Implementation of the NHLBI Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Rationale and study design for Young Hearts, Strong Starts, a cluster-randomized trial targeting body mass index, blood pressure, and tobacco

被引：5

作者：

LaBresh, Kenneth A. ^{[1
]}

Lazorick, Suzanne ^{[2
,3
]}

Ariza, Adolfo J. ^{[4
]}

Furberg, Robert D. ^{[5
]}

Whetstone, Lauren ^{[2
,3
]}

Hobbs, Connie ^{[5
]}

de Jesus, Janet ^{[6
]}

Bender, Randall H. ^{[5
]}

Salinas, Ilse G. ^{[4
]}

Binns, Helen J. ^{[4
]}

机构：

[1] RTI Int, Waltham, MA 02451 USA

[2] E Carolina Univ, Brody Sch Med, Dept Pediat, Greenville, NC 27834 USA

[3] E Carolina Univ, Brody Sch Med, Dept Publ Hlth, Greenville, NC 27834 USA

[4] Ann & Robert H Lurie Childrens Hosp Chicago, Res Ctr, Mary Ann & J Milburn Smith Child Hlth Res Program, Pediat Practice Res Grp, Chicago, IL 60611 USA

[5] RTI Int, Res Triangle Pk, NC 27709 USA

[6] NHLBI, Bethesda, MD 20892 USA

来源：

CONTEMPORARY CLINICAL TRIALS | 2014年 / 37卷 / 01期

关键词：

Guideline implementation; Quality improvement; Cardiovascular disease; Prevention; Cluster randomized trial; Children; DETERMINANTS; DISEASE;

D O I：

10.1016/j.cct.2013.11.011

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Background: Cardiovascular disease (CVD) and the underlying atherosclerosis begin in childhood, and their presence and intensity are related to known cardiovascular disease risk factors. Attention to risk factor control in childhood has the potential to reduce subsequent risk of CVD. Objective: The Young Hearts Strong Starts Study was designed to test strategies facilitating adoption of the National, Heart, Lung and Blood Institute supported Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. This study compares guideline-based quality measures for body mass index, blood pressure, and tobacco using two strategies: a multifaceted, practice-directed intervention versus standard dissemination. Study Design: Two primary care research networks recruited practices and provided support for the intervention and outcome evaluations. Individual practices were randomly assigned to the intervention or control groups using a cluster randomized design based on network affiliation, number of clinicians per practice, urban versus nonurban location, and practice type. The units of observation are individual children because measure adherence is abstracted from individual patient's medical records. The units of randomization are physician practices. This results in a multilevel design in which patients are nested within practices. The intervention practices received toolkits and supported guideline implementation including academic detailing, an ongoing e-learning group. This project is aligned with the American Board of Pediatrics Maintenance of Certification requirements including monthly physician self-abstraction, webinars, and other elements of the trial. Significance: This trial will provide an opportunity to demonstrate tools and strategies to enhance CV prevention in children by guideline-based interventions. (C) 2013 Elsevier Inc. All rights reserved.

引用

页码：98 / 105

页数：8