Study protocol: a pragmatic, stepped-wedge trial of tailored support for implementing social determinants of health documentation/action in community health centers, with realist evaluation.
Adolescent
Adult
Aged
Child
Child, Preschool
Cluster Analysis
Community Health Centers
/ organization & administration
Data Collection
Diabetes Mellitus
/ therapy
Electronic Health Records
Female
Humans
Implementation Science
Infant
Infant, Newborn
Interprofessional Relations
Male
Middle Aged
Multicenter Studies as Topic
/ methods
Patient Care Team
/ organization & administration
Pragmatic Clinical Trials as Topic
Randomized Controlled Trials as Topic
/ methods
Referral and Consultation
Social Determinants of Health
Social Support
Young Adult
Community health centers
Electronic health records
Implementation
Implementation strategies
Social determinants of health
Journal
Implementation science : IS
ISSN: 1748-5908
Titre abrégé: Implement Sci
Pays: England
ID NLM: 101258411
Informations de publication
Date de publication:
28 01 2019
28 01 2019
Historique:
received:
15
11
2018
accepted:
08
01
2019
entrez:
30
1
2019
pubmed:
30
1
2019
medline:
14
8
2019
Statut:
epublish
Résumé
National leaders recommend documenting social determinants of health and actions taken to address social determinants of health in electronic health records, and a growing body of evidence suggests the health benefits of doing so. However, little evidence exists to guide implementation of social determinants of health documentation/action. This paper describes a 5-year, mixed-methods, stepped-wedge trial with realist evaluation, designed to test the impact of providing 30 community health centers with step-by-step guidance on implementing electronic health record-based social determinants of health documentation. This guidance will entail 6 months of tailored support from an interdisciplinary team, including training and technical assistance. We will report on tailored support provided at each of five implementation steps; impact of tailored implementation support; a method for tracking such tailoring; and context-specific pathways through which these tailored strategies effect change. We will track the competencies and resources needed to support the study clinics' implementation efforts. Results will inform how to tailor implementation strategies to meet local needs in real-world practice settings. Secondary analyses will assess impacts of social determinants of health documentation and referral-making on diabetes outcomes. By learning whether and how scalable, tailored implementation strategies help community health centers adopt social determinants of health documentation and action, this study will yield timely guidance to primary care providers. We are not aware of previous studies exploring implementation strategies that support adoption of social determinants of action using electronic health and interventions, despite the pressing need for such guidance. clinicaltrials.gov, NCT03607617 , registration date: 7/31/2018-retrospectively registered.
Sections du résumé
BACKGROUND
National leaders recommend documenting social determinants of health and actions taken to address social determinants of health in electronic health records, and a growing body of evidence suggests the health benefits of doing so. However, little evidence exists to guide implementation of social determinants of health documentation/action.
METHODS
This paper describes a 5-year, mixed-methods, stepped-wedge trial with realist evaluation, designed to test the impact of providing 30 community health centers with step-by-step guidance on implementing electronic health record-based social determinants of health documentation. This guidance will entail 6 months of tailored support from an interdisciplinary team, including training and technical assistance. We will report on tailored support provided at each of five implementation steps; impact of tailored implementation support; a method for tracking such tailoring; and context-specific pathways through which these tailored strategies effect change. We will track the competencies and resources needed to support the study clinics' implementation efforts.
DISCUSSION
Results will inform how to tailor implementation strategies to meet local needs in real-world practice settings. Secondary analyses will assess impacts of social determinants of health documentation and referral-making on diabetes outcomes. By learning whether and how scalable, tailored implementation strategies help community health centers adopt social determinants of health documentation and action, this study will yield timely guidance to primary care providers. We are not aware of previous studies exploring implementation strategies that support adoption of social determinants of action using electronic health and interventions, despite the pressing need for such guidance.
TRIAL REGISTRATION
clinicaltrials.gov, NCT03607617 , registration date: 7/31/2018-retrospectively registered.
Identifiants
pubmed: 30691480
doi: 10.1186/s13012-019-0855-9
pii: 10.1186/s13012-019-0855-9
pmc: PMC6348649
doi:
Banques de données
ClinicalTrials.gov
['NCT03607617']
Types de publication
Clinical Trial Protocol
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Pagination
9Subventions
Organisme : NIMH NIH HHS
ID : K01 MH113806
Pays : United States
Organisme : NIMH NIH HHS
ID : L30 MH108060
Pays : United States
Organisme : NIDDK NIH HHS
ID : R18 DK114701
Pays : United States
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