Abstract:
BACKGROUND:Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD). However, data are lacking in terms of its efficacy and cost-effectiveness when implemented in ethnic and low-income populations. METHODS:The Stanford and San Mateo Heart to Heart (HTH) project is a randomized controlled clinical trial designed to rigorously evaluate the efficacy and cost-effectiveness of a multi-risk cardiovascular case management program in low-income, primarily ethnic minority patients served by a local county health care system in California. Randomization occurred at the patient level. The primary outcome measure is the absolute CHD risk over 10 years. Secondary outcome measures include adherence to guidelines on CHD prevention practice. We documented the study design, methodology, and baseline sociodemographic, clinical and lifestyle characteristics of 419 participants. RESULTS:We achieved equal distributions of the sociodemographic, biophysical and lifestyle characteristics between the two randomization groups. HTH participants had a mean age of 56 years, 63% were Latinos/Hispanics, 65% female, 61% less educated, and 62% were not employed. Twenty percent of participants reported having a prior cardiovascular event. 10-year CHD risk averaged 18% in men and 13% in women despite a modest low-density lipoprotein cholesterol level and a high on-treatment percentage at baseline. Sixty-three percent of participants were diagnosed with diabetes and an additional 22% had metabolic syndrome. In addition, many participants had depressed high-density lipoprotein (HDL) cholesterol levels and elevated values of total cholesterol-to-HDL ratio, triglycerides, triglyceride-to-HDL ratio, and blood pressure. Furthermore, nearly 70% of participants were obese, 45% had a family history of CHD or stroke, and 16% were current smokers. CONCLUSION:We have recruited an ethnically diverse, low-income cohort in which to implement a case management approach and test its efficacy and cost-effectiveness. HTH will advance the scientific understanding of better strategies for CHD prevention among these priority subpopulations and aid in guiding future practice that will reduce health disparities.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Ma J,Lee KV,Berra K,Stafford RSdoi
10.1186/1748-5908-1-21subject
Has Abstractpub_date
2006-09-27 00:00:00pages
21issn
1748-5908pii
1748-5908-1-21journal_volume
1pub_type
杂志文章abstract:BACKGROUND:Shared decision-making (SDM) is rarely implemented in pediatric practice. Pediatric health decision-making differs from that of adult practice. Yet, little is known about the factors that influence the implementation of pediatric shared decision-making (SDM). We synthesized pediatric SDM barriers and facilit...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0851-5
更新日期:2019-01-18 00:00:00
abstract:BACKGROUND:Considerable racial and socio-economic disparities exist in breast cancer. In spite of the existence of numerous evidence-based interventions (EBIs) aimed at reducing breast cancer screening barriers among the underserved, there is a lack of uptake or sub-optimal uptake of EBIs in community and clinical sett...
journal_title:Implementation science : IS
pub_type: 临床试验,杂志文章
doi:10.1186/s13012-015-0334-x
更新日期:2015-10-14 00:00:00
abstract:BACKGROUND:The importance of behaviour change in improving health is illustrated by the increasing investment by funding bodies in the development and evaluation of complex interventions to change population, patient, and practitioner behaviours. The development of effective interventions is hampered by the absence of ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-10
更新日期:2011-02-07 00:00:00
abstract:BACKGROUND:Integrated knowledge translation (IKT) refers to collaboration between researchers and decision-makers. While advocated as an approach for enhancing the relevance and use of research, IKT is challenging and inconsistently applied. This study sought to inform future IKT practice and research by synthesizing s...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0399-1
更新日期:2016-03-17 00:00:00
abstract:BACKGROUND:The translation of research into policy and practice is enhanced by policymakers who can recognise and articulate their information needs and researchers that understand the policymakers' environment. As researchers, we sought to understand the policymaking process and how research evidence may contribute in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0315-0
更新日期:2015-09-03 00:00:00
abstract:BACKGROUND:Significant gaps related to measurement issues are among the most critical barriers to advancing implementation science. Three issues motivated the study aims: (a) the lack of stakeholder involvement in defining pragmatic measure qualities; (b) the dearth of measures, particularly for implementation outcomes...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0287-0
更新日期:2015-07-22 00:00:00
abstract:BACKGROUND:Men with localized prostate cancer often have unrealistic expectations. Practitioners are poor judges of men's preferences, contributing to preference misdiagnosis and unwarranted practice variation. Patient decision aids (PtDAs) can support men with decisions about localized prostate cancer. This is a compa...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0451-1
更新日期:2016-07-02 00:00:00
abstract:BACKGROUND:The Dutch multidisciplinary sciatica guideline recommends that the team of professionals involved in sciatica care and the patient together decide on surgical or prolonged conservative treatment (shared decision making [SDM]). Despite this recommendation, SDM is not yet integrated in sciatica care. Existing ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-95
更新日期:2013-08-23 00:00:00
abstract:BACKGROUND:Previous efforts to produce case descriptions have typically not focused on the organizations that produce research evidence and support its use. External evaluations of such organizations have typically not been analyzed as a group to identify the lessons that have emerged across multiple evaluations. Case ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-56
更新日期:2008-12-17 00:00:00
abstract:BACKGROUND:In Belgium, the construction of the national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, healthcare providers, Evidence-Based Medicine (EBM) partners, and vend...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-8-83
更新日期:2013-08-05 00:00:00
abstract::As more quality improvement programs are implemented to achieve gains in performance, the need to evaluate their lasting effects has become increasingly evident. However, such long-term follow-up evaluations are scarce in healthcare implementation science, being largely relegated to the "need for further research" sec...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-21
