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Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial

BACKGROUND: The relationship between health care practices' capacity for change and the results and sustainability of interventions to improve health care delivery is unclear. METHODS: In the setting of an intervention to increase preventive service delivery (PSD), we assessed practice capacity...

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Autores principales: Litaker, David, Ruhe, Mary, Weyer, Sharon, Stange, Kurt C
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396667/
https://www.ncbi.nlm.nih.gov/pubmed/18485216
http://dx.doi.org/10.1186/1748-5908-3-25
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author Litaker, David
Ruhe, Mary
Weyer, Sharon
Stange, Kurt C
author_facet Litaker, David
Ruhe, Mary
Weyer, Sharon
Stange, Kurt C
author_sort Litaker, David
collection PubMed
description BACKGROUND: The relationship between health care practices' capacity for change and the results and sustainability of interventions to improve health care delivery is unclear. METHODS: In the setting of an intervention to increase preventive service delivery (PSD), we assessed practice capacity for change by rating motivation to change and instrumental ability to change on a one to four scale. After combining these ratings into a single score, random effects models tested its association with change in PSD rates from baseline to immediately after intervention completion and 12 months later. RESULTS: Our measure of practices' capacity for change varied widely at baseline (range 2–8; mean 4.8 ± 1.6). Practices with greater capacity for change delivered preventive services to eligible patients at higher rates after completion of the intervention (2.7% per unit increase in the combined effort score, p < 0.001). This relationship persisted for 12 months after the intervention ended (3.1%, p < 0.001). CONCLUSION: Greater capacity for change is associated with a higher probability that a practice will attain and sustain desired outcomes. Future work to refine measures of this practice characteristic may be useful in planning and implementing interventions that result in sustained, evidence-based improvements in health care delivery.
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spelling pubmed-23966672008-05-28 Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial Litaker, David Ruhe, Mary Weyer, Sharon Stange, Kurt C Implement Sci Short Report BACKGROUND: The relationship between health care practices' capacity for change and the results and sustainability of interventions to improve health care delivery is unclear. METHODS: In the setting of an intervention to increase preventive service delivery (PSD), we assessed practice capacity for change by rating motivation to change and instrumental ability to change on a one to four scale. After combining these ratings into a single score, random effects models tested its association with change in PSD rates from baseline to immediately after intervention completion and 12 months later. RESULTS: Our measure of practices' capacity for change varied widely at baseline (range 2–8; mean 4.8 ± 1.6). Practices with greater capacity for change delivered preventive services to eligible patients at higher rates after completion of the intervention (2.7% per unit increase in the combined effort score, p < 0.001). This relationship persisted for 12 months after the intervention ended (3.1%, p < 0.001). CONCLUSION: Greater capacity for change is associated with a higher probability that a practice will attain and sustain desired outcomes. Future work to refine measures of this practice characteristic may be useful in planning and implementing interventions that result in sustained, evidence-based improvements in health care delivery. BioMed Central 2008-05-16 /pmc/articles/PMC2396667/ /pubmed/18485216 http://dx.doi.org/10.1186/1748-5908-3-25 Text en Copyright © 2008 Litaker et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Report
Litaker, David
Ruhe, Mary
Weyer, Sharon
Stange, Kurt C
Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial
title Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial
title_full Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial
title_fullStr Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial
title_full_unstemmed Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial
title_short Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial
title_sort association of intervention outcomes with practice capacity for change: subgroup analysis from a group randomized trial
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396667/
https://www.ncbi.nlm.nih.gov/pubmed/18485216
http://dx.doi.org/10.1186/1748-5908-3-25
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