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Contemp Clin Trials. 2019 Sep;84:105816. doi: 10.1016/j.cct.2019.105816. Epub 2019 Jul 22.

A virtual learning collaborative to implement health promotion in routine mental health settings: Protocol for a cluster randomized trial.

Author information

1
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, United States of America. Electronic address: Kelly.Aschbrenner@dartmouth.edu.
2
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, United States of America. Electronic address: Sarah.Pratt@dartmouth.edu.
3
Westat, Lebanon, NH, United States of America. Electronic address: GaryBond@westat.com.
4
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, United States of America; White River Junction VAMC, White River Junction, VT, United States of America. Electronic address: Lisa.Zubkoff@dartmouth.edu.
5
Department of Global Health & Social Medicine, Harvard Medical School, Boston, MA, United States of America. Electronic address: John_Naslund@hms.harvard.edu.
6
Ken Jue Consulting, Keene, NH, United States of America. Electronic address: ken@kenjue.com.
7
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America. Electronic address: Gail.E.Williams@dartmouth.edu.
8
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America. Electronic address: Allison.R.Kinney@dartmouth.edu.
9
MJC Health Solutions, Amherst, NH, United States of America. Electronic address: michael@mjchealthsolutions.com.
10
The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, United States of America. Electronic address: Marjorie.M.Godfrey@dartmouth.edu.
11
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America; The Mongan Institute, Massachusetts General Hospital, Boston, MA, United States of America. Electronic address: SJBARTELS@mgh.harvard.edu.

Abstract

BACKGROUND:

Despite widespread use of learning collaboratives in health care, few randomized trials have evaluated their effectiveness. The primary aim of this cluster randomized implementation trial is to evaluate the effectiveness of a virtual learning collaborative (VLC) in the implementation of a lifestyle intervention for persons with serious mental illness (SMI) in routine mental health settings, compared to standard individual technical assistance.

METHODS:

Forty-eight mental health provider organizations from across the United States will be recruited to participate in the trial. The evidence-based practice to be implemented is the InSHAPE health promotion intervention for persons with SMI. Sites will be stratified by size and randomized to receive an 18-month intensive group-based VLC with monthly learning sessions or individual technical assistance with four scheduled conference calls over 18 months. Sites will be enrolled in three blocks of 16 sites each. The primary outcomes are InSHAPE program participation and fidelity, and participant weight loss; secondary outcomes are program operation, program uptake, participant health behaviors of physical activity and nutrition, organizational change, and program sustainment. Implementation outcomes are measured at 3, 6, 12, 18, and 24 months after the program start-up. Participant-level outcomes are measured at fixed intervals every 3 months after each participant enrolls in the study.

DISCUSSION:

This study will determine whether VLCs are an effective implementation strategy among resource-limited providers when the new practice necessitates a shift in mission, scope of practice, type of services delivered, and new financing.

TRIAL REGISTRATION:

ClinicalTrials.gov identifier: NCT03891368 Registered 25 March 2019, retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03891368?term=NCT03891368&rank=1.

KEYWORDS:

Fidelity; Health promotion; Implementation strategy; Learning collaborative; Serious mental illness

PMID:
31344520
DOI:
10.1016/j.cct.2019.105816

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