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https://www.readbyqxmd.com/read/29328873/selecting-and-improving-quasi-experimental-designs-in-effectiveness-and-implementation-research
#1
Margaret A Handley, Courtney R Lyles, Charles McCulloch, Adithya Cattamanchi
Interventional researchers face many design challenges when assessing intervention implementation in real-world settings. Intervention implementation requires holding fast on internal validity needs while incorporating external validity considerations (such as uptake by diverse subpopulations, acceptability, cost, and sustainability). Quasi-experimental designs (QEDs) are increasingly employed to achieve a balance between internal and external validity. Although these designs are often referred to and summarized in terms of logistical benefits, there is still uncertainty about (a) selecting from among various QEDs and (b) developing strategies to strengthen the internal and external validity of QEDs...
January 12, 2018: Annual Review of Public Health
https://www.readbyqxmd.com/read/29321338/improving-access-to-thrombolysis-and-inhospital-management-times-in-ischemic-stroke-a-stepped-wedge-randomized-trial
#2
Julie Haesebaert, Norbert Nighoghossian, Catherine Mercier, Anne Termoz, Sylvie Porthault, Laurent Derex, Pierre-Yves Gueugniaud, Estelle Bravant, Muriel Rabilloud, Anne-Marie Schott
BACKGROUND AND PURPOSE: A suboptimal number of ischemic stroke patients eligible for thrombolysis actually receive it, partly because of extended inhospital delays. We developed a comprehensive program designed for emergency unit staff and evaluated its effectiveness for reducing intrahospital times and improving access to thrombolysis. METHODS: We conducted a randomized stepped-wedge controlled trial in 18 emergency unit. The sequentially implemented training intervention, targeting emergency physicians and nurses, was based on specifically designed videos and interactive simulation workshops on intrahospital management optimization...
January 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29321033/environmental-enrichment-intervention-for-rett-syndrome-an-individually-randomised-stepped-wedge-trial
#3
Jenny Downs, Jenny Rodger, Chen Li, Xuesong Tan, Nan Hu, Kingsley Wong, Nicholas de Klerk, Helen Leonard
BACKGROUND: Rett syndrome is caused by a pathogenic mutation in the MECP2 gene with major consequences for motor and cognitive development. One of the effects of impaired MECP2 function is reduced production of Brain Derived Neurotrophic Factor (BDNF), a protein required for normal neuronal development. When housed in an enriched environment, MECP2 null mice improved motor abilities and increased levels of BDNF in the brain. We investigated the effects of environmental enrichment on gross motor skills and blood BDNF levels in girls with Rett syndrome...
January 10, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29315688/modeling-clustering-and-treatment-effect-heterogeneity-in-parallel-and-stepped-wedge-cluster-randomized-trials
#4
Karla Hemming, Monica Taljaard, Andrew Forbes
Cluster randomized trials are frequently used in health service evaluation. It is common practice to use an analysis model with a random effect to allow for clustering at the analysis stage. In designs where clusters are exposed to both control and treatment conditions, it may be of interest to examine treatment effect heterogeneity across clusters. In designs where clusters are not exposed to both control and treatment conditions, it can also be of interest to allow heterogeneity in the degree of clustering between arms...
January 8, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29282109/simulated-patient-encounters-to-improve-adolescent-retention-in-hiv-care-in-kenya-study-protocol-of-a-stepped-wedge-randomized-controlled-trial
#5
Kate S Wilson, Cyrus Mugo, David Bukusi, Irene Inwani, Anjuli D Wagner, Helen Moraa, Tamara Owens, Joseph B Babigumira, Barbra A Richardson, Grace C John-Stewart, Jennifer A Slyker, Dalton C Wamalwa, Pamela K Kohler
BACKGROUND: Adolescent-friendly policies aim to tailor HIV services for adolescents and young adults aged 10-24 years (AYA) to promote health outcomes and improve retention in HIV care and treatment. However, few interventions focus on improving healthcare worker (HCW) competencies and skills for provision of high-quality adolescent care. Standardized patients (SPs) are trained actors who work with HCWs in mock clinical encounters to improve clinical assessment, communication, and empathy skills...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29207983/protocol-for-project-impact-improving-millions-hearts-for-provider-and-community-transformation-a-quasi-experimental-evaluation-of-an-integrated-electronic-health-record-and-community-health-worker-intervention-study-to-improve-hypertension-management-among
#6
Priscilla M Lopez, Jennifer Zanowiak, Keith Goldfeld, Katarzyna Wyka, Ahmad Masoud, Susan Beane, Rashi Kumar, Phoebe Laughlin, Chau Trinh-Shevrin, Lorna Thorpe, Nadia Islam
BACKGROUND: The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative...
