Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Implementation Science
Published in: Implementation Science 1/2013

Open Access 01-12-2013 | Study protocol

Evaluating the effectiveness of a clinical practice change intervention in increasing clinician provision of preventive care in a network of community-based mental health services: a study protocol of a non-randomized, multiple baseline trial

Authors: Kate Bartlem, Jennifer Bowman, Megan Freund, Paula Wye, Kathleen McElwaine, Jenny Knight, Patrick McElduff, Karen Gillham, John Wiggers

Published in: Implementation Science | Issue 1/2013

Login to get access

Abstract

Background

People with a mental illness experience substantial disparities in health, including increased rates of morbidity and mortality caused by potentially preventable chronic diseases. One contributing factor to such disparity is a higher prevalence of modifiable health risk behaviors, such as smoking, inadequate fruit and vegetable intake, harmful alcohol consumption, and inadequate physical activity. Evidence supports the effectiveness of preventive care in reducing such risks, and guidelines recommend that preventive care addressing such risks be incorporated into routine clinical care. Although community-based mental health services represent an important potential setting for ensuring that people with a mental illness receive such care, research suggests its delivery is currently sub-optimal. A study will be undertaken to evaluate the effectiveness of a clinical practice change intervention in increasing the routine provision of preventive care by clinicians in community mental health settings.

Methods/design

A two-group multiple baseline design will be utilized to assess the effectiveness of a multi-strategic intervention implemented over 12 months in increasing clinician provision of preventive care. The intervention will be implemented sequentially across the two groups of community mental health services to increase provision of client assessment, brief advice, and referral for four health risk behaviors (smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Outcome measures of interest will be collected via repeated cross-sectional computer-assisted telephone interviews undertaken on a weekly basis for 36 months with community mental health clients.

Discussion

This study is the first to assess the effectiveness of a multi-strategic clinical practice change intervention in increasing routine clinician provision of preventive care for chronic disease behavioral risk factors within a network of community mental health services. The results will inform future policy and practice regarding the ability of clinicians within mental health settings to improve preventive care provision as a result of such interventions.

