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Published in: BMC Primary Care 1/2018

Open Access 01-12-2018 | Study protocol

A protocol for a cluster randomized trial comparing strategies for translating self-management support into primary care practices

Authors: W. Perry Dickinson, L. Miriam Dickinson, Bonnie T. Jortberg, Danielle M. Hessler, Douglas H. Fernald, Lawrence Fisher

Published in: BMC Primary Care | Issue 1/2018

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Abstract

Background

Advanced primary care models emphasize patient-centered care, including self-management support (SMS), but the effective use of SMS for patients with type 2 diabetes (T2DM) remains a challenge. Interactive behavior-change technology (IBCT) can facilitate the adoption of SMS interventions. To meet the need for effective SMS intervention, we have developed Connection to Health (CTH), a comprehensive, evidence-based SMS program that enhances interactions between primary care clinicians and patients to resolve self-management problems and improve outcomes. Uptake and maintenance of programs such as CTH in primary care have been limited by the inability of practices to adapt and implement program components into their culture, patient flow, and work processes. Practice facilitation has been shown to be effective in helping practices make the changes required for optimal program implementation. The proposed research is designed to promote the translation of SMS into primary care practices for patients with T2DM by combining two promising lines of research, specifically, (a) testing the effectiveness of CTH in diverse primary-care practices, and (b) evaluating the impact of practice facilitation to enhance implementation of the intervention.

Methods

A three-arm, cluster-randomized trial will evaluate three discrete strategies for implementing SMS for patients with T2DM in diverse primary care practices. Practices will be randomly assigned to receive and implement the CTH program, the CTH program plus practice facilitation, or a SMS academic detailing educational intervention. Through this design, we will compare the effectiveness, adoption and implementation of these three SMS practice implementation strategies. Primary effectiveness outcomes including lab values and evidence of SMS will be abstracted from medical records covering baseline through 18 months post-baseline. Data from CTH assessments and action plans completed by patients enrolled in CTH will be used to evaluate practice implementation of CTH and the impact of CTH participation. Qualitative data including field notes from encounters with the practices and interviews of practice personnel will be analyzed to assess practice implementation of SMS.

Discussion

This study will provide important information on the implementation of SMS in primary care, the effectiveness of an IBCT tool such as CTH, and the use of practice facilitation to assist implementation.

