A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: The ESCALATES study protocol

Deborah Cohen, Bijal A. Balasubramanian, Leah Gordon, Miguel Marino, Sarah Ono, Leif I. Solberg, Benjamin F. Crabtree, Kurt C. Stange, Melinda Davis, William L. Miller, Laura J. Damschroder, Kenneth (John) McConnell, John Creswell

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). Methods: This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. Discussion: ESCALATES is a national evaluation of an ambitious large-scale dissemination and implementation effort focused on transforming smaller primary care practices. Insights will help to inform the design of national health care practice extension systems aimed at supporting practice transformation efforts in the USA. Clinical Trial Registration:NCT02560428(09/21/15)

Original languageEnglish (US)
Article number86
JournalImplementation Science
Volume11
Issue number1
DOIs
StatePublished - Jun 29 2016

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Primary Health Care
Cardiovascular Diseases
Learning
Health Services Research
Preventive Medicine
Electronic Health Records
Smoking Cessation
Quality Improvement
Aspirin
Observational Studies
Referral and Consultation
Cholesterol
Observation
Clinical Trials
Organizations
Prospective Studies
Interviews
Blood Pressure
Delivery of Health Care
Physicians

Keywords

  • Cardiovascular disease prevention
  • Dissemination and implementation research
  • Multi-site evaluation
  • Practice capacity
  • Practice facilitation
  • Primary care practice
  • Primary care practice extension
  • Quality improvement
  • Regional learning collaboratives

ASJC Scopus subject areas

  • Health Policy
  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Health Informatics

Cite this

A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care : The ESCALATES study protocol. / Cohen, Deborah; Balasubramanian, Bijal A.; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I.; Crabtree, Benjamin F.; Stange, Kurt C.; Davis, Melinda; Miller, William L.; Damschroder, Laura J.; McConnell, Kenneth (John); Creswell, John.

In: Implementation Science, Vol. 11, No. 1, 86, 29.06.2016.

Research output: Contribution to journalArticle

Cohen, Deborah ; Balasubramanian, Bijal A. ; Gordon, Leah ; Marino, Miguel ; Ono, Sarah ; Solberg, Leif I. ; Crabtree, Benjamin F. ; Stange, Kurt C. ; Davis, Melinda ; Miller, William L. ; Damschroder, Laura J. ; McConnell, Kenneth (John) ; Creswell, John. / A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care : The ESCALATES study protocol. In: Implementation Science. 2016 ; Vol. 11, No. 1.
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