December 6, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29178891/rationale-and-design-for-sharehd-a-quality-improvement-collaborative-to-scale-up-shared-haemodialysis-care-for-patients-on-centre-based-haemodialysis
#7
James Fotheringham, Tania Barnes, Louese Dunn, Sonia Lee, Steven Ariss, Tracey Young, Stephen J Walters, Paul Laboi, Andy Henwood, Rachel Gair, Martin Wilkie
BACKGROUND: The study objective is to assess the effectiveness and economic impact of a structured programme to support patient involvement in centre-based haemodialysis and to understand what works for whom in what circumstances and why. It implements a program of Shared Haemodialysis Care (SHC) that aims to improve experience and outcomes for those who are treated with centre-based haemodialysis, and give more patients the confidence to dialyse independently both at centres and at home...
November 24, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29170309/12%C3%A2-a-multi-centre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#8
Ceri Battle, Hayley Hutchings, Zoe Abbott, Claire O'neill, Sam Groves, Alan Watkins, Fiona Lecky, Sally Jones, James Gagg, Rick Body, Phillip Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the Emergency Department (ED). A definitive randomised controlled trial (impact trial), is required to assess the clinical and cost effectiveness of the new model, before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29116022/enhancing-mental-and-physical-health-of-women-through-engagement-and-retention-empower-a-protocol-for-a-program-of-research
#9
Alison B Hamilton, Melissa M Farmer, Tannaz Moin, Erin P Finley, Ariel J Lang, Sabine M Oishi, Alexis K Huynh, Jessica Zuchowski, Sally G Haskell, Bevanne Bean-Mayberry
BACKGROUND: The Enhancing Mental and Physical health of Women through Engagement and Retention or EMPOWER program represents a partnership with the US Department of Veterans Health Administration (VA) Health Service Research and Development investigators and the VA Office of Women's Health, National Center for Disease Prevention and Health Promotion, Primary Care-Mental Health Integration Program Office, Women's Mental Health Services, and the Office of Patient Centered Care and Cultural Transformation...
November 7, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29101258/impact-on-prehospital-delay-of-a-stroke-preparedness-campaign-a-sw-rct-stepped-wedge-cluster-randomized-controlled-trial
#10
RANDOMIZED CONTROLLED TRIAL
Licia Denti, Caterina Caminiti, Umberto Scoditti, Andrea Zini, Giovanni Malferrari, Maria Luisa Zedde, Donata Guidetti, Mario Baratti, Luca Vaghi, Enrico Montanari, Barbara Marcomini, Silvia Riva, Elisa Iezzi, Paola Castellini, Silvia Olivato, Filippo Barbi, Eva Perticaroli, Daniela Monaco, Ilaria Iafelice, Guido Bigliardi, Laura Vandelli, Angelica Guareschi, Andrea Artoni, Carla Zanferrari, Peter J Schulz
BACKGROUND AND PURPOSE: Public campaigns to increase stroke preparedness have been tested in different contexts, showing contradictory results. We evaluated the effectiveness of a stroke campaign, designed specifically for the Italian population in reducing prehospital delay. METHODS: According to an SW-RCT (Stepped-Wedge Cluster Randomized Controlled Trial) design, the campaign was launched in 4 provinces in the northern part of the region Emilia Romagna at 3-month intervals in randomized sequence...