Trial registration

Registered with ClinicalTrials.gov – ClinicalTrials.gov ID: NCT01945918, date 08/27/2013. Modifications have been updated.
Literature
1.
IOM Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.
2.
Wagner EH, Austin BT, Von Korff M. Improving outcomes in chronic illness. Manag Care Q. 1996;4:12–25.PubMed
3.
Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Millbank Q. 1996;74:511–44.CrossRef
4.
Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002;288:1775–9.CrossRefPubMed
5.
Bodenheimer T, Wagner EH, Grumback K. Improving primary care for patients with chronic illness: the chronic care model, part 2. JAMA. 2002;288:1909–14.CrossRefPubMed
6.
Berenson RA, Hammons T, Gans DN, Zuckerman S, Merrell K, Underwood WS, Williams AF. A house is not a home: keeping patients at the center of practice redesign. Health Aff (Millwood). 2008;27:1219–30.CrossRef
7.
Grumbach K, Bodenheimer T. A primary care home for Americans: putting the house in order. JAMA. 2002;288:889–93.CrossRefPubMed
8.
Riley KM, Glasgow RE, Eakin EG. Resources for health: a social-ecological intervention for supporting self-management of chronic conditions. J Health Psychol. 2001;6:693–705.CrossRefPubMed
9.
Glasgow RE, Toobert DJ, Hampson SE. Effects of a brief office-based intervention to facilitate diabetes dietary self-management. Diabetes Care. 1996;19:835–42.CrossRefPubMed
10.
Barrera M, Toobert DJ, Angell KL, Glasgow RE, MacKinnon DP. Social support and social-ecological resources as mediators of lifestyle intervention effects for type 2 diabetes. J Health Psychol. 2006;11:483–95.CrossRefPubMed
11.
Schillinger D, Handley M, Wang F, Hammer H. Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes: a three-arm practical clinical trial. Diabetes Care. 2009;32:559–66.CrossRefPubMedPubMedCentral
12.
Norris SL, Engelgau MM, Narayan KM. Effectiveness of self-management training in type 2 diabetes. A systematic review of randomized control trials. Diabetes Care. 2001;24:561–87.CrossRefPubMed
13.
Tallia AF, Stange KC, McDaniel RR Jr, Aita VA, Miller WL, Crabtree BF. Understanding organizational designs of primary care practices. J Healthc Manag. 2003;48:45–59. discussion 60-41CrossRefPubMed
14.
Solberg LI, Brekke ML, Fazio CJ, Fowles J, Jacobsen DN, Kottke TE, Mosser G, O'Connor PJ, Ohnsorg KA, Rolnick SJ. Lessons from experienced guideline implementers: attend to many factors and use multiple strategies. Jt Comm J Qual Improv. 2000;26:171–88.PubMed
15.
Jaen CR. Successful health information technology implementation requires practice and health care system transformation. Ann Fam Med. 2011;9:388–9.
16.
Sittig DF, Ash JS. On the importance of using a multidimensional sociotechnical model to study health information technology. Ann Fam Med. 2011;9:390–1.
17.
Glasgow RE, Bull SS, Piette JD, Steiner JF. Interactive behavior change technology. A partial solution to the competing demands of primary care. Am J Prev Med. 2004;27:80–7.CrossRefPubMed
18.
Glasgow RE. Interactive media for diabetes self-management: issues in maximizing public health impact. Med Decis Mak. 2010;30:745–58.
19.
Oenema A, Brug J, Dijkstra A, de Weerdt I, de Vries H. Efficacy and use of an internet-delivered computer-tailored lifestyle intervention, targeting saturated fat intake, physical activity and smoking cessation: a randomized controlled trial. Ann Behav Med. 2008;35:125–35.CrossRefPubMed
20.
Prochaska JO, Velicer WF, Redding C, Rossi JS, Goldstein M, DePue J, Greene GW, Rossi SR, Sun X, Fava JL, et al. Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms. Prev Med. 2005;41:406–16.CrossRefPubMed
21.
Vandelanotte C, De Bourdeaudhuij I, Brug J. Two-year follow-up of sequential and simultaneous interactive computer-tailored interventions for increasing physical activity and decreasing fat intake. Ann Behav Med. 2007;33:213–9.CrossRefPubMed
