| Title |
Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial)
|
|---|---|
| Published in |
Implementation Science, August 2018
|
| DOI | 10.1186/s13012-018-0795-9 |
| Pubmed ID | |
| Authors |
Joseph E. Glass, Jennifer F. Bobb, Amy K. Lee, Julie E. Richards, Gwen T. Lapham, Evette Ludman, Carol Achtmeyer, Ryan M. Caldeiro, Rebecca Parrish, Emily C. Williams, Paula Lozano, Katharine A. Bradley |
| Abstract |
Experts recommend that alcohol-related care be integrated into primary care (PC) to improve prevention and treatment of unhealthy alcohol use. However, few healthcare systems offer such integrated care. To address this gap, implementation researchers and clinical leaders at Kaiser Permanente Washington (KPWA) partnered to design a high-quality program of evidence-based care for unhealthy alcohol use: the Sustained Patient-centered Alcohol-related Care (SPARC) program. SPARC implements systems of clinical care designed to increase both prevention and treatment of unhealthy alcohol use. This clinical care for unhealthy alcohol use was implemented using three strategies: electronic health record (EHR) decision support, performance monitoring and feedback, and front-line support from external practice coaches with expertise in alcohol-related care ("SPARC implementation intervention" hereafter). The purpose of this report is to describe the protocol of the SPARC trial, a pragmatic, cluster-randomized, stepped-wedge implementation trial to evaluate whether the SPARC implementation intervention increased alcohol screening and brief alcohol counseling (so-called brief interventions), and diagnosis and treatment of alcohol use disorders (AUDs) in 22 KPWA PC clinics. The SPARC trial sample includes all adult patients who had a visit to any of the 22 primary care sites in the trial during the study period (January 1, 2015-July 31, 2018). The 22 sites were randomized to implement the SPARC program on different dates (in seven waves, approximately every 4 months). Primary outcomes are the proportion of patients with PC visits who (1) screen positive for unhealthy alcohol use and have documented brief interventions and (2) have a newly recognized AUD and subsequently initiate and engage in alcohol-related care. Main analyses compare the rates of these primary outcomes in the pre- and post-implementation periods, following recommended approaches for analyzing stepped-wedge trials. Qualitative analyses assess barriers and facilitators to implementation and required adaptations of implementation strategies. The SPARC trial is the first study to our knowledge to use an experimental design to test whether practice coaches with expertise in alcohol-related care, along with EHR clinical decision support and performance monitoring and feedback to sites, increase both preventive care-alcohol screening and brief intervention-as well as diagnosis and treatment of AUDs. The trial is registered at ClinicalTrials.Gov: NCT02675777. Registered February 5, 2016, https://clinicaltrials.gov/ct2/show/NCT02675777 . |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 43% |
| Unknown | 4 | 57% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 2 | 29% |
| Practitioners (doctors, other healthcare professionals) | 2 | 29% |
| Members of the public | 2 | 29% |
| Science communicators (journalists, bloggers, editors) | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 105 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 105 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 14 | 13% |
| Student > Ph. D. Student | 13 | 12% |
| Student > Bachelor | 11 | 10% |
| Student > Master | 9 | 9% |
| Student > Doctoral Student | 4 | 4% |
| Other | 13 | 12% |
| Unknown | 41 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 21% |
| Psychology | 12 | 11% |
| Nursing and Health Professions | 12 | 11% |
| Social Sciences | 7 | 7% |
| Business, Management and Accounting | 2 | 2% |
| Other | 6 | 6% |
| Unknown | 44 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 August 2018.
All research outputs
#6,483,718
of 23,577,654 outputs
Outputs from Implementation Science
#1,088
of 1,728 outputs
Outputs of similar age
#110,381
of 331,781 outputs
Outputs of similar age from Implementation Science
#33
of 38 outputs
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