Abstract:
BACKGROUND:The shortage of organs for kidney transplantation for patients with end-stage renal disease (ESRD) is magnified in Hispanics/Latin Americans in the United States. Living donor kidney transplantation (LDKT) is the treatment of choice for ESRD. However, compared to their representation on the transplant waitlist, fewer Hispanics receive a LDKT than non-Hispanic whites. Barriers to LDKT for Hispanics include: lack of knowledge, cultural concerns, and language barriers. Few interventions have been designed to reduce LDKT disparities. This study aims to reduce Hispanic disparities in LDKT through a culturally targeted intervention. METHODS/DESIGN:Using a prospective effectiveness-implementation hybrid design involving pre-post intervention evaluation with matched controls, we will implement a complex culturally targeted intervention at two transplant centers in Dallas, TX and Phoenix, AZ. The goal of the study is to evaluate the effect of Northwestern Medicine's® Hispanic Kidney Transplant Program's (HKTP) key culturally targeted components (outreach, communication, education) on Hispanic LDKT rates over five years. The main hypothesis is that exposure to the HKTP will reduce disparities by increasing the ratio of Hispanic to non-Hispanic white LDKTs and the number of Hispanic LDKTs. We will also examine other process and outcome measures including: dialysis patient outreach, education session attendance, marketing efforts, Hispanic patients added to the waitlist, Hispanic potential donors per potential recipient, and satisfaction with culturally competent care. We will use mixed methods based on the Promoting Action on Research Implementation in Health Services (revised PARIHS) and the Consolidated Framework for Implementation Research (CFIR) frameworks to formatively evaluate the fidelity and innovative adaptations to HKTP's components at both study sites, to identify moderating factors that most affect implementation fidelity, and to identify adaptations that positively and negatively affect outcomes for patients. DISCUSSION:Our study will provide new knowledge about implementing culturally targeted interventions and their impact on reducing health disparities. Moreover, the study of a complex organizational-level intervention's implementation over five years is rare in implementation science; as such, this study is poised to contribute new knowledge to the factors influencing how organizational-level interventions are sustained over time. TRIAL REGISTRATION:(ClinicalTrials.gov registration # NCT03276390 , date of registration: 9-7-17, retrospectively registered).
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Gordon EJ,Lee J,Kang RH,Caicedo JC,Holl JL,Ladner DP,Shumate MDdoi
10.1186/s12913-018-3151-5subject
Has Abstractpub_date
2018-05-16 00:00:00pages
368issue
1issn
1472-6963pii
10.1186/s12913-018-3151-5journal_volume
18pub_type
杂志文章,多中心研究abstract:BACKGROUND:Australia's Aboriginal and Torres Strait Islander women have poorer survival and twice the disease burden from breast cancer compared to other Australian women. These disparities are influenced, but not fully explained, by more diagnoses at later stages. Incorporating breast screening, hospital and out of ho...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4147-5
更新日期:2019-06-14 00:00:00
abstract:BACKGROUND:Accurate TNM stage information is essential for cancer health services research, but is often impractical and expensive to collect at the population-level. We evaluated algorithms using administrative healthcare data to identify patients with metastatic gastric cancer. METHODS:A population-based cohort of g...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3125-7
更新日期:2018-05-02 00:00:00
abstract:BACKGROUND:The clinical environment in which health care providers have to work everyday is highly complex; this increases the risk for the occurrence of unintended events. The aim of this randomised controlled trial is to improve patient safety for a vulnerable group of patients that have to go through a complex care ...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1472-6963-11-59
更新日期:2011-03-21 00:00:00
abstract:BACKGROUND:Healthcare professionals engage in discharge planning of people with dementia during hospitalisation, however plans for transitioning the person into community services can be patchy and ineffective. The aim of this study was to report acute, community and residential care health professionals' (HP) perspect...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1227-z
更新日期:2015-12-18 00:00:00
abstract:BACKGROUND:Health, fair financing and responsiveness to the user's needs and expectations are seen as the essential objectives of health systems. Efforts have been made to conceptualise and measure responsiveness as a basis for evaluating the non-health aspects of health systems performance. This study assesses the app...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-243
更新日期:2009-12-22 00:00:00
abstract:BACKGROUND:Several Western and Arab countries, as well as over 30 States in the US are using the "All-Patient Refined Diagnosis-Related Groups" (APR-DRGs) with four severity-of-illness (SOI) subcategories as a model for hospital funding. The aim of this study is to verify whether this is an adequate model for funding s...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3134-6
更新日期:2018-05-11 00:00:00
abstract:BACKGROUND:There is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. The aim of this study was to identify the relationships between general practitioner (GP) co-location ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-2913-4
更新日期:2018-02-21 00:00:00
abstract:BACKGROUND:Along with economic growth and living standard improvement, hypertension has become one of the most prevalent chronic diseases in China. Self-reported measures and tested measures of hypertension may differ significantly due to the low awareness of prevalence. The objective of this study is to figure out whe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4289-5
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:To evaluate the extent of the difference in elective (ELCS) and emergency (EMCS) caesarean section (CS) rates between nulliparous women in public maternity hospitals in Ireland by model of care, and to quantify the contribution of maternal, clinical, and hospital characteristics in explaining the difference ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1494-3
更新日期:2016-07-08 00:00:00
abstract:BACKGROUND:Little is known about service providers' knowledge, attitudes, and experiences in relation to the assessment, diagnosis, and treatment of individuals seeking care for sexually transmitted infections (STIs), and how they influence the delivery of services. The purpose of this study was to explore the percepti...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-240
更新日期:2012-08-06 00:00:00
abstract:BACKGROUND:Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-2939-7
更新日期:2018-02-23 00:00:00
