Trial reportMedical care2019
Change in Patient Outcomes After Augmenting a Low-level Implementation Strategy in Community Practices That Are Slow to Adopt a Collaborative Chronic Care Model: A Cluster Randomized Implementation Trial.
Trial report in Medical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022.Implementation science : IS · 2024Pooled it
- Collaborative care approaches for people with severe mental illness.The Cochrane database of systematic reviews · 2024Pooled it
- Eliminating Inappropriate Postoperative Antibiotics: A Stepped-Wedge Cluster Randomized Trial.Pediatrics · 2026Trial
- Student mental health outcomes of a clustered SMART for developing an adaptive implementation strategy to support school-based CBT delivery.Journal of affective disorders · 2024Trial
- Results of a multi-site pragmatic hybrid type 3 cluster randomized trial comparing level of facilitation while implementing an intervention in community-dwelling disabled and older adults in a Medicaid waiver.Implementation science : IS · 2022Trial
- Primary aim results of a clustered SMART for developing a school-level, adaptive implementation strategy to support CBT delivery at high schools in Michigan.Implementation science : IS · 2022Trial
- Comparative effectiveness of external vs blended facilitation on collaborative care model implementation in slow-implementer community practices.Health services research · 2020Trial
- Real-world quantification of implementation dose across twenty-five implementation instances.Implementation science communications · 2025Article
- Achieving cardiovascular health equity in community mental health: study protocol for a cluster-randomized hybrid Type 3 effectiveness-implementation trial.Implementation science : IS · 2025Article
- Integrating implementation science and intervention optimization.Implementation science : IS · 2025Article
- BDJournal of affective disorders · 2025Article
- Can theory-driven implementation interventions help clinician champions promote opioid stewardship after childbirth? Protocol for a pragmatic implementation study.Frontiers in global women's health · 2025Article
- Intervention Optimization: A Paradigm Shift and Its Potential Implications for Clinical Psychology.Annual review of clinical psychology · 2024Review
- Adaptive Designs in Implementation Science and Practice: Their Promise and the Need for Greater Understanding and Improved Communication.Annual review of public health · 2024Review
- Matters of Fidelity: School Provider Adherence and Competence in a Clustered Study of Adaptive Implementation Strategies.Evidence-based practice in child and adolescent mental health · 2024Article
- Healthy Parent Carers: Acceptability and practicability of online delivery and learning through implementation by delivery partner organisations.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- How does facilitation in healthcare work? Using mechanism mapping to illuminate the black box of a meta-implementation strategy.Implementation science communications · 2023Article
- Stepped implementation-to-target: a study protocol of an adaptive trial to expand access to addiction medications.Implementation science : IS · 2022Article
- Care team and practice-level implementation strategies to optimize pediatric collaborative care: study protocol for a cluster-randomized hybrid type III trial.Implementation science : IS · 2022Article
- The Life Goals Self-Management Mobile App for Bipolar Disorder: Consumer Feasibility, Usability, and Acceptability Study.JMIR formative research · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundImplementation strategies are essential for promoting the uptake of evidence-based practices and for patients to receive optimal care. Yet strategies differ substantially in their intensity and feasibility. Lower-intensity strategies (eg, training and technical support) are commonly used but may be insufficient for all clinics. Limited research has examined the comparative effectiveness of augmentations to low-level implementation strategies for nonresponding clinics.
objectivesTo compare 2 augmentation strategies for improving uptake of an evidence-based collaborative chronic care model (CCM) on 18-month outcomes for patients with depression at community-based clinics nonresponsive to lower-level implementation support. RESEARCH
designProviders initially received support using a low-level implementation strategy, Replicating Effective Programs (REP). After 6 months, nonresponsive clinics were randomized to add either external facilitation (REP+EF) or external and internal facilitation (REP+EF/IF). MEASURES: The primary outcome was patient 12-item short form survey (SF-12) mental health score at month 18. Secondary outcomes were patient health questionnaire (PHQ-9) depression score at month 18 and receipt of the CCM during months 6 through 18.
resultsTwenty-seven clinics were nonresponsive after 6 months of REP. Thirteen clinics (N=77 patients) were randomized to REP+EF and 14 (N=92) to REP+EF/IF. At 18 months, patients in the REP+EF/IF arm had worse SF-12 [diff, 8.38; 95% confidence interval (CI), 3.59-13.18] and PHQ-9 scores (diff, 1.82; 95% CI, -0.14 to 3.79), and lower odds of CCM receipt (odds ratio, 0.67; 95% CI, 0.30-1.49) than REP+EF patients.
conclusionsPatients at sites receiving the more intensive REP+EF/IF saw less improvement in mood symptoms at 18 months than those receiving REP+EF and were no more likely to receive the CCM. For community-based clinics, EF augmentation may be more feasible than EF/IF for implementing CCMs.
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