Optimizing the Implementation of a Population Panel Management Intervention in Safety-Net Clinics for Childhood Hypertension

Project: Research project

Description

are available, yet the diagnosis of HTN in youth is often missed, and management may not follow
guidelines due to the complexity of interpreting youth blood pressure standards, diagnosing HTN, and variable familiarity with HTN in childhood and adolescence among providers. Evidence suggests that wide adherence to HTN guidelines would result in lower risk among youths for target organ damage and HTN-related cardiovascular disease in adulthood. The overarching goal of the 1-year R56 project is to develop a testable and feasible implementation strategy package to increase adherence to clinical practice guidelines for childhood HTN within community health centers (CHCs). The centerpiece of the proposed project is a provider-facing population panel management (PPM) tool with clinical decision support. Prior research indicates that multiple specific implementation strategies are needed to institute practice- and provider-level adoption of PPM tools. Consequently, we will focus on 4 broad strategy types: stakeholder involvement, readiness planning, training, and ongoing audit and feedback. The aims of the project are: Aim 1. Refine a population panel management tool that addresses multilevel implementation barriers and Aim 2. Develop a multicomponent implementation strategy package. Using participatory research methods involving a group of stakeholders (physicians, practice managers) from the AllianceChicago practice-based research network of community health centers, with input from a scientific advisory board, we will 1) tailor an existing PPM tool to adhere to the latest guidelines for childhood HTN and 2) use an adapted concept mapping approach for selection of implementation strategies to support adoption of the tool to change guideline-adherent physician behaviors. Multilevel process evaluation using surveys and key informant interview data will assess the acceptability, adoption, appropriateness, cost, and feasibility of both the PPM tool and its multicomponent implementation strategy. The proposed research has the potential to improve identification, diagnosis, and management of HTN in primary care settings for high-risk youth by implementing best practice guidelines using an EHR-integrated PPM tool with clinical decision support. The developed tool and implementation strategy package will be subsequently tested using in a randomized rollout implementation trial described in the proposed R01 HL148192-01. Should the strategy package for PPM
tool adoption be successful for youth HTN, findings will be translatable to other settings and for PPM of other chronic cardiovascular conditions that affect overall population health.
StatusActive
Effective start/end date9/20/198/31/20

Funding

  • National Heart, Lung, and Blood Institute (1R56HL148192-01)

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Safety-net Providers
Hypertension
Population
Clinical Decision Support Systems
Practice Guidelines
Community Health Centers
Guidelines
Research
Physicians
Primary Health Care
Cardiovascular Diseases
Interviews
Blood Pressure
Costs and Cost Analysis