De-implementing Prolonged Rest Advice for Concussion in Primary Care Settings: A Pilot Stepped Wedge Cluster Randomized Trial.
Objective: To evaluate the feasibility and preliminary efficacy of a de-implementation intervention to support return to-activity guideline use after concussion. Setting: Community. Participants: Family physicians in community practice (n = 21 at 5 clinics). Design: Pilot stepped wedge cluster rando...
| Publicado en: | Journal of Head Trauma Rehabilitation Vol. 36; no. 2; pp. 79 - 87 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Mar/Apr2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149612767&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149612767 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08859701 0NX jtl: Journal of Head Trauma Rehabilitation issn: 08859701 maglogo: N pubinfo: dt: Mar/Apr2021 vid: 36 iid: 2 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 149612767 149612767 149612767 10.1097/HTR.0000000000000609 149612767 ppf: 79 ppct: 8 formats: tig: atl: De-implementing Prolonged Rest Advice for Concussion in Primary Care Settings: A Pilot Stepped Wedge Cluster Randomized Trial. aug: au: Silverberg, Noah D. Otamendi, Thalia Panenka, William J. Archambault, Patrick Babul, Shelina MacLellan, Anna Li, Linda C. affil: Division of Physical Medicine & Rehabilitation, The University of British Columbia, Vancouver, Canada sug: subj: Brain Concussion Primary Health Care Rehabilitation, Vocational Pilot Studies Randomized Controlled Trials Physicians, Family Cluster Sample Qualitative Studies Interviews Guideline Adherence Behavioral Changes Implementation Science Descriptive Statistics Human Funding Source ab: Objective: To evaluate the feasibility and preliminary efficacy of a de-implementation intervention to support return to-activity guideline use after concussion. Setting: Community. Participants: Family physicians in community practice (n = 21 at 5 clinics). Design: Pilot stepped wedge cluster randomized trial with qualitative interviews. Training on new guidelines for return to activity after concussion was provided in education outreach visits. Main Measures: The primary feasibility outcomes were recruitment, retention, and postencounter form completion (physicians prospectively recorded what they did for each new patient with concussion). Efficacy indicators included a knowledge test and guideline compliance based on postencounter form data. Qualitative interviews covered Theoretical Domains Framework elements. Results: Recruitment, retention, and postencounter form completion rates all fell below feasibility benchmarks. Family physicians demonstrated increased knowledge about the return-to-activity guideline (M - 8.8 true-false items correct out of 10 after vs 6.3 before) and improved guideline adherence (86% after vs 25% before) after the training. Qualitative interviews revealed important barriers (eg, beliefs about contraindications) and facilitators (eg, patient handouts) to behavior change. Conclusions: Education outreach visits might facilitate de-implementation ofprolonged rest advice after concussion, but methodological changes will be necessary to improve the feasibility of a larger trial. The qualitative findings highlight opportunities for refining the intervention. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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