Overview

This trial is active, not recruiting.

Condition program evaluation
Treatment escalates
Sponsor Oregon Health and Science University
Collaborator University of Texas
Start date April 2015
End date April 2019
Trial size 7 participants
Trial identifier NCT02560428, 11482

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.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Observational model case-only
Time perspective cross-sectional

Primary Outcomes

Measure
Percentage of participants with AMI, coronary artery bypass graft, PCI or IVD, and who had documentation of used of aspirin or another antithrombotic during the measurement period.
time frame: Quarterly for 4 years
Percentage of participants with diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90 mmHg) during the measurement period.
time frame: Quarterly for 4 years
Percentage of participants considered at high risk of cardiovascular events who were prescribed or were on a statin therapy during the measurement period.
time frame: Quarterly for 4 years
Percentage of participants who were screened for tobacco use and received cessation counseling intervention if identified as a tobacco user.
time frame: Quarterly for 4 years

Secondary Outcomes

Measure
Practice capacity for change measured by adaptive reserve (AR)
time frame: Baseline, immediately after intervention, 6 months post-intervention (4 years maximum)
Practice capacity for quality improvement measured by CPCQ
time frame: Baseline, immediately after intervention, 6 months post-intervention (4 years maximum)

Eligibility Criteria

Male or female participants from 18 years up to 89 years old.

Inclusion Criteria: - All R18 grant awardees are included in the study. Exclusion Criteria:

Additional Information

Official title Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES)
Principal investigator Debbie Cohen, PhD
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.
Trial information was received from ClinicalTrials.gov and was last updated in October 2016.
Information provided to ClinicalTrials.gov by Oregon Health and Science University.