更新日期:2008-04-22 00:00:00
abstract:BACKGROUND:Worksites are important locations for interventions to promote health. However, occupational programs with documented efficacy often are not used, and those being implemented have not been studied. The research in this report was funded through the American Reinvestment and Recovery Act Challenge Topic 'Path...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-73
更新日期:2010-10-08 00:00:00
abstract:BACKGROUND:Implementation scientists and practitioners, alike, recognize the importance of sustaining practice change, however post-implementation studies of interventions are rare. This is a protocol for the Sustainment, Sustainability and Spread Study (SSaSSy). The purpose of this study is to contribute to knowledge ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0959-2
更新日期:2019-12-19 00:00:00
abstract:BACKGROUND:The last year of life is one of the most resource-intensive periods for people with cancer. Very little population-based research has been conducted on end-of-life cancer care in the Australian health care setting. The objective of this program is to undertake a series of observational studies examining reso...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0148-2
更新日期:2015-02-26 00:00:00
abstract:BACKGROUND:There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain. METHODS:We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline disseminati...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-14
更新日期:2010-02-09 00:00:00
abstract:BACKGROUND:While it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation o...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-019-0865-7
更新日期:2019-02-18 00:00:00
abstract::Following publication of the original article [1], the authors reported an error in one of the authors' names. In this Correction the incorrect and correct author name are shown. The original article has been corrected. ...
journal_title:Implementation science : IS
pub_type: 杂志文章,已发布勘误
doi:10.1186/s13012-019-0862-x
更新日期:2019-02-08 00:00:00
abstract:BACKGROUND:We sought to determine whether a multi-modal intervention, which included mailing a patient reminder with a colon cancer decision aid to patients and system changes allowing direct access to scheduling screening tests through standing orders, would be an effective and efficient means of promoting colon cance...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-32
更新日期:2008-06-02 00:00:00
abstract::Economic evaluations can inform decisions about the efficiency and allocation of resources to implementation strategies-strategies explicitly designed to inform care providers and patients about the best available research evidence and to enhance its use in their practices. These strategies are increasingly popular in...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/s13012-014-0168-y
更新日期:2014-12-18 00:00:00
abstract:BACKGROUND:It is difficult to foster research utilization among allied health professionals (AHPs). Tailored, multifaceted knowledge translation (KT) strategies are now recommended but are resource intensive to implement. Employers need effective KT solutions but little is known about; the impact and viability of multi...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-8-132
更新日期:2013-11-13 00:00:00
abstract:BACKGROUND:Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features of local context. Given this real-world complexity, implementation researchers may be interested in a new mat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01070-3
更新日期:2020-12-11 00:00:00
abstract:BACKGROUND:Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted be...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-28
更新日期:2006-11-21 00:00:00
abstract::This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-base...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-7-43
更新日期:2012-05-14 00:00:00
abstract:OBJECTIVE:Formative evaluation of the implementation process for a digitally supported intervention in polypharmacy in Germany. Qualitative research was conducted within a cluster randomized controlled trial (C-RCT). It focused on understanding how the intervention influences behavior-related outcomes in the prescripti...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01043-6
更新日期:2020-09-21 00:00:00
abstract:BACKGROUND:Healthcare systems are challenged by a demand that exceeds available resources. One policy to meet this challenge is task substitution-transferring tasks to other professions and settings. Our study aimed to explore stakeholders' perceived feasibility of transferring hospital-based monitoring of stable glauc...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-14
更新日期:2013-01-25 00:00:00
abstract:BACKGROUND:Diabetes is a common disease with self-management a key aspect of care. Large prospective trials have shown that maintaining glycated hemoglobin less than 7% greatly reduces complications but translating this level of control into everyday clinical practice can be difficult. Intensive improvement programs ar...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-24
更新日期:2006-10-20 00:00:00
abstract:BACKGROUND:The WISE (Whole System Informing Self-management Engagement) approach encompasses creating, finding, and implementing appropriate self-care support for people with long-term conditions. A training package for primary care to introduce the approach was developed and underwent formative evaluation. This entail...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-7
更新日期:2010-01-29 00:00:00
abstract:BACKGROUND:Assessing the quality of primary care is becoming a priority in national healthcare agendas. Audit and feedback on healthcare quality performance indicators can help improve the quality of care provided. In some instances, fewer numbers of more comprehensive indicators may be preferable. This paper describes...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-2-11
更新日期:2007-04-02 00:00:00
abstract:BACKGROUND:Services to treat tobacco dependence are not readily available to smokers in low-middle income countries (LMICs) where smoking prevalence remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of two strategies for implementing tobacco use treatment guidelines in 26...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0558-z
更新日期:2017-02-28 00:00:00
abstract::In 2004 a UK charity, The Health Foundation, established the 'Engaging with Quality Initiative' to explore and evaluate the benefits of engaging clinicians in quality improvement in healthcare. Eight projects run by professional bodies or specialist societies were commissioned in various areas of acute care. A develop...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-46
更新日期:2008-10-30 00:00:00