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Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol

BACKGROUND: Alcohol-related care, including screening, brief intervention, and provision of/referral to medication or behavioral treatments for alcohol use disorder, could be delivered in liver clinics to better reach patients with chronic liver conditions. However, the provision of alcohol-related...

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Autores principales: Frost, Madeline C., Ioannou, George N., Tsui, Judith I., Edelman, E. Jennifer, Weiner, Bryan J., Fletcher, Olivia V., Williams, Emily C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393339/
https://www.ncbi.nlm.nih.gov/pubmed/32835226
http://dx.doi.org/10.1186/s43058-020-00062-0
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author Frost, Madeline C.
Ioannou, George N.
Tsui, Judith I.
Edelman, E. Jennifer
Weiner, Bryan J.
Fletcher, Olivia V.
Williams, Emily C.
author_facet Frost, Madeline C.
Ioannou, George N.
Tsui, Judith I.
Edelman, E. Jennifer
Weiner, Bryan J.
Fletcher, Olivia V.
Williams, Emily C.
author_sort Frost, Madeline C.
collection PubMed
description BACKGROUND: Alcohol-related care, including screening, brief intervention, and provision of/referral to medication or behavioral treatments for alcohol use disorder, could be delivered in liver clinics to better reach patients with chronic liver conditions. However, the provision of alcohol-related care in liver clinics is currently suboptimal. Practice facilitation is an evidence-based implementation strategy that may address barriers, harness facilitators, and optimize the implementation of alcohol-related care in liver clinic settings using a clinic-centered approach. We report the protocol of a study to test a practice facilitation intervention to implement alcohol-related care in four Veterans Health Administration liver clinics. METHODS: This study will employ a Hybrid Type 3 effectiveness-implementation design, in which implementation outcomes are considered primary and clinical outcomes secondary. Intervention and evaluation design were informed by the Consolidated Framework for Implementation Research. Qualitative data collected from clinical stakeholders and patients were used to tailor the intervention. The intervention involves a 6-month period of external practice facilitation, including regular meetings to identify clinic goals, challenges, and solutions; engagement of clinic champions; provision of training and development of educational materials for clinic staff and patients; and performance monitoring and feedback. Ongoing formative evaluation involves the collection of quantitative facilitator tracking data and qualitative data from meeting notes and patient interviews to describe intervention acceptability, feasibility, and adoption, and adjust implementation as needed. In the summative evaluation, implementation outcomes (clinic rates of screening, brief intervention, and treatment referral/receipt) and clinical outcomes (unhealthy alcohol use, liver health) will be assessed among patients in participating clinics using secondary electronic health record data and interrupted time series analysis. DISCUSSION: This will be the first study to our knowledge to test practice facilitation to implement alcohol-related care in liver clinic settings. Results from formative and summative evaluation will inform a framework for the successful implementation of effective alcohol-related care through practice facilitation in liver clinics, which may ultimately lead to better health outcomes for patients with chronic liver disease.
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spelling pubmed-73933392020-07-31 Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol Frost, Madeline C. Ioannou, George N. Tsui, Judith I. Edelman, E. Jennifer Weiner, Bryan J. Fletcher, Olivia V. Williams, Emily C. Implement Sci Commun Study Protocol BACKGROUND: Alcohol-related care, including screening, brief intervention, and provision of/referral to medication or behavioral treatments for alcohol use disorder, could be delivered in liver clinics to better reach patients with chronic liver conditions. However, the provision of alcohol-related care in liver clinics is currently suboptimal. Practice facilitation is an evidence-based implementation strategy that may address barriers, harness facilitators, and optimize the implementation of alcohol-related care in liver clinic settings using a clinic-centered approach. We report the protocol of a study to test a practice facilitation intervention to implement alcohol-related care in four Veterans Health Administration liver clinics. METHODS: This study will employ a Hybrid Type 3 effectiveness-implementation design, in which implementation outcomes are considered primary and clinical outcomes secondary. Intervention and evaluation design were informed by the Consolidated Framework for Implementation Research. Qualitative data collected from clinical stakeholders and patients were used to tailor the intervention. The intervention involves a 6-month period of external practice facilitation, including regular meetings to identify clinic goals, challenges, and solutions; engagement of clinic champions; provision of training and development of educational materials for clinic staff and patients; and performance monitoring and feedback. Ongoing formative evaluation involves the collection of quantitative facilitator tracking data and qualitative data from meeting notes and patient interviews to describe intervention acceptability, feasibility, and adoption, and adjust implementation as needed. In the summative evaluation, implementation outcomes (clinic rates of screening, brief intervention, and treatment referral/receipt) and clinical outcomes (unhealthy alcohol use, liver health) will be assessed among patients in participating clinics using secondary electronic health record data and interrupted time series analysis. DISCUSSION: This will be the first study to our knowledge to test practice facilitation to implement alcohol-related care in liver clinic settings. Results from formative and summative evaluation will inform a framework for the successful implementation of effective alcohol-related care through practice facilitation in liver clinics, which may ultimately lead to better health outcomes for patients with chronic liver disease. BioMed Central 2020-07-31 /pmc/articles/PMC7393339/ /pubmed/32835226 http://dx.doi.org/10.1186/s43058-020-00062-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Study Protocol
Frost, Madeline C.
Ioannou, George N.
Tsui, Judith I.
Edelman, E. Jennifer
Weiner, Bryan J.
Fletcher, Olivia V.
Williams, Emily C.
Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol
title Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol
title_full Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol
title_fullStr Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol
title_full_unstemmed Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol
title_short Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol
title_sort practice facilitation to implement alcohol-related care in veterans health administration liver clinics: a study protocol
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393339/
https://www.ncbi.nlm.nih.gov/pubmed/32835226
http://dx.doi.org/10.1186/s43058-020-00062-0
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