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Brooks-Carthon JM, Brom H, Grantham-Murrillo M, Sliwinski K, Mason A, Roeser M, Miles D, Garcia D, Bennett J, Harhay MO, Flores E, Amenyedor K, Clark R
Equity-Centered Postdischarge Support for Medicaid-Insured People: Protocol for a Type 1 Hybrid Effectiveness-Implementation Stepped Wedge Cluster Randomized Controlled Trial
Equity Centered Post Discharge Support for Medicaid Insured: Protocol for a Type 1 Hybrid Effectiveness Implementation Stepped-Wedge Cluster Randomized Trial
J. Margo Brooks-Carthon;
Heather Brom;
Marsha Grantham-Murrillo;
Kathy Sliwinski;
Aleigha Mason;
Mindi Roeser;
Donna Miles;
Dianne Garcia;
Jovan Bennett;
Michael O. Harhay;
Emilia Flores;
Kelvin Amenyedor;
Rebecca Clark
ABSTRACT
Background:
Disparities in posthospitalization outcomes for people with chronic medical conditions and insured by Medicaid are well documented, yet interventions that mitigate them are lacking. Prevailing transitional care interventions narrowly target people over age 65, with specific disease processes, or limitedly focus on individual-level behavioral change such as self-care or symptom management, thus failing to adequately provide a holistic approach to ensure an optimal post-hospital care continuum.
Objective:
The current study evaluates the implementation of THRIVE – an evidence-based, equity-focused clinical pathway that supports Medicaid-insured individuals with multiple chronic conditions transitioning from hospital to home by focusing on the social determinants of health and systemic and structural barriers in health care delivery. THRIVE services include coordinating care, standardizing interdisciplinary communication, and addressing unmet clinical and social needs following hospital discharge.
Methods:
Type I Hybrid Effectiveness-Implementation Stepped-Wedge Cluster Randomized Trial
Results:
This study was approved by the Institutional Review Board in January 2023 and launched in March 2023 with grant funding from the Rita and Alex Hillman Foundation. Recruitment and data collection began on March 27, 2023, and will be completed in December 2024. As of 10/31/23, 87 participants have been referred to the Thrive pathway for post discharge care support.
Conclusions:
The implementation and evaluation of the THRIVE clinical pathway will identify clinical supports and practice factors that influence success. Clinical Trial: ClinicalTrials.govNCT05714605. Registered February 6, 2023 – Implementation and Evaluation of a Health Innovation to Support Medicaid-Insured Individuals Following Hospitalization
Citation
Please cite as:
Brooks-Carthon JM, Brom H, Grantham-Murrillo M, Sliwinski K, Mason A, Roeser M, Miles D, Garcia D, Bennett J, Harhay MO, Flores E, Amenyedor K, Clark R
Equity-Centered Postdischarge Support for Medicaid-Insured People: Protocol for a Type 1 Hybrid Effectiveness-Implementation Stepped Wedge Cluster Randomized Controlled Trial