A protocol for a cluster randomized trial comparing strategies for translating self-management support into primary...

Area of Science:

• Primary care research
• Health behavior change
• Diabetes management

Background:

• Advanced primary care models prioritize patient-centered care and self-management support (SMS).
• Effective SMS for type 2 diabetes mellitus (T2DM) remains a challenge.
• Interactive behavior-change technology (IBCT) can enhance SMS adoption.

Purpose of the Study:

• To test the effectiveness of the Connection to Health (CTH) SMS program in diverse primary care practices.
• To evaluate the impact of practice facilitation on CTH implementation.
• To compare CTH with and without practice facilitation against an academic detailing intervention.

Main Methods:

• A three-arm, cluster-randomized trial involving diverse primary care practices.
• Practices assigned to CTH program, CTH program plus practice facilitation, or SMS academic detailing.
• Outcomes assessed via medical record abstraction (lab values, SMS evidence) and CTH data (assessments, action plans).

Main Results:

• The study aims to compare the effectiveness, adoption, and implementation of three SMS practice implementation strategies.
• Primary effectiveness outcomes will be abstracted from medical records up to 18 months post-baseline.
• Qualitative data from interviews and field notes will assess practice implementation of SMS.

Conclusions:

• This research will provide crucial data on implementing SMS in primary care settings.
• The study will evaluate the effectiveness of the CTH IBCT tool for T2DM self-management.
• It will also assess the utility of practice facilitation in enhancing intervention implementation.