Implementation Science studies
A Non-Inferiority Comparative Effectiveness Trial of Home-Based Palliative Care in Older Adults (HomePal)
The aim of this pragmatic trial is to compare the effects of a standard home-based palliative care (HBPC) model to a more efficient tech-supported model that includes remote physician supervision/consultation on patient symptom burden and days spent at home in the last 6 months of life and family caregiving preparedness.
An Evaluation of the National Zero Suicide Model across Learning Healthcare Systems
Our project seeks to develop metrics to measure fidelity and outcomes for the National Zero Suicide Model components implemented in each system using electronic health records and insurance claims data sources that are easily extractable and generalizable to other systems. Then, we propose to use these metrics to conduct fidelity and outcome evaluation of the various Zero Suicide Initiative approaches in each system using Interrupted Time Series Designs, which are among the strongest, pragmatic designs appropriate for evaluating care system intervention and policy changes in ‘Learning Healthcare Systems.’ We hypothesize that the implementation of various National Zero Suicide Model components will significantly reduce suicidal behavior within and across the participating systems. We seek to accomplish the following aims: 1) Collaborate with health system leaders to develop EHR metrics to measure specific quality improvement targets and care processes tailored to local Zero Suicide Initiative implementation; 2) examine the fidelity of the specific Zero Suicide Initiative care processes implemented in each system; and 3) investigate suicide attempt and mortality outcomes within and across Zero Suicide Initiative healthcare system models.
Breast cancer screening decisions in younger women: a hybrid effectiveness-implementation study
The major goals of the project are to evaluate the effectiveness of a web-based decision aid on improving knowledge about breast cancer screening in women age 40 to 49 and reducing decisional conflict about breast cancer screening, and to explore the acceptability and feasibility of large-scale implementation.
Developing tailored de-implementation strategies to reduce use of low-value cancer care services
The goal of this mixed methods study is to develop and test interventions to reduce use of surveillance biomarkers for early stage breast cancer patients.
Digital Mindfulness Based Cognitive Therapy for Perinatal Depression
Mindfulness Based Cognitive Therapy (MBCT) an 8-session in-person intervention using mindfulness meditation and cognitive-behavioral strategies, has shown effectiveness in reducing residual depressive symptoms and risk for recurrence among pregnant women with histories of depression. A digital adaptation of MBCT for pregnant women, Mindful Mood Balance for Moms (MMBFM), was recently developed to overcome access barriers to in-person groups and increase potential for scale-up in OB care settings. We will address the following aims for this study: 1) Compare the clinical effectiveness (i.e. engagement and symptom reduction) of MMBFM supported by clinician vs. peer coaches among women with a history of prior depressive episodes; 2) examine specific mechanisms of action for MMBFM participants receiving clinician vs. peer coaching; 3) examine the effects of specific implementation strategies on reach of the MMBFM program; and 4) estimate the cost-effectiveness of MMBFM supported by clinician vs. peer coaches. We hypothesize that MMBFM will be more cost-effective when supported by peer vs. clinician coaches.
Implementing systematic distress screening in breast cancer
This project focuses on implementation and effectiveness of an evidence-based guideline recommendation for systematic distress screening for breast cancer patients.
Translation of a Lung Cancer Palliative Care Intervention for Clinical Practice
The purpose of this study is to test the dissemination of a Palliative Care Intervention (PCI) for patients with non-small cell lung cancer (NSCLC) and their primary family caregivers (FCG)