22.
Glasgow RE, Edwards LL, Whitesides H, Carroll N, Sanders TJ, McCray BL. Reach and effectiveness of DVD and in-person diabetes self-management education. Chronic Illn. 2009;5:243–9.CrossRefPubMed
23.
Rabin BA, Glasgow RE. Dissemination and implementation of interactive health communication applications. In: Noar SM, Harrington NG, editors. eHealth applications : promising strategies for health behavior change. New York: Routledge; 2011.
24.
Brug J, Oenema A, Campbell M. Past, present, and future of computer-tailored nutrition education. Am J Clin Nutr. 2003;77:1028S–34S.CrossRefPubMed
25.
Tate DF, Jackvony EH, Wing RR. Effects of internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA. 2003;289:1833–6.CrossRefPubMed
26.
Oenema A, Brug J, Lechner L. Web-based tailored nutrition education: results of a randomized controlled trial. Health Educ Res. 2001;16:647–60.CrossRefPubMed
27.
Vandelanotte C, De Bourdeaudhuij I, Brug J. Acceptability and feasibility of an interactive computer-tailored fat intake intervention in Belgium. Health Promot Int. 2004;19:463–70.CrossRefPubMed
28.
Wanner M, Martin-Diener E, Braun-Fahrlander C, Bauer G, Martin BW. Effectiveness of active-online, an individually tailored physical activity intervention, in a real-life setting: randomized controlled trial. J Med Internet Res. 2009;11:e23.CrossRefPubMedPubMedCentral
29.
Spittaels H, De Bourdeaudhuij I, Brug J, Vandelanotte C. Effectiveness of an online computer-tailored physical activity intervention in a real-life setting. Health Educ Res. 2007;22:385–96.CrossRefPubMed
30.
Steele R, Mummery WK, Dwyer T. Using the internet to promote physical activity: a randomized trial of intervention delivery modes. J Phys Act Health. 2007;4:245–60.CrossRefPubMed
31.
Strecher VJ, McClure J, Alexander G, Chakraborty B, Nair V, Konkel J, Greene S, Couper M, Carlier C, Wiese C, et al. The role of engagement in a tailored web-based smoking cessation program: randomized controlled trial. J Med Internet Res. 2008;10:e36.CrossRefPubMedPubMedCentral
32.
Strecher VJ, McClure JB, Alexander GL, Chakraborty B, Nair VN, Konkel JM, Greene SM, Collins LM, Carlier CC, Wiese CJ, et al. Web-based smoking-cessation programs: results of a randomized trial. Am J Prev Med. 2008;34:373–81.CrossRefPubMedPubMedCentral
33.
Austin, Boren S, Gunlock TL, Krishna S, Kramer TC. Computer-aided diabetes education: a synthesis of randomized controlled trials. AMIA Annu Symp Proc. 2006:51–5.
34.
Welch G, Weinger K, Anderson B, Polonsky WH. Responsiveness of the problem areas in diabetes (PAID) questionnaire. Diabet Med. 2003;20:69–72.CrossRefPubMed
35.
Bennett GG, Glasgow RE. The delivery of public health interventions via the internet: actualizing their potential. Annu Rev Public Health. 2009;30:273–92.CrossRefPubMed
36.
Strecher V. Internet methods for delivering behavioral and health-related interventions (eHealth). Annu Rev Clin Psychol. 2007;3:53–76.CrossRefPubMed
37.
Bandura A, editor. Self-efficacy: the exercise of control. New York: W.H. Freeman; 1997.
38.
Glasgow RE. A practical model of diabetes management and education. Diabetes Care. 1995;18:117–26.CrossRefPubMed
39.
Glasgow RE, Eakin EG. Issues in diabetes self-management. In: Shumaker SA, Schron EB, Ockene JK, McBee WL, editors. The handbook of health behavior change 2nd edition. New York: Springer Publishing Company; 1998. p. 435–61.
40.
Glasgow RE, Strycker LA, Toobert DJ, Eakin E. A social-ecologic approach to assessing support for disease self-management: the chronic illness resources survey. J Behav Med. 2000;23:559–83.CrossRefPubMed
41.
McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15:351–77.CrossRefPubMed
42.
