Evidence map›Paper›PMID 41198205›Full record

ArticleBMJ open2025

Implementation strategies to improve adoption of screening and linkages for non-medical drivers of health in care management using enabling technologies: study protocol for a cluster randomised trial.

Nicole Cook, Rose Gunn, Brenda M McGrath, Jenna Donovan, Maura Pisciotta, Constance Owens-Jasey, Hannah L Fein, Anna Templeton, Zoe Larson, Rachel Gold

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06489002 (DEDICATE), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

NCT06489002 naactive not recruitingnot on this map

DEDICATE: aDvancing carE Management aDoption In Community heAlTh cEnters

TypeinterventionalSponsorOCHIN, Inc.Ran2025 to 2028Enrolled20ConditionsSocial Determinants of Health, Primary Care, Diabetes Mellitus, Type 2, HypertensionArmsImplementation Support
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Nicole CookOCHIN, Portland, Oregon, USA cookn@ochin.org.ORCID http://orcid.org/0000-0003-3863-7587
Rose GunnOCHIN, Portland, Oregon, USA.ORCID http://orcid.org/0000-0002-2673-0699
Brenda M McGrathOCHIN, Portland, Oregon, USA.ORCID http://orcid.org/0000-0003-4208-1059
Jenna DonovanOCHIN, Portland, Oregon, USA.ORCID http://orcid.org/0000-0002-2793-0457
Maura PisciottaOCHIN, Portland, Oregon, USA.ORCID http://orcid.org/0000-0003-3120-798X
Constance Owens-JaseyOCHIN, Portland, Oregon, USA.ORCID http://orcid.org/0000-0002-6596-165X
Hannah L FeinOCHIN, Portland, Oregon, USA.
Anna TempletonOCHIN, Portland, Oregon, USA.
Zoe LarsonOCHIN, Portland, Oregon, USA.
Rachel GoldOCHIN, Portland, Oregon, USA.

Funding

DEDICATE: aDvancing carE management aDoption In Community heAlTh cEntersR01NR021115 · NINR · OCHIN, INC. · PI Nicole Jill Cook, RACHEL GOLD · 2023 to 2026
$2.8M
NINR NIH HHS R01 NR021115
6 · The paper itself

Abstract

introductionPractice guidelines recommend addressing patient non-medical drivers of health such as access to nutritious food and transportation as part of whole-person care. Emergent electronic health record (EHR)-based tools can enable non-medical needs care coordination, but adoption commonly faces workflow and infrastructure barriers. Targeted implementation support strategies (eg, training, practice facilitation) can enhance technology adoption in healthcare settings, but no prior research has assessed if implementation strategies can improve how care managers use enabling technologies for non-medical needs care coordination. This study will test whether providing implementation support to primary care health centre care management teams improves the adoption of EHR-based enabling technologies to address patients' non-medical needs. METHODS AND ANALYSIS: This hybrid implementation-effectiveness type 2 pragmatic trial has a mixed methods design. The primary outcomes include: (1) Whether patients enrolled in care management programmes have been screened for unmet non-medical health-related needs and (2) Whether patients with identified unmet non-medical health-related needs received a referral to a community organisation to address their need. The secondary outcomes include: (1) Whether referrals for financial-related non-medical needs had a documented outcome in the EHR, such as successful connection to services, service unavailability or other disposition statuses, (2) Whether the referral outcomes indicated 'successful connection to services' and (3) Clinical markers including hypertension and diabetes control. Formative evaluation of barriers and facilitators to using EHR tools to conduct non-medical needs screening, referrals and tracking of receipt of services will include semi-structured interviews and a 'guided tour' of enabling technology used by care managers. A modified Delphi process will then inform the development of a set of implementation strategies for inclusion in the intervention. The intervention will be piloted in three health centres, refined, then tested in a stepped-wedge cluster-randomised trial in 20 health centres. ETHICS AND DISSEMINATION: We obtained ethics approval for all study activities from Advarra Institutional Review Board (registration number #00000971). Results will be disseminated to Health Centres and Health Centre network nationally at meetings and we will disseminate to researchers via manuscripts in peer-reviewed journals and scientific meetings. TRIAL REGISTRATION NUMBER: NCT06489002.

Indexed as

Electronic Health RecordsPrimary Health CareHumansPragmatic Clinical Trials as TopicHealth EquityHealth informaticsPatient Care ManagementPercieved Social SupportPrimary Care

Identifiers

PMID41198205
PMCPMC12593445

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.