December 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29078810/improving-oxygen-therapy-for-children-and-neonates-in-secondary-hospitals-in-nigeria-study-protocol-for-a-stepped-wedge-cluster-randomised-trial
#11
Hamish R Graham, Adejumoke I Ayede, Ayobami A Bakare, Oladapo B Oyewole, David Peel, Amy Gray, Barbara McPake, Eleanor Neal, Shamim Qazi, Rasa Izadnegahdar, Adegoke G Falade, Trevor Duke
BACKGROUND: Oxygen is a life-saving, essential medicine that is important for the treatment of many common childhood conditions. Improved oxygen systems can reduce childhood pneumonia mortality substantially. However, providing oxygen to children is challenging, especially in small hospitals with weak infrastructure and low human resource capacity. METHODS/DESIGN: This trial will evaluate the implementation of improved oxygen systems at secondary-level hospitals in southwest Nigeria...
October 27, 2017: Trials
https://www.readbyqxmd.com/read/29071130/scaling-up-quality-improvement-intervention-for-perinatal-care-in-nepal-neperiqip-study-protocol-of-a-cluster-randomised-trial
#12
Ashish Kc, Anna Bergström, Dipak Chaulagain, Olivia Brunell, Uwe Ewald, Abhishek Gurung, Leif Eriksson, Helena Litorp, Johan Wrammert, Erik Grönqvist, Per-Anders Edin, Claire Le Grange, Bikash Lamichhane, Parashuram Shrestha, Amrit Pokharel, Asha Pun, Chahana Singh, Mats Målqvist
INTRODUCTION: Nepal Perinatal Quality Improvement Project (NePeriQIP) intends to scale up a quality improvement (QI) intervention for perinatal care according to WHO/National guidelines in hospitals of Nepal using the existing health system structures. The intervention builds on previous research on the implementation of Helping Babies Breathe-quality improvement cycle in a tertiary healthcare setting in Nepal. The objective of this study is to evaluate the effect of this scaled-up intervention on perinatal health outcomes...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29045666/quality-improvement-feature-series-article-4-advanced-designs-for-quality-improvement-studies
#13
Lilliam Ambroggio, Amanda Schondelmeyer, Erik Hoefgen, Patrick Brady, Erin Shaughnessy
Each quality improvement (QI) project has an implicit study design, although these designs are not discussed as commonly as they are in clinical research. Most QI projects fall under the quasi-experimental study category, in which observations are made before and after the implementation of an intervention(s). The simplest and most commonly used for QI studies is the pre-post design, in which observations are made before and after each intervention that was implemented over a specified period. More sophisticated designs for QI studies enable a study team to draw stronger inferences about the system that is being changed and the individual effects of the interventions that are implemented...
October 14, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29027505/impact-of-non-uniform-correlation-structure-on-sample-size-and-power-in-multiple-period-cluster-randomised-trials
#14
J Kasza, K Hemming, R Hooper, Jns Matthews, A B Forbes
Stepped wedge and cluster randomised crossover trials are examples of cluster randomised designs conducted over multiple time periods that are being used with increasing frequency in health research. Recent systematic reviews of both of these designs indicate that the within-cluster correlation is typically taken account of in the analysis of data using a random intercept mixed model, implying a constant correlation between any two individuals in the same cluster no matter how far apart in time they are measured: within-period and between-period intra-cluster correlations are assumed to be identical...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29026932/-protocol-based-mobilization-on-intensive-care-units-design-of-a%C3%A2-cluster-randomized-pilot-study
#15
REVIEW
P Nydahl, A Diers, U Günther, B Haastert, S Hesse, C Kerschensteiner, S Klarmann, S Köpke
BACKGROUND: Despite convincing evidence for early mobilization of patients on intensive care units (ICU), implementation in practice is limited. Protocols for early mobilization, including in- and exclusion criteria, assessments, safety criteria, and step schemes may increase the rate of implementation and mobilization. HYPOTHESIS: Patients (population) on ICUs with a protocol for early mobilization (intervention), compared to patients on ICUs without protocol (control), will be more frequently mobilized (outcome)...
