ArticleFrontiers in health services2026
Bridging evidence and practice: multi-method evaluation of implementation fidelity of a multilevel hypertension intervention in a federally qualified health center.
Article in Frontiers in health services, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03713515 (Bridging the Evidence-to-practice Gap), which is not on this map. Not yet cited in PubMed.
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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.
Bridging the Evidence-to-practice Gap: Evaluating Practice Facilitation as a Strategy to Accelerate Translation of a Systems-level Adherence Intervention Into Safety Net Practices
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Authors and funding
9 authors.
Funding
Abstract
Background: Multilevel interventions targeting patients, providers, and health systems improve hypertension outcomes, but little is known about how well they are implemented in resource-limited settings. This study evaluated the implementation fidelity of ALTA, a multilevel approach for hypertension management, supported by practice facilitation, across six primary care practices in a Federally Qualified Health Center (FQHC). Methods: ALTA included five components delivered by FQHC staff. At the practice level, staff: (1) Results: From 2022-2024, 124 staff across 6 FQHC sites implemented ALTA. Implementation adherence varied across sites. The identify component ranged from 49.0% to 57.9% across sites, while the refer component showed greater variability, ranging from 50.0% to 84.4%. Enrollment into health coaching also varied substantially, ranging from 20.8% to 88.5% across sites. The centralized nurse-led team delivered coaching to 91.4% of enrolled patients, completed all documentation, and conducted monitoring for 94.5%. Median implementation dose (patient exposure) was six coaching visits over 5.5 months, and 2.1 BP readings per week. Implementation quality was high, with comprehensive documentation of coaching visits. Six fidelity-consistent adaptations were made to improve feasibility, including simplifying the adherence screener and adding asynchronous training. Interviews ( Conclusions: Implementation fidelity varied across the ALTA components and participating sites, with the greatest variability observed in delivery of the site-level components of identify and refer. Centralized components delivered by the nurse-led team (coach, document, monitor) were delivered consistently with high fidelity. Contextual factors like staffing and patient engagement shaped implementation success. Clinical Trial Registration: ClinicalTrials.gov, NCT03713515.
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