abstract:BACKGROUND:Risk adjustment and mortality prediction in studies of critical care are usually performed using acuity of illness scores, such as Acute Physiology and Chronic Health Evaluation II (APACHE II), which emphasize physiological derangement. Common risk adjustment systems used in administrative datasets, like the...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-129
更新日期:2009-07-30 00:00:00
abstract:BACKGROUND:Residential care infrastructure, in terms of the characteristics of the organisation (such as proprietary status, size, and location) and the physical environment, have been found to directly influence resident outcomes. This review aimed to summarise the existing literature of economic evaluations of reside...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-017-2165-8
更新日期:2017-03-21 00:00:00
abstract:BACKGROUND:While most breast-related research focuses on cancer, presentation of symptomatic persons in non-screened environments requires understanding the spectrum of breast diseases so as to plan services in resource-constrained settings. This study presents the variety of breast disease managed at a government, ope...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1959-4
更新日期:2017-01-21 00:00:00
abstract:BACKGROUND:The poor physical health of people with severe mental illness (SMI) is often attributed to lifestyle, disease-related medication side effects and disparate provision of healthcare. The complexity and inexact nature of this issue prohibits the identification of a clear and concise causal pathway, which in tur...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0744-0
更新日期:2015-03-03 00:00:00
abstract:BACKGROUND:Global neonatal mortality remains unacceptably high. Health workers who attend to prenatal and postnatal mothers need to be knowledgeable in preventive and curative care for pregnant women and their newborn babies. This study aimed to determine the level of knowledge related to prenatal and immediate newborn...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-65
更新日期:2014-02-11 00:00:00
abstract:BACKGROUND:Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient pro...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-6-50
更新日期:2006-04-11 00:00:00
abstract:BACKGROUND:Social Prescribing is a service in primary care that involves the referral of patients with non-clinical needs to local services and activities provided by the third sector (community, voluntary, and social enterprise sector). Social Prescribing aims to promote partnership working between the health and the ...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-018-2893-4
更新日期:2018-02-07 00:00:00
abstract:BACKGROUND:Adults with certain comorbid conditions have a higher risk of pneumonia than the overall population. If treatment of pneumonia is more costly in certain predictable situations, this would affect the value proposition of populations for pneumonia prevention. We estimate the economic impact of community-acquir...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-379
更新日期:2012-10-31 00:00:00
abstract:BACKGROUND:The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-6-138
更新日期:2006-10-23 00:00:00
abstract:BACKGROUND:Medications to treat and prevent chronic disease have substantially reduced morbidity and mortality; however, their diffusion has been uneven. Little is known about prescribing of chronic disease medications by nurse practitioners (NPs) and physician assistants (PAs), despite their increasingly important rol...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1569-1
更新日期:2016-07-27 00:00:00
abstract:BACKGROUND:Off-patent pharmaceuticals (OPPs) hold vital importance in meeting public health objectives, especially in developing countries where resources are limited. OPPs are comprised of off-patent originals, branded generics and unbranded generics; nonetheless, these products are not identical and often there are d...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3805-3
更新日期:2018-12-29 00:00:00
abstract:BACKGROUND:The aim of this study was to understand the quality of discharge guidance for patients with chronic diseases, to clarify the gap between patient needs and the content of discharge guidance, and to provide a reference for health education and clinical path management of patients with chronic diseases in the f...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-020-05518-6
更新日期:2020-07-11 00:00:00
abstract:BACKGROUND:Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1272-2
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:In 2017, ostomy patients gained access to ostomy products in community pharmacies that are fully reimbursed by the Portuguese National Health Service. This impacted the daily lives of people with ostomy and opened a new market of products and services for pharmacies. However, little is known about the sociod...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05765-7
更新日期:2020-10-02 00:00:00
abstract:BACKGROUND:During the SARS epidemic, healthcare utilization and medical services decreased significantly. However, the long-term impact of SARS on hospital performance needs to be further discussed. METHODS:A municipal hospital in Taipei City was shut down for a month due to SARS and then became the designated SARS an...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-228
更新日期:2008-11-06 00:00:00
abstract:BACKGROUND:While governments are urging adult mental health services to support consumers in the context of their family, there is little information about what family focused practice is, nor how it might be enacted. METHODS:Informed by the principles of Community Based Participatory Research, workshops were held in ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-2844-0
更新日期:2018-01-30 00:00:00
abstract:BACKGROUND:In 2000, midwifery was regulated in the Canadian Province of Manitoba. Since the establishment of the midwifery program, little formal research has analyzed the utilization of regulated midwifery services. In Manitoba, the demand for midwifery services has exceeded the number of midwives in practice. The spe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1334-5
更新日期:2016-03-15 00:00:00
abstract:BACKGROUND:Concerns have been raised regarding the reasonableness of using personal health responsibility as a principle or criterion for setting priorities in healthcare. While this debate continues, little is known about clinicians' views on the role of patient responsibility in clinical contexts. This paper contribu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05364-6
更新日期:2020-06-03 00:00:00
abstract:BACKGROUND:Understanding the factors that influence the hospital length of stay (LOS) for patients with stroke will help in discharge planning and stroke unit management. We explored how intravenous thrombolysis (IVT) affects LOS in an acute-care hospital setting. METHODS:We analyzed adult patients with ischemic strok...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1080-0
更新日期:2015-09-23 00:00:00