综合行为健康和初级保健随机实用干预试验中干预阶段完成的影响
Kari A Stephens1, Constance van Eeghen2, Zihan Zheng1
1Department of Family Medicine, University of Washington, Seattle, WA 98195, USA.
medRxiv : the preprint server for health sciences
|February 19, 2024
概括
实践转型干预改善了初级保健中的行为健康整合,但没有显著影响患者的健康结果. 灵活的干预措施对复杂的患者群体有希望.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 行为健康整合行为健康整合
背景情况:
- 在初级保健中整合行为健康对于管理多种慢性疾病的患者至关重要.
- 现有的干预措施往往缺乏灵活性,限制了它们在各种实践环境中的适用性.
研究的目的:
- 评估一项全面的,多阶段的实践转型干预措施,旨在增强初级保健中的行为健康整合.
- 检查国家初级保健实践样本中完成干预阶段和患者健康结果之间的关联.
主要方法:
- 一个实用,集群随机控制试验,涉及42个美国初级保健实践.
- 2,426名患有多种慢性疾病的患者在基线,中期和两年后期完成了调查.
- 多层混合效应模型用于分析干预对患者健康的影响和实践整合结果,控制基线测量.
主要成果:
- 根据完成的干预阶段数量,没有观察到患者健康结果 (如抑郁,焦虑,疼痛,满意度) 的显著差异.
- 每个干预阶段的完成与实践整合档案 (PIP) 域得分的统计学上显著增加有关,包括工作流,整合方法,患者识别和总整合.
结论:
- 一个灵活的,以实践为中心的干预措施有效地改善了多样化的初级保健环境中的行为健康整合.
- 虽然患者健康结果没有直接影响,但该干预措施在增强实践层面整合方面取得了成功,这表明对复杂患者群体的潜在益处.
- 需要进一步的研究,以优化干预措施,以改善患者在人口层面的健康结果.
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