self-management, patient engagement, primary care, boot camp translation, chronic disease
Purpose: Self-management support (SMS) is a pillar of the well-established chronic care model and a key component of improving outcomes for patients with chronic illnesses. The Implementing Networks’ Self-management Tools Through Engaging Patients and Practices (INSTTEPP) trial sought to determine whether a boot camp translation process could assist small to medium-sized primary care practices with care managers implement SMS tools.
Methods: INSTTEPP used a stepped-wedge design across 16 practices from 4 practice-based research networks over 12 months. Each network completed a 2-month boot camp translation for creating SMS tools with 16 participants (2 patients, a clinician, and a care manager from each of 4 practices) and subsequent implementation. Outcome measures for patients were the Patient Activation Measure (PAM), self-rated health, and Patient Assessment of Chronic Illness Care (PACIC) process-of-care items at baseline, 1 and 2 months. Clinician Support for Patient Activation Measure (CS-PAM) and theory of planned behavior outcomes were assessed at 5 points over 10 months for clinicians and staff.
Results: A total of 297 patients and 89 practice staff and clinicians completed surveys during the study. Over successive 2-month sampling periods, intervention patients experienced greater improvement in PACIC process of care and self-rated health compared to control patients (P < 0.0001 and P = 0.0273, respectively). PAM (P = 0.3515), CS-PAM (P = 0.7464), and theory of planned behavior outcomes (P > 0.10 for all) were not significantly different.
Conclusions: Significant effects on process of care and self-rated health are evidence that the boot camp translation intervention impacted SMS. A larger trial with a typical 6-month boot camp intervention may show significant effects on other outcomes.
Nease DE Jr, Daly JM, Dickinson LM, Fernald DH, Hahn DL, Levy BT, Michaels LC, Simpson MJ, Westfall JM, Fagnan LJ. Impact of a boot camp translation intervention on self-management support in primary care. J Patient Cent Res Rev. 2018;5:256-66. doi: 10.17294/2330-0698.1635