Stokols D, Allen J, Bellingham RL. The social ecology of health promotion: implications for research and practice. Am J Health Promot. 1996;10:247–51.CrossRefPubMed
43.
Battersby M, Von Korff M, Schaefer J, Davis C, Ludman E, Greene SM, Parkerton M, Wagner EH. Twelve evidence-based principles for implementing self-management support in primary care. Jt Comm J Qual Patient Saf. 2010;36:561–70.CrossRefPubMed
44.
Daubenmier JJ, Weidner G, Sumner MD, Mendell N, Merritt-Worden T, Studley J, Ornish D. The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the multisite cardiac lifestyle intervention program. Ann Behav Med. 2007;33:57–68.CrossRefPubMed
45.
Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med. 2001;345:892–902.CrossRefPubMed
46.
Brochu M, Poehlman ET, Ades PA. Obesity, body fat distribution, and coronary artery disease. J Cardpulm Rehabil. 2000;20:96–108.CrossRef
47.
48.
Baron RJ. Quality improvement with an electronic health record: achievable, but not automatic. Ann Intern Med. 2007;147:549–52.CrossRefPubMed
49.
Crosson JC, Etz RS, Wu S, Straus SG, Eisenman D, Bell DS. Meaningful use of electronic prescribing in 5 exemplar primary care practices. Ann Fam Med. 2011;9:392–7.
50.
Crosson J, Isaacson N, Lancaster D, McDonald E, Schueth A, DiCicco-Bloom B, Newman J, Wang C, Bell D. Variation in electronic prescribing implementation among twelve ambulatory practices. J Gen Intern Med. 2008;23:364–71.CrossRefPubMedPubMedCentral
51.
Baron RJ, Desnouee E. Practice profile. The struggle to support patients' efforts to change their unhealthy behavior. Health Aff (Millwood). 2010;29:953–5.
52.
Harvey G, Loftus-Hills A, Rycroft-Malone J, Titchen A, Kitson A, McCormack B, Seers K. Getting evidence into practice: the role and function of facilitation. J Adv Nurs. 2002;37:577–88.CrossRefPubMed
53.
Nagykaldi Z, Mold JW, Aspy CB. Practice facilitators: a review of the literature. Fam Med. 2005;37:581–8.PubMed
54.
Goodwin MA, Zyzanski SJ, Zronek S, Ruhe M, Weyer SM, Konrad N, Esola D, Stange KC. A clinical trial of tailored office systems for preventive service delivery. The study to enhance prevention by understanding practice (STEP-UP). [see comments]. Am J Prev Med. 2001;21:20–8.CrossRefPubMed
55.
Margolis PA, Lannon CM, Stuart JM, Fried BJ, Keyes-Elstein L, Moore DE Jr. Practice based education to improve delivery systems for prevention in primary care: randomised trial. BMJ. 2004;328:388.CrossRefPubMedPubMedCentral
56.
Stange KC, Goodwin MA, Zyzanski SJ, Dietrich AJ. Sustainability of a practice-individualized preventive service delivery intervention. Am J Prev Med. 2003;25:296–300.CrossRefPubMed
57.
Hogg W, Baskerville N, Nykiforuk C, Mallen D. Improved preventive care in family practices with outreach facilitation: understanding success and failure. J Health Serv Res Policy. 2002;7:195–201.CrossRefPubMed
58.
Buscaj E, Hall T, Montgomery L, Fernald DH, King J, Deaner N, Dickinson WP. Practice facilitation for PCMH implementation in residency practices. Fam Med. 2016;48:795–800.PubMed
59.
White DE, Straus SE, Stelfox HT, Holroyd-Leduc JM, Bell CM, Jackson K, Norris JM, Flemons WW, Moffatt ME, Forster AJ. What is the value and impact of quality and safety teams? A scoping review. Implement Sci. 2011;6:97.
60.
Ivers NM, Halperin IJ, Barnsley J, Grimshaw JM, Shah BR, Tu K, Upshur R, Zwarenstein M. Allocation techniques for balance at baseline in cluster randomized trials: a methodological review. Trials. 2012;13:120.CrossRefPubMedPubMedCentral
61.
Alexander F, Roberts MM, Lutz W, Hepburn W. Randomisation by cluster and the problem of social class bias. J Epidemiol Community Health. 1989;43:29–36.CrossRefPubMedPubMedCentral
62.
Shah S, Peat JK, Mazurski EJ, Wang H, Sindhusake D, Bruce C, Henry RL, Gibson PG. Effect of peer led programme for asthma education in adolescents: cluster randomised controlled trial. BMJ. 2001;322:583–5.CrossRefPubMedPubMedCentral
