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  • 标题:Recruitment activities for a nationwide, population-based, group-randomized trial: the VA MI-Plus study
  • 本地全文:下载
  • 作者:Ellen Funkhouser ; Deborah A Levine ; Joe K Gerald
  • 期刊名称:Implementation Science
  • 印刷版ISSN:1748-5908
  • 电子版ISSN:1748-5908
  • 出版年度:2011
  • 卷号:6
  • 期号:1
  • 页码:105
  • DOI:10.1186/1748-5908-6-105
  • 语种:English
  • 出版社:BioMed Central
  • 摘要:The Veterans Health Administration (VHA) oversees the largest integrated healthcare system in the United States. The feasibility of a large-scale, nationwide, group-randomized implementation trial of VHA outpatient practices has not been reported. We describe the recruitment and enrollment of such a trial testing a clinician-directed, Internet-delivered intervention for improving the care of postmyocardial infarction patients with multiple comorbidities. With a recruitment goal of 200 eligible community-based outpatient clinics, parent VHA facilities (medical centers) were recruited because they oversee their affiliated clinics and the research conducted there. Eligible facilities had at least four VHA-owned and -operated primary care clinics, an affiliated Institutional Review Board (IRB), and no ongoing, potentially overlapping, quality-improvement study. Between December 2003 and December 2005, in two consecutive phases, we used initial and then intensified recruitment strategies. Overall, 48 of 66 (73%) eligible facilities were recruited. Of the 219 clinics and 957 clinicians associated with the 48 facilities, 168 (78%) clinics and 401 (42%) clinicians participated. The median time from initial facility contact to clinic enrollment was 222 days, which decreased by over one-third from the first to the second recruitment phase (medians: 323 and 195 days, respectively; p < .001), when more structured recruitment with physician recruiters was implemented and a dedicated IRB manager was added to the coordinating center staff. Large group-randomized trials benefit from having dedicated physician investigators and IRB personnel involved in recruitment. A large-scale, nationally representative, group-randomized trial of community-based clinics is feasible within the VHA or a similar national healthcare system.
  • 关键词:Veteran Health Administration ; Central Institutional Review Board ; Clinic Enrollment ; Local Principal Investigator ; Veteran Health Administration Health
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