Evaluating the effectiveness of a clinical practice change intervention in increasing clinician provision of preventive care in a network of community-based mental health services: a study protocol of a non-randomized, multiple baseline trial

Implementation Science

John Wiggers²  Karen Gillham²  Patrick McElduff²  Jenny Knight²  Kathleen McElwaine²  Paula Wye¹  Megan Freund²  Jennifer Bowman¹  Kate Bartlem¹ 

[1] School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;Hunter Medical Research Institute, Clinical Research Centre, Level 3 John Hunter Hospital, Lookout Road, New Lambton Heights, NSW 2305, Australia

关键词: Physical activity;    Alcohol;    Nutrition;    Smoking;    Preventive care;    Community mental health;    Mental health services;    Mental health;    Clinical practice change;    Practice change;   

Others  :  813462
DOI  :  10.1186/1748-5908-8-85

 received in 2013-06-20, accepted in 2013-07-31,  发布年份 2013

【 摘 要 】

Background

People with a mental illness experience substantial disparities in health, including increased rates of morbidity and mortality caused by potentially preventable chronic diseases. One contributing factor to such disparity is a higher prevalence of modifiable health risk behaviors, such as smoking, inadequate fruit and vegetable intake, harmful alcohol consumption, and inadequate physical activity. Evidence supports the effectiveness of preventive care in reducing such risks, and guidelines recommend that preventive care addressing such risks be incorporated into routine clinical care. Although community-based mental health services represent an important potential setting for ensuring that people with a mental illness receive such care, research suggests its delivery is currently sub-optimal. A study will be undertaken to evaluate the effectiveness of a clinical practice change intervention in increasing the routine provision of preventive care by clinicians in community mental health settings.

Methods/design

A two-group multiple baseline design will be utilized to assess the effectiveness of a multi-strategic intervention implemented over 12 months in increasing clinician provision of preventive care. The intervention will be implemented sequentially across the two groups of community mental health services to increase provision of client assessment, brief advice, and referral for four health risk behaviors (smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Outcome measures of interest will be collected via repeated cross-sectional computer-assisted telephone interviews undertaken on a weekly basis for 36 months with community mental health clients.

Discussion

This study is the first to assess the effectiveness of a multi-strategic clinical practice change intervention in increasing routine clinician provision of preventive care for chronic disease behavioral risk factors within a network of community mental health services. The results will inform future policy and practice regarding the ability of clinicians within mental health settings to improve preventive care provision as a result of such interventions.

Trial registration

Australian and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729.

【 授权许可】

   
2013 Bartlem et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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