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Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study
BACKGROUND: Considerable disparities in chronic pain management have been identified. Persons in rural, lower income and minoritized communities are less likely to receive evidence-based, nonpharmacologic care. Telehealth delivery of nonpharmacologic, evidence-based interventions for persons with ch...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Journal Experts
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543377/ https://www.ncbi.nlm.nih.gov/pubmed/37790359 http://dx.doi.org/10.21203/rs.3.rs-3267087/v1 |
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author | Fritz, Julie M Gibson, Bryan Wetter, David W Fiol, Guilherme Del Solis, Victor H Ford, Isaac Lundberg, Kelly Thackeray, Anne |
author_facet | Fritz, Julie M Gibson, Bryan Wetter, David W Fiol, Guilherme Del Solis, Victor H Ford, Isaac Lundberg, Kelly Thackeray, Anne |
author_sort | Fritz, Julie M |
collection | PubMed |
description | BACKGROUND: Considerable disparities in chronic pain management have been identified. Persons in rural, lower income and minoritized communities are less likely to receive evidence-based, nonpharmacologic care. Telehealth delivery of nonpharmacologic, evidence-based interventions for persons with chronic pain is a promising strategy to lessen disparities, but implementation comes with many challenges. The BeatPain Utah study is a hybrid type I effectiveness-implementation pragmatic clinical trial investigating telehealth strategies to provide nonpharmacologic care from physical therapists to persons with chronic back pain receiving care in Community Health Centers (CHCs). CHCs provide primary care to all persons regardless of ability to pay. This paper outlines the use of implementation mapping to develop a multifaceted implementation plan for the BeatPain study. METHODS: During a planning year for the BeatPain trial we developed a comprehensive logic model including the 5-step implementation mapping process informed by additional frameworks and theories. The five iterative implementation mapping steps were addressed in the planning year; 1) conduct needs assessments for involved groups; 2) identify implementation outcomes, performance objectives and determinants; 3) select implementation strategies; 4) produce implementation protocols and materials; and 5) evaluate implementation outcomes. RESULTS: CHC leadership/providers, patients and physical therapists were identified as involved groups. Barriers and assets were identified across groups which informed identification of performance objectives necessary to implement two key processes; 1) electronic referral of patients with back pain in CHC clinics to the BeatPain team; and 2) connecting patients with physical therapists providing telehealth. Determinants of the performance objectives for each group informed our choice of implementation strategies which focused on training, education, clinician support and tailoring physical therapy interventions for telehealth delivery and cultural competency. We selected implementation outcomes for the BeatPain trial to evaluate the success of our implementation strategies. CONCLUSIONS: Implementation mapping provided a comprehensive and systematic approach to develop an implementation plan during the planning phase for our ongoing hybrid effectiveness-implementation trial. We will be able to evaluate the implementation strategies used in the BeatPain Utah study to inform future efforts to implement telehealth delivery of evidence-based pain care in CHCs and other settings. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT04923334. Registered June 11, 2021 (https://clinicaltrials.gov/study/NCT04923334 |
format | Online Article Text |
id | pubmed-10543377 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Journal Experts |
record_format | MEDLINE/PubMed |
spelling | pubmed-105433772023-10-03 Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study Fritz, Julie M Gibson, Bryan Wetter, David W Fiol, Guilherme Del Solis, Victor H Ford, Isaac Lundberg, Kelly Thackeray, Anne Res Sq Article BACKGROUND: Considerable disparities in chronic pain management have been identified. Persons in rural, lower income and minoritized communities are less likely to receive evidence-based, nonpharmacologic care. Telehealth delivery of nonpharmacologic, evidence-based interventions for persons with chronic pain is a promising strategy to lessen disparities, but implementation comes with many challenges. The BeatPain Utah study is a hybrid type I effectiveness-implementation pragmatic clinical trial investigating telehealth strategies to provide nonpharmacologic care from physical therapists to persons with chronic back pain receiving care in Community Health Centers (CHCs). CHCs provide primary care to all persons regardless of ability to pay. This paper outlines the use of implementation mapping to develop a multifaceted implementation plan for the BeatPain study. METHODS: During a planning year for the BeatPain trial we developed a comprehensive logic model including the 5-step implementation mapping process informed by additional frameworks and theories. The five iterative implementation mapping steps were addressed in the planning year; 1) conduct needs assessments for involved groups; 2) identify implementation outcomes, performance objectives and determinants; 3) select implementation strategies; 4) produce implementation protocols and materials; and 5) evaluate implementation outcomes. RESULTS: CHC leadership/providers, patients and physical therapists were identified as involved groups. Barriers and assets were identified across groups which informed identification of performance objectives necessary to implement two key processes; 1) electronic referral of patients with back pain in CHC clinics to the BeatPain team; and 2) connecting patients with physical therapists providing telehealth. Determinants of the performance objectives for each group informed our choice of implementation strategies which focused on training, education, clinician support and tailoring physical therapy interventions for telehealth delivery and cultural competency. We selected implementation outcomes for the BeatPain trial to evaluate the success of our implementation strategies. CONCLUSIONS: Implementation mapping provided a comprehensive and systematic approach to develop an implementation plan during the planning phase for our ongoing hybrid effectiveness-implementation trial. We will be able to evaluate the implementation strategies used in the BeatPain Utah study to inform future efforts to implement telehealth delivery of evidence-based pain care in CHCs and other settings. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT04923334. Registered June 11, 2021 (https://clinicaltrials.gov/study/NCT04923334 American Journal Experts 2023-09-11 /pmc/articles/PMC10543377/ /pubmed/37790359 http://dx.doi.org/10.21203/rs.3.rs-3267087/v1 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. |
spellingShingle | Article Fritz, Julie M Gibson, Bryan Wetter, David W Fiol, Guilherme Del Solis, Victor H Ford, Isaac Lundberg, Kelly Thackeray, Anne Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study |
title | Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study |
title_full | Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study |
title_fullStr | Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study |
title_full_unstemmed | Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study |
title_short | Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study |
title_sort | use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the beatpain utah study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543377/ https://www.ncbi.nlm.nih.gov/pubmed/37790359 http://dx.doi.org/10.21203/rs.3.rs-3267087/v1 |
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