Stroke Ready: a multi-level program that combines implementation science and community-based participatory research approaches to increase acute stroke treatment: protocol for a stepped wedge trial.
Background: Post-stroke disability is common, costly, and projected to increase. Acute stroke treatments can substantially reduce post-stroke disability, but few patients take advantage of these cost-effective treatments. Practical, cost-efficient, and sustainable interventions to address underutili...
| Published in: | Implementation Science Vol. 14; no. 1 |
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| Main Authors: | , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Published: |
BioMed Central
3/7/2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135139347&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135139347 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17485908 38MN jtl: Implementation Science issn: 17485908 maglogo: N pubinfo: dt: 3/7/2019 vid: 14 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 135139347 135139347 NLM30845958 10.1186/s13012-019-0869-3 NLM30845958 135139347 ppct: 1 formats: tig: atl: Stroke Ready: a multi-level program that combines implementation science and community-based participatory research approaches to increase acute stroke treatment: protocol for a stepped wedge trial. aug: au: Skolarus, Lesli E. Sales, Anne E. Zimmerman, Marc A. Corches, Casey L. Landis-Lewis, Zach Robles, Maria Cielito McBride, A. Camille Rehman, Narmeen Oliver, Alina Islam, Nishat Springer, Mellanie V. O'Brien, Alison Bailey, Sarah Morgenstern, Lewis B. Meurer, William J. Burke, James F. affil: Stroke Program, University of Michigan Medical School, 1500 E Medical Center Dr, 48109, Ann Arbor, MI, USA sug: subj: Stroke Therapy Stroke Economics Michigan Acute Disease Quality-Adjusted Life Years Treatment Outcomes Stroke Ethnology African Americans Cost Benefit Analysis Clinical Trials Methods Scales ab: Background: Post-stroke disability is common, costly, and projected to increase. Acute stroke treatments can substantially reduce post-stroke disability, but few patients take advantage of these cost-effective treatments. Practical, cost-efficient, and sustainable interventions to address underutilized acute stroke treatments are currently lacking. In this context, we present the Stroke Ready project, a stepped wedge design, multi-level intervention that combines implementation science and community-based participatory research approaches to increase acute stroke treatments in the predominately African American community of Flint, Michigan, USA.Methods: Guided by the Tailored Implementation of Chronic Disease (TICD) framework, we begin with optimization of acute stroke care in emergency departments, with particular attention given to our safety-net hospital partners. Then, we move to a community-wide, multi-faceted, stroke preparedness intervention, with workshops led by peer educators, over 2 years. Measures of engagement of the safety-net hospital and the feasibility and sustainability of the implementation strategy as well as community intervention reach, dose delivered, and satisfaction will be collected. The primary outcome is acute stroke treatment rates, which includes both intravenous tissue plasminogen activator, and endovascular treatment. The co-secondary outcomes are intravenous tissue plasminogen activator treatment rates and the proportion of stroke patients who arrive by ambulance.Discussion: If successful, Stroke Ready will increase acute stroke treatment rates through emergency department and community level interventions. The stepped wedge design and process evaluation will provide insight into how Stroke Ready works and where it might work best. By exploring the relative effectiveness of the emergency department optimization and the community intervention, we will inform hospitals and communities as they determine how best to use their resources to optimize acute stroke care.Trial Registration: ClinicalTrials.gov Trial Identifier NCT03645590 . pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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