Effects of Facilitated Team Meetings and Learning Collaboratives on Colorectal Cancer Screening Rates in Primary Care Practices: A Cluster Randomized Trial

Shaw, Eric K.; Ohman‐Strickland, Pamela; Piasecki, Alicja K.; Hudson, Shawna V.; Ferrante, Joan M.; McDaniel, Reuben R.; Nutting, Paul A.; Crabtree, Benjamin F.

doi:10.1370/afm.1505

Cited by 52 publications

(61 citation statements)

References 52 publications

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“…In contrast to the Supporting Colorectal Cancer Outcomes through Participatory Enhancements trial, 33 which showed no significant improvement in colorectal cancer screening after an intervention that combined learning collaboratives and on-site facilitation, in this population-based study we found an improvement in screening comparable to that with other interventions, such as audit and feedback, noted in the Colorectal Cancer Screening in Primary Care Practice study 34 and Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice study. 35 Our results also contrast with those of our chart audit, which failed to show a significant difference in screening rates in a small subsample of patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

et al. 2017

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CMAJ OPEN, 5(2) E281 P rimary health care plays a key role in health care systems in Canada and around the world. 1,2 Studies consistently show that the vast majority of care is delivered in primary care settings [3][4][5][6][7] and that strong primary care systems are associated with improved outcomes and decreased health care costs. 5,8,9 In Ontario, primary care is the backbone of the publicly funded health care system, accounting for about 80% of all visits annually. 7,10 Over the past decade, improving and strengthening primary health care have been key priorities of successive governments in Ontario, which have implemented a series of reforms and initiatives in this key sector. 10 These include changes to payment models for physicians, formal enrolment of patients with primary care providers, support for multidisciplinary teams, support for the adoption of electronic health records and province-wide quality-improvement initiatives. 8,11,12 Family Health Teams represent the most highly reformed model of primary health care in Ontario and include all of the elements described above. 13 There is also consistent evidence that there is room for improvement in the quality of Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

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Section: Discussionmentioning

confidence: 99%

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

et al. 2017

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“…Field notes followed the method of Shaw and colleagues. 15 Immediately after each session, team members synthesized field notes into summaries that were coded and organized with the use of NVivo 10. Questionnaire data were collected after the 6-month intervention and at 12 months.…”

Section: Data Collectionmentioning

confidence: 99%

Impact of the 5As Team study on clinical practice in primary care obesity management: a qualitative study

et al. 2017

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“…60 It would be pertinent to analyze the behavior within each group to understand such changes, as was done in a recent cluster study. 61 We integrated characteristics of the general practitioners into our analysis, and are further evaluating patients' behavior according to these characteristics and the practitioners' practices. This analysis of behavior of each cluster in a clustered response test is one of the challenges of research in primary care.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Cannabis and Young Users—A Brief Intervention to Reduce Their Consumption (CANABIC): A Cluster Randomized Controlled Trial in Primary Care

et al. 2017

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PURPOSE Brief intervention to reduce cannabis is a promising technique that could be adapted for use in primary care, but it has not been well studied in this setting. We tested the efficacy of a brief intervention conducted by general practitioners among cannabis users aged 15 to 25 years. METHODSWe performed a cluster randomized controlled trial with 77 general practitioners in France. The intervention consisted of an interview designed according to the FRAMES (feedback, responsibility, advice, menu, empathy, selfefficacy) model, while the control condition consisted of routine care. RESULTSThe general practitioners screened and followed up 261 young cannabis users. After 1 year, there was no significant difference between the intervention and control groups in the median number of joints smoked per month among all users (17.5 vs 17.5; P = .13), but there was a difference in favor of the intervention among nondaily users (3 vs 10 ; P = .01). After 6 months, the intervention was associated with a more favorable change from baseline in the number of joints smoked (-33.3% vs 0%, P = .01) and, among users younger than age of 18, smoking of fewer joints per month (12.5 vs 20, P = .04).CONCLUSIONS Our findings suggest that a brief intervention conducted by general practitioners with French young cannabis users does not affect use overall. They do, however, strongly support use of brief intervention for younger users and for moderate users. INTRODUCTIONC annabis is the first illegal substance used by young people worldwide.1 Across continents, 7% to 12% of adolescents and teenagers younger than 18 years and 6.6% to 25% of young adults aged 18 to 25 years are monthly users. [1][2][3][4] In Europe, France has the highest consumption of cannabis.3 As of 2014, 25.5% of French adolescents (aged 15 to 17 years) and 17% of young adults (aged 18 to 25 years) were monthly users of cannabis. 5,6 Current data are clear about the risks of cannabis use, 7 which include social and psychiatric risks (eg, anxiety, depression, and an increased incidence of schizophrenia in vulnerable individuals), 8,9 risks of lung and otorhinolaryngeal cancers, 10,11 and cardiovascular risk. [12][13][14] Use before driving increases the likelihood of motor vehicle collision-related morbidity and mortality. [15][16][17][18] During adolescence, cannabis use causes cerebral microstructural changes that are not always reversible and have been implicated in cognitive and psychiatric disorders. 19 In France, 80% of youth aged 15 to 25 years have visited their general practitioner in the preceding year.5 These visits could represent a privileged opportunity to identify young cannabis users and intervene to reduce their consumption. Motivational interviewing is a method of interaction centered on the patient and intended to modify behavior. 33,34 or the general public following media calls for participation. [35][36][37][38][39][40] The initial levels of consumption varied greatly, from once a year 19 to weekly 11,13,14,16 to monthly, [20][21][22]...

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Effects of Facilitated Team Meetings and Learning Collaboratives on Colorectal Cancer Screening Rates in Primary Care Practices: A Cluster Randomized Trial

Cited by 52 publications

References 52 publications

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

Impact of the 5As Team study on clinical practice in primary care obesity management: a qualitative study

Cannabis and Young Users—A Brief Intervention to Reduce Their Consumption (CANABIC): A Cluster Randomized Controlled Trial in Primary Care

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