63.
Carman WF, Elder AG, Wallace LA, McAulay K, Walker A, Murray GD, Stott DJ. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet. 2000;355:93–7.CrossRefPubMed
64.
Dickinson LM, Beaty B, Fox C, Pace W, Dickinson WP, Emsermann C, Kempe A. Pragmatic cluster randomized trials using covariate constrained randomization: a method for practice-based research networks (PBRNs). J Am Board Fam Med. 2015;28:663–72.CrossRefPubMed
65.
Li F, Lokhnygina Y, Murray DM, Heagerty PJ, DeLong ER. An evaluation of constrained randomization for the design and analysis of group-randomized trials. Stat Med. 2016;35:1565–79.CrossRefPubMed
66.
67.
Puffer S, Torgerson D, Watson J. Evidence for risk of bias in cluster randomised trials: review of recent trials published in three general medical journals. BMJ. 2003;327:785–9.CrossRefPubMedPubMedCentral
68.
69.
Murray D, editor. Design and analysis of group-randomized trials. New York: Oxford University Press; 1998.
70.
Liddy C, wiens M, Hogg W. Methods to achieve high interrater reliability in data collection from primary care medical records. Ann Fam Med. 2011;9:57–62.CrossRefPubMedPubMedCentral
71.
Glasgow RE, Dickinson WP, Fisher L, Christiansen S, Toobert DJ, Bender BG, Dickinson LM, Jortberg B, Estabrooks PA: Patient-Centered Assessment, communication, and Outcomes in the Primary Care Medical Home: Use of RE-AIM to Develop a Multi-Media Facilitation Tool. Implementation Science. In Press.
72.
Glasgow RE, McKay HG, Piette JD, Reynolds KD. The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management? Patient Educ Couns. 2001;44:119–27.CrossRefPubMed
73.
Glasgow RE, Linnan LA. Evaluation of theory-based interventions. In: Glanz K, Rimer BK, Viswanath K, editors. Health Behavior and Health Education: Theory, Research, and Practice 4th ed. San Francisco: Jossey-Bass; 2008. p. 487–508.
74.
Gaglio B, Glasgow RE. Evaluation Approaches for Dissemination and Implementation Research. In: Brownson RC, Colditz GA, Proctor EK, editors. Dissemination and implementation research in health : translating science to practice. Oxford: Oxford University Press; 2010.
75.
Belza B, Toobert DJ, Glasgow RE. RE-AIM for program planning: overview and applications: Center for Healthy Aging Issue Brief. VA: National Council on Aging in Arlington; 2007.
76.
Toobert DJ. RE-AIM: application to AoA evidence-based demonstration projects. In: 3rd annual Agency on Aging grantees conference. Washington, D.C. p. 2006.
77.
78.
Glasgow R, Emmons KM. The public health need for patient-reported measures and health behaviors in electronic health records: a policy statement of the Society of Behavioral Medicine. Translational Behav Med. 2011;1:108–9.
79.
Paxton AE, Strycker LA, Toobert DJ, Ammerman AS, Glasgow RE. Starting the conversation performance of a brief dietary assessment and intervention tool for health professionals. Am J Prev Med. 2011;40:67–71.
80.
Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23:943–50.CrossRefPubMed
81.
Jilcott SB, Keyserling TC, Samuel-Hodge CD, Johnston LF, Gross MD, Ammerman AS. Validation of a brief dietary assessment to guide counseling for cardiovascular disease risk reduction in an underserved population. J Am Diet Assoc. 2007;107:246–55.CrossRefPubMed
82.
Moshfegh A, Goldman J, Ahuja J, Rhodes D, LaComb R: What We Eat in America, NHANES 2005–2006: Usual nutrient intakes from food and water compared to 1997 Dietary Reference Intakes for Vitamin D, Calcium, Phosphorous, and Magnesium. Beltsville: U.S. Department of Agriculture, Agricultural Research Service; 2009.
83.
Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.CrossRefPubMed
84.
Bender BG, Bartlett SJ, Rand CS, Turner C, Wamboldt FS, Zhang L. Impact of interview mode on accuracy of child and parent report of adherence with asthma-controller medication. Pediatrics. 2007;120:e471–7.CrossRefPubMed
