Evidence map›Paper›PMID 32723386›Full record

ArticleBMC health services research2020

Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study.

Jacqueline R Halladay, Bryan J Weiner, Jung In Kim, Darren A DeWalt, Stephanie Pierson, Jason Fine, Ann Lefebvre, Monique Mackey, Dawn Bergmire, Crystal Cené and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 14% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  4. Trial
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Jacqueline R HalladayDepartment of Family Medicine, School of Medicine, The University of North Carolina at Chapel Hill, 590 Manning Drive, CB #7595, Chapel Hill, NC, 27599-7595, USA. Jacqueline_halladay@med.unc.edu.ORCID http://orcid.org/0000-0002-1300-353X
Bryan J WeinerDepartment of Global Health, University of Washington, Box 357965, Seattle, WA, 98195-7965, USA.
Jung In KimDepartment of Statistics, Eberly College of Science, The Pennsylvania State University, University Park, State College, PA, USA.
Darren A DeWaltDivision of General Medicine and Clinical Epidemiology, Department of Medicine, The University of North Carolina at Chapel Hill, 5034 Old Clinic Bldg, CB #7110, Chapel Hill, NC, 27599-7110, USA.
Stephanie PiersonCecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB #7590, Chapel Hill, NC, 27599-7590, USA.
Jason FineDepartment of Biostatistics, Gilling's School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420, Chapel Hill, NC, 27599-7420, USA.
Ann LefebvreDepartment of Family Medicine, South Carolina Area Health Education Center, Medical University of South Carolina, 5 Charleston Center, Suite 263, Charleston, SC, 29425, USA.
Monique MackeyArea L AHEC, 1631 S Wesleyan Blvd, Rocky Mount, NC, 27804, USA.
Dawn BergmireCecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB #7590, Chapel Hill, NC, 27599-7590, USA.
Crystal CenéDivision of General Medicine and Clinical Epidemiology, Department of Medicine, The University of North Carolina at Chapel Hill, 5034 Old Clinic Bldg, CB #7110, Chapel Hill, NC, 27599-7110, USA.
Kamal HendersonDivision of Cardiology, Department of Medicine, The University of North Carolina at Chapel Hill, 6th Floor, Burnett-Womack Bldg, 160 Dental Circle, CB #7075, Chapel Hill, NC, 27599-7075, USA.
Samuel CykertCecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB #7590, Chapel Hill, NC, 27599-7590, USA.
University of North Carolina at Chapel Hill · USCharleston Area Medical Center · USPennsylvania State University · USUniversity of Washington · US

Funding

AHRQ HHS 1R18HS023912AHRQ HHS R18 HS023912
6 · The paper itself

Abstract

backgroundPractice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. In this analysis, we explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Understanding factors associated with greater engagement with facilitators in practice-based quality improvement can assist practice facilitation programs with planning and resource allocation.

methodsOne hundred thirty-six ambulatory care small to medium sized primary care practices that participated in the EvidenceNow initiative's NC Cooperative, named Heart Health Now (HHN), fit the eligibility criteria for this analysis. We explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month intervention using a retrospective cohort design that included baseline survey data, monthly practice activity implementation data and information about facilitator's experience. Generalized linear mixed-effects models (GLMMs) identified variables associated with greater odds of team engagement using an ordinal scale for level of team engagement.

resultsAmong our practice cohort, over half were clinician-owned and 27% were Federally Qualified Health Centers. The mean number of clinicians was 4.9 (SD 4.2) and approximately 40% of practices were in Medically Underserved Areas (MUA). GLMMs identified a best fit model. The Model presented as odd ratios and 95% confidence intervals suggests greater odds ratios of higher team engagement with greater practice QI leadership 17.31 (5.24-57.19), [0.00], and practice location in a MUA 7.25 (1.8-29.20), [0.005]. No facilitator characteristics were independently associated with greater engagement.

conclusionsOur analysis provides information for practice facilitation stakeholders to consider when considering which practices may be more amendable to embracing facilitation services.

Indexed as

Quality ImprovementCardiovascular DiseasesHumansPatient Care TeamPrimary Health CareRetrospective Studies

Identifiers

PMID32723386
PMCPMC7388469
OpenAlexW3045686860

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.