Trial registration

Australian and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693​729.
Appendix
Available only for authorised users
Literature
1.
WHO: The world health report: reducing risks, promoting healthy life. 2002, Geneva: World Health Organization
2.
AIHW: Australia's health 2010. Australia's health series no. 12. Cat. no. AUS 122. 2010, Canberra: AIHW
3.
O'Brien K, AIHW: Living dangerously: Australians with multiple risk factors for cardiovascular disease. 2005, Canberra: AIHW
4.
WHO: Global status report on noncommunicable diseases 2010. 2011, Geneva: World Health Organization
5.
AIHW: 2010 National Drug Strategy Household Survey Report. Drug Statistics Series No 25. Cat no PHE 145. 2011, Canberra: AIHW
6.
Robson D, Gray R: Serious mental illness and physical health problems: a discussion paper. Int J Nurs Stud. 2007, 44: 457-466. 10.1016/j.ijnurstu.2006.07.013.CrossRefPubMed
7.
8.
Coghlan R, Lawrence D, Holman C, Jablensky A: Duty to care: physical illness in people with mental illness. 2001, Perth: The University of Western Australia
9.
National Preventive Health Taskforce: Australia: the healthiest country by 2020-National Preventative Health Strategy-the roadmap for action. 2010
10.
Agency for Healthcare Research and Quality: Guide to Clinical Preventive Services 2010–2011. 2010, Rockville, MD: AHRQ Publication No. 10-05145
11.
NICE: Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care. 2002, London: Clinical guideline 1
12.
Health NSW: Physical health care within mental health services. 2009, Sydney: NSW Department of Health
13.
Glasgow R, Goldstein M, Ockene J, Pronk N: Translating what we have learned into practice: principles and hypotheses for interventions addressing multiple behaviors in primary care. Am J Prev Med. 2004, 27: 88-101. 10.1016/j.amepre.2004.04.019.CrossRefPubMed
14.
Kaner E, Beyer F, Dickinson H, Pienaar E, Campbell E, Schlesinger C, Heather N, Saunders J, Burnand B: Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007, 2: CD004148-PubMed
15.
Rigotti N, Munafo M, Stead L: Interventions for smoking cessation in hospitalised patients. Cochrane Database Syst Rev. 2007, 3: CD001837-PubMed
16.
Eakin E, Lawler S, Vandelanotte C, Owen N: Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med. 2007, 32: 419-434. 10.1016/j.amepre.2007.01.004.CrossRefPubMed
17.
Prochaska J, Nigg C, Spring B, Velicer W: The benefits and challenges of multiple health behavior change in research and in practice. Prev Med. 2010, 50: 26-29. 10.1016/j.ypmed.2009.11.009.CrossRefPubMed
18.
Organ B, Nicholson E, Castle D: Implementing a physical health strategy in a mental health service. Australas Psychiatry. 2010, 18: 456-459. 10.3109/10398562.2010.506217.CrossRefPubMed
19.
Wye P, Bowman J, Wiggers J, Baker A, Knight J, Carr V, Terry M, Clancy C: Smoking restrictions and treatment for smoking: policies and procedures in psychiatric inpatient units in Australia. Psychiatr Serv. 2009, 60: 100-107. 10.1176/appi.ps.60.1.100.CrossRefPubMed
20.
Anderson A, Bowman J, Knight J, Wye P, Terry M, Grimshaw S, Wiggers J: Smoking cessation care provision and support procedures in Australian community mental health centers. Psychiatr Serv. 2013, 64: 707-710. 10.1176/appi.ps.201200213.CrossRefPubMed
21.
Daumit G, Crum R, Guallar E, Ford D: Receipt of preventive medical services at psychiatric visits by patients with severe mental illness. Psychiatr Serv. 2002, 53: 884-887. 10.1176/appi.ps.53.7.884.CrossRefPubMed
22.
Daumit G, Pratt L, Crum R, Powe N, Ford D: Characteristics of primary care visits for individuals with severe mental illness in a national sample. Gen Hosp Psychiatry. 2002, 24: 391-395. 10.1016/S0163-8343(02)00213-X.CrossRefPubMed
23.
Carney C, Allen J, Doebbeling B: Receipt of clinical preventive medical services among psychiatric patients. Psychiatr Serv. 2002, 53: 1028-1030. 10.1176/appi.ps.53.8.1028.CrossRefPubMed
24.
Smith S, Yeomans D, Bushe C, Eriksson C, Harrison T, Holmes R, Mynors-Wallis L, Oatway H, Sullivan G: A well-being programme in severe mental illness. Baseline findings in a UK cohort. Int J Clin Pract. 2007, 61: 1971-1978. 10.1111/j.1742-1241.2007.01605.x.CrossRefPubMedPubMedCentral
25.
Greening J: Physical health of patients in rehabilitation and recovery: a survey of case note records. Psychiatr Bull. 2005, 29: 210-212. 10.1192/pb.29.6.210.CrossRef
26.
Levinson-Miller C, Druss B, Dombrowski E, Rosenheck R: Barriers to primary medical care among patients at a community mental health center. Psychiatr Serv. 2003, 54: 1158-1160. 10.1176/appi.ps.54.8.1158.CrossRefPubMed
27.
Johnson J, Malchy L, Ratner P, Hossain S, Procyshyn R, Bottorff J, Groening M, Gibson P, Osborne M, Schultz A: Community mental healthcare providers' attitudes and practices related to smoking cessation interventions for people living with severe mental illness. Patient Educ Couns. 2009, 77: 289-295. 10.1016/j.pec.2009.02.013.CrossRefPubMed
28.
Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, Dorfman SF, Froelicher ES, Wewers ME: Treating tobacco use and dependence: 2008 update. Clinical practice guidelines. 2008, Rockville, MD: US Department of Health and Human Services. Public Health Service
29.
Flodgren G, Parmelli E, Doumit G, Gattellari M, O'Brien M, Grimshaw J, Eccles M: Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2011, 8: CD000125-10.1002/14651858.CD000125.pub4.PubMed
30.
Jamtvedt G, Young J, Kristofferson D, O'Brien M, Oxman A: Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2006, 2 (Issue 2): CD000259-PubMed
31.
Shojania K, Jennings A, Mayhew A, Ramsay C, Eccles M, Grimshaw J: The effects of on-screen, point of care computer reminders on processes and outcomes of care. Cochrane Database Syst Rev. 2009, 3: CD001096-PubMed
