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Using intervention mapping to develop and adapt a secondary stroke prevention program in Veterans Health Administration medical centers

机译:在退伍军人卫生管理局医疗中心中使用干预图谱来制定和适应二级卒中预防计划

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摘要

Secondary stroke prevention is championed by the stroke guidelines; however, it is rarely systematically delivered. We sought to develop a locally tailored, evidence-based secondary stroke prevention program. The purpose of this paper was to apply intervention mapping (IM) to develop our locally tailored stroke prevention program and implementation plan. We completed a needs assessment and the five Steps of IM. The needs assessment included semi-structured interviews of 45 providers; 26 in Indianapolis and 19 in Houston. We queried frontline clinical providers of stroke care using structured interviews on the following topics: current provider practices in secondary stroke risk factor management; barriers and needs to support risk factor management; and suggestions on how to enhance secondary stroke risk factor management throughout the continuum of care. We then describe how we incorporated each of the five Steps of IM to develop locally tailored programs at two sites that will be evaluated through surveys for patient outcomes, and medical records chart abstraction for processes of care.
机译:卒中指南倡导二级卒中预防。但是,它很少系统地交付。我们试图制定一个本地定制的,循证的二级卒中预防计划。本文的目的是应用干预图(IM)来制定我们本地定制的中风预防计划和实施计划。我们完成了需求评估和IM的五个步骤。需求评估包括对45个提供者的半结构化访谈;印第安纳波利斯有26个,休斯顿有19个。我们对以下主题进行了结构化访谈,询问了中风护理的一线临床提供者:当前的中风继发危险因素管理提供者实践;支持风险因素管理的障碍和需求;以及在整个护理过程中如何加强继发性中风危险因素管理的建议。然后,我们描述了我们如何结合IM的五个步骤中的每个步骤,以在两个站点上开发本地量身定制的计划,这些计划将通过对患者结果的调查以及对医疗过程的病历图表摘要进行评估。

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