85.
Bender BG, Rankin A, Tran ZV, Wamboldt FS. Brief-interval telephone surveys of medication adherence and asthma symptoms in the childhood asthma management program continuation study. Ann Allergy Asthma Immunol. 2008;101:382–6.CrossRefPubMedPubMedCentral
86.
Horne R, Weinman J. Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47:555–67.CrossRefPubMed
87.
Dawson DA, Grant BF, Li TK. Quantifying the risks associated with exceeding recommended drinking limits. Alcohol Clin Exp Res. 2005;29:902–8.CrossRefPubMed
88.
89.
Ory MG, Jordan PJ, Bazzarre T. The behavior change consortium: setting the stage for a new century of health behavior-change research. Health Educ Res. 2002;17:500–11.CrossRefPubMed
90.
91.
Kroenke K, Spitzer RL, Williams JB, Lowe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50:613–21.PubMed
92.
Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed
93.
Fisher L, Skaff MM, Mullan JT, Arean P, Glasgow R, Masharani U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes. Diabet Med. 2008;25:1096–101.CrossRefPubMedPubMedCentral
94.
Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, Jackson RA. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005;28:626–31.CrossRefPubMed
95.
Raudenbush SW, Liu X. Statistical power and optimal design for multisite randomized trials. Psychol Methods. 2000;5:199–213.CrossRefPubMed
96.
Hedeker D, Gibbons RD, Waternaux C. Sample size estimation for longitudinal designs with attrition. J Educ Behav Stat. 1999;24:70–93.CrossRef
97.
Dempster AP, Laird NM, Rubin DB: Maximum likelihood estimation from incomplete data via the EM algorithm. J R Stat Soc 1977;Series B:1–38.
98.
Little RJA, Rubin DB. Statistical analysis with missing data. New York: Wiley; 1987.
99.
Fairclough D, editor. Design and analysis of quality of life studies in clinical trials. Boca Raton: Chapman & Hall/CRC; 2002.
100.
Diggle P, Kenward MG. Informative drop-out in longitudinal data-analysis. J R Stat Soc Ser C Appl Stat. 1994;43:49–93.
101.
Littell R, Milliken GA, Stroup WW, Wolfinger RD, editors. SAS System for Mixed Models. Cary: SAS Institute Inc; 1996.
102.
Hedeker D, Gibbons RD. Longitudinal Data Analysis. Hoboken, New Jersey: Wiley; 2006.
103.
Raman R, Hedeker D. A mixed-effects regression model for three-level ordinal response data. Stat Med. 2005;24:3331–45.CrossRefPubMed
104.
Bryk AS, Raudenbush SW, editors. Hierarchical Linear Models: Applications and Data Analysis Methods., Second edition. Newbury Park: Sage Publications; 2000.
105.
Miller WL, Crabtree BF. The dance of interpretation. In: Crabtree BF, Miller WL, editors. 2nd edition. Thousand Oaks: Sage Publications, Inc; 1999. p. 127–43.
106.
Vale MJ, Jelinek MV, Best JD, Dart AM, Grigg LE, Hare DL, Ho BP, Newman RW, JJ MN, Group CS. Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med. 2003;163:2775–83.CrossRefPubMed
107.
Holmes-Rovner M, Stommel M, Corser WD, Olomu A, Holtrop JS, Siddiqi A, Dunn SL. Does outpatient telephone coaching add to hospital quality improvement following hospitalization for acute coronary syndrome? J Gen Intern Med. 2008;23:1464–70.CrossRefPubMedPubMedCentral
108.
Whittemore R, Melkus GD, Sullivan A, Grey M. A nurse-coaching intervention for women with type 2 diabetes. Diabetes Educ. 2004;30:795–804.CrossRefPubMed
Metadata
Title
A protocol for a cluster randomized trial comparing strategies for translating self-management support into primary care practices
Authors
W. Perry Dickinson
L. Miriam Dickinson
Bonnie T. Jortberg
Danielle M. Hessler
Douglas H. Fernald
Lawrence Fisher
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2018
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-018-0810-x

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