32.
Farmer A, Legare F, Turcot L, Grimshaw J, Harvey E, McGowan J, Wolf F: Printed educational materials: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2008, 3: CD004398-PubMed
33.
Forsetlund L, Bjorndal A, Rashidian A, Jamtvedt G, O'Brien M, Wolf F, Davis D, Odgaard-Jensen J, Oxman A: Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2009, 2: CD003030-PubMed
34.
Wye P: Decreasing risk factors for coronary heart disease: reducing smoking in patients in mental health settings. 2011, NHMRC: NICS Fellowships Project Completion Report
35.
Mangurian C, Miller G, Jackson C, Li H, Essock S, Sederer L: Physical health screening in state mental health clinics: the New York Health Indicator Initiative. Psychiatr Serv. 2010, 61: 346-348. 10.1176/appi.ps.61.4.346.CrossRefPubMed
36.
Hardy S, White J, Deane K, Gray R: Educating healthcare professionals to act on the physical health needs of people with serious mental illness: a systematic search for evidence. J Psychiatr Ment Health Nurs. 2011, 18: 721-727. 10.1111/j.1365-2850.2011.01722.x.CrossRefPubMed
37.
Druss B, Marcus S, Campbell J, Cuffel B, Harnett J, Ingoglia C, Mauer B: Medical services for clients in community mental health centers: results from a national survey. Psychiatrc Serv. 2008, 59: 917-920. 10.1176/appi.ps.59.8.917.CrossRef
38.
NSW Health: NSW community mental health strategy 2007–2012. 2008, Sydney: NSW Department of Health
39.
40.
WHO: Organization of services for mental health. 2003, Geneva: World Health Organization (Mental Health Policy and Service Guidance Package)
41.
Eagar K, Owen A, Cranny C, Samsa P, Thompson C: Community health: the state of play. A report for the NSW Community Health Review. 2008, Wollongong: Centre for Health Service Development, University of Wollongong
42.
Hawkins N, Sanson-Fisher R, Shakeshaft A, D'Este C, Green L: The multiple baseline design for evaluating population-based research. Am J Prev Med. 2007, 33: 162-168. 10.1016/j.amepre.2007.03.020.CrossRefPubMed
43.
Laws R, Kemp L, Harris M, Davies G, Williams A, Eames-Brown R: An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study. Implement Sci. 2009, 4: 66-10.1186/1748-5908-4-66.CrossRefPubMedPubMedCentral
44.
Ministry of Health: New Zealand smoking cessation guidelines. 2007, Wellington: Ministry of Health
45.
Kaufman E: Exploring barriers to primary care for patients with severe mental illness: frontline patient and provider accounts. Issues Ment Health Nurs. 2012, 33: 172-180. 10.3109/01612840.2011.638415.CrossRefPubMed
46.
Dunbar L, Brandt T, Wheeler A, Harrison J: Barriers and solutions to implementing metabolic risk assessment in a secondary mental health service. Australas Psychiatry. 2010, 18: 322-325. 10.3109/10398561003692571.CrossRefPubMed
47.
Schroeder S: What to do with a patient who smokes. JAMA. 2005, 294: 482-487. 10.1001/jama.294.4.482.CrossRefPubMed
48.
Revell C, Schroeder S: Simplicity matters: using system-level changes to encourage clinician intervention in helping tobacco users quit. Nicotine Tob Res. 2005, 7: S67-S69. 10.1080/14622200500078162.CrossRefPubMed
49.
Ministerial Council on Drug Strategy: National tobacco strategy, 2004–2009: the strategy. 2004, Canberra: Commonwealth of Australia
50.
NHMRC: Dietary guidelines for Australian adults. 2003, Canberra: Commonwealth Department of Health and Ageing
51.
NHMRC: Australian guidelines to reduce health risks from drinking alcohol. 2009, Canberra: Commonwealth of Australian
52.
Department of Health and Aged Care: An active way to better health. 1999, Canberra: Australian Government
53.
Bazzano L: The high cost of not consuming fruits and vegetables. J Am Diet Assoc. 2006, 106: 1364-1368. 10.1016/j.jada.2006.06.021.CrossRefPubMed
54.
Nothlings U, Schulze M, Weikert C, Boeing H, van der Schouw Y, Bamia C, Benetou V, Lagiou P, Krogh V, Beulens J, Peeters P, Lund E, Trichopoulo T: Intake of vegetables, legumes, and fruit, and risk for all-cause, cardiovascular, and cancer mortality in a European diabetic population. J Nutr. 2008, 13: 775-781.
55.
Dauchet L, Amouyel P, Hercberg S, Dallongeville J: Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006, 136: 2588-2593.PubMed
56.
Grimshaw J, Eccles M, Lavis J, Hill S, Squires J: Knowledge translation of research findings. Implement Sci. 2012, 7: 10.1186/1748-5908-7-50.
57.
Greenland S, Pearl J, Robins J: Causal diagrams for epidemiologic research. Epidemiol. 1999, 10: 37-48. 10.1097/00001648-199901000-00008.CrossRef
Metadata
Title
Evaluating the effectiveness of a clinical practice change intervention in increasing clinician provision of preventive care in a network of community-based mental health services: a study protocol of a non-randomized, multiple baseline trial
Authors
Kate Bartlem
Jennifer Bowman
Megan Freund
Paula Wye
Kathleen McElwaine
Jenny Knight
Patrick McElduff
Karen Gillham
John Wiggers
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2013
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-8-85

Other articles of this Issue 1/2013

Implementation Science 1/2013 Go to the issue

Debate

Knowledge translation within a population health study: how do you do it?

Study protocol

Improving physician hand hygiene compliance using behavioural theories: a study protocol

Study protocol

Preventive evidence into practice (PEP) study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial

Study protocol

Improving practice in community-based settings: a randomized trial of supervision – study protocol

Methodology

Development of two shortened systematic review formats for clinicians

Research

Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems