TY - JOUR
T1 - Implementation of the NHLBI Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents
T2 - Rationale and study design for Young Hearts, Strong Starts, a cluster-randomized trial targeting body mass index, blood pressure, and tobacco
AU - LaBresh, Kenneth A.
AU - Lazorick, Suzanne
AU - Ariza, Adolfo Javier
AU - Furberg, Robert D.
AU - Whetstone, Lauren
AU - Hobbs, Connie
AU - de Jesus, Janet
AU - Bender, Randall H.
AU - Salinas, Ilse G.
AU - Binns, Helen
N1 - Funding Information:
This study was funded by the National Heart, Lung, and Blood Institute , NHLBI-PB-(HL)-2009195D HHSN268200900120U. The sponsor participated in the design of the trial, and the decision to submit the article for publication, and reviewed the publication.
PY - 2014/1
Y1 - 2014/1
N2 - Background: Cardiovascular disease (CVD) and the underlying atherosclerosis begin in childhood, and their presence and intensity are related to known cardiovascular disease risk factors. Attention to risk factor control in childhood has the potential to reduce subsequent risk of CVD. Objective: The Young Hearts Strong Starts Study was designed to test strategies facilitating adoption of the National, Heart, Lung and Blood Institute supported Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. This study compares guideline-based quality measures for body mass index, blood pressure, and tobacco using two strategies: a multifaceted, practice-directed intervention versus standard dissemination. Study Design: Two primary care research networks recruited practices and provided support for the intervention and outcome evaluations. Individual practices were randomly assigned to the intervention or control groups using a cluster randomized design based on network affiliation, number of clinicians per practice, urban versus nonurban location, and practice type. The units of observation are individual children because measure adherence is abstracted from individual patient's medical records. The units of randomization are physician practices. This results in a multilevel design in which patients are nested within practices. The intervention practices received toolkits and supported guideline implementation including academic detailing, an ongoing e-learning group. This project is aligned with the American Board of Pediatrics Maintenance of Certification requirements including monthly physician self-abstraction, webinars, and other elements of the trial. Significance: This trial will provide an opportunity to demonstrate tools and strategies to enhance CV prevention in children by guideline-based interventions.
AB - Background: Cardiovascular disease (CVD) and the underlying atherosclerosis begin in childhood, and their presence and intensity are related to known cardiovascular disease risk factors. Attention to risk factor control in childhood has the potential to reduce subsequent risk of CVD. Objective: The Young Hearts Strong Starts Study was designed to test strategies facilitating adoption of the National, Heart, Lung and Blood Institute supported Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. This study compares guideline-based quality measures for body mass index, blood pressure, and tobacco using two strategies: a multifaceted, practice-directed intervention versus standard dissemination. Study Design: Two primary care research networks recruited practices and provided support for the intervention and outcome evaluations. Individual practices were randomly assigned to the intervention or control groups using a cluster randomized design based on network affiliation, number of clinicians per practice, urban versus nonurban location, and practice type. The units of observation are individual children because measure adherence is abstracted from individual patient's medical records. The units of randomization are physician practices. This results in a multilevel design in which patients are nested within practices. The intervention practices received toolkits and supported guideline implementation including academic detailing, an ongoing e-learning group. This project is aligned with the American Board of Pediatrics Maintenance of Certification requirements including monthly physician self-abstraction, webinars, and other elements of the trial. Significance: This trial will provide an opportunity to demonstrate tools and strategies to enhance CV prevention in children by guideline-based interventions.
KW - Cardiovascular disease
KW - Children
KW - Cluster randomized trial
KW - Guideline implementation
KW - Prevention
KW - Quality improvement
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U2 - 10.1016/j.cct.2013.11.011
DO - 10.1016/j.cct.2013.11.011
M3 - Article
C2 - 24295879
AN - SCOPUS:84890421077
SN - 1551-7144
VL - 37
SP - 98
EP - 105
JO - Contemporary Clinical Trials
JF - Contemporary Clinical Trials
IS - 1
ER -