October 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28969702/crowdsourcing-to-promote-hiv-testing-among-msm-in-china-study-protocol-for-a-stepped-wedge-randomized-controlled-trial
#16
Joseph D Tucker
BACKGROUND: HIV testing for marginalized populations is critical to controlling the HIV epidemic. However, the HIV testing rate among men who have sex with men (MSM) in China remains low. Crowdsourcing, the process of shifting individual tasks to a group, has been increasingly adopted in public health programs and may be a useful tool for spurring innovation in HIV testing campaigns. We designed a multi-site study to develop a crowdsourced HIV test promotion campaign and evaluate its effectiveness against conventional campaigns among MSM in China...
October 2, 2017: Trials
https://www.readbyqxmd.com/read/28936633/evaluation-of-an-online-family-history-tool-for-identifying-hereditary-and-familial-colorectal-cancer
#17
F G J Kallenberg, C M Aalfs, F O The, C A Wientjes, A C Depla, M W Mundt, P M M Bossuyt, E Dekker
Identifying a hereditary colorectal cancer (CRC) syndrome or familial CRC (FCC) in a CRC patient may enable the patient and relatives to enroll in surveillance protocols. As these individuals are insufficiently recognized, we evaluated an online family history tool, consisting of a patient-administered family history questionnaire and an automated genetic referral recommendation, to facilitate the identification of patients with hereditary CRC or FCC. Between 2015 and 2016, all newly diagnosed CRC patients in five Dutch outpatient clinics, were included in a trial with a stepped-wedge design, when first visiting the clinic...
September 21, 2017: Familial Cancer
https://www.readbyqxmd.com/read/28923034/an-implementation-science-protocol-of-the-women-s-health-coop-in-healthcare-settings-in-cape-town-south-africa-a-stepped-wedge-design
#18
Wendee M Wechsberg, Jacqueline W Ndirangu, Ilene S Speizer, William A Zule, Winnifred Gumula, Courtney Peasant, Felicia A Browne, Laura Dunlap
BACKGROUND: HIV persists as a public health emergency in South Africa, especially among women of childbearing age. In response to the HIV epidemic, the Joint United Nations Programme on HIV/AIDS has put forth the 90-90-90 global goals to achieve an AIDS-free generation by 2020. This goal aspires to have 90% of people living with HIV diagnosed; 90% of those who test positive on sustained antiretroviral therapy (ART); and 90% of those on ART be virally suppressed. Ensuring access to ART is an important first step in reducing HIV incidence, especially among vulnerable populations such as women who use substances and bear the burden of HIV in South Africa...
September 18, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28885557/evaluation-of-a-pilot-implementation-to-integrate-alcohol-related-care-within-primary-care
#19
Jennifer F Bobb, Amy K Lee, Gwen T Lapham, Malia Oliver, Evette Ludman, Carol Achtmeyer, Rebecca Parrish, Ryan M Caldeiro, Paula Lozano, Julie E Richards, Katharine A Bradley
Alcohol use is a major cause of disability and death worldwide. To improve prevention and treatment addressing unhealthy alcohol use, experts recommend that alcohol-related care be integrated into primary care (PC). However, few healthcare systems do so. To address this gap, implementation researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). Here, we describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators...
September 8, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28882116/thistle-trial-of-hands-on-interprofessional-simulation-training-for-local-emergencies-a-research-protocol-for-a-stepped-wedge-clustered-randomised-controlled-trial
#20
Erik Lenguerrand, Catherine Winter, Karen Innes, Graeme MacLennan, Dimitrios Siassakos, Pauline Lynch, Alan Cameron, Joanna Crofts, Alison McDonald, Kirsty McCormack, Mark Forrest, John Norrie, Siladitya Bhattacharya, Tim Draycott
BACKGROUND: Many adverse pregnancy outcomes in the UK could be prevented with better intrapartum care. Training for intrapartum emergencies has been widely recommended but there are conflicting data about their effectiveness. Observational studies have shown sustained local improvements in perinatal outcomes associated with the use of the PRactical Obstetric Multi-Professional Training - (PROMPT) training package. However this effect needs to be investigated in the context of randomised study design in settings other than enthusiastic early adopter single-centres...
September 7, 2017: BMC Pregnancy and Childbirth
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