med       Date:  2022-01-03       Impact factor: 5.128

Review 3.  Implementation of Technology-Delivered Diabetes Self-care Interventions in Clinical Care: a Narrative Review.

Authors:  Lyndsay A Nelson; Sarah E Williamson; Audriana Nigg; William Martinez
Journal:  Curr Diab Rep       Date:  2020-11-18       Impact factor: 4.810

4.  Individual goal-based plan based on nursing theory for adults with type 2 diabetes and self-care deficits: a study protocol of a randomised controlled trial.

Authors:  Jessica Rosman; Jan W Eriksson; Mats Martinell; Anna Lindholm Olinder; Janeth Leksell
Journal:  BMJ Open       Date:  2022-03-29       Impact factor: 2.692

5.  The impact of enhancing self-management support for diabetes in Community Health Centers through patient engagement and relationship building: a primary care pragmatic cluster-randomized trial.

Authors:  Danielle Hessler; Lawrence Fisher; Miriam Dickinson; Perry Dickinson; José Parra; Michael B Potter
Journal:  Transl Behav Med       Date:  2022-10-07       Impact factor: 3.626
  5 in total

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