The PURSUIT project aims to improve access to evidence-based nonsurgical UI treatment for women Veterans in the Southeast region of the United States using the most effective remote delivery modality. Using cluster randomization, the study will compare two models at the practice level: (1) the use of a practice facilitation toolkit with a mHealth UI modality alone and (2) the practice facilitation toolkit with a mHealth UI model combined with education on clinical pathways for consultation. Patient level outcomes related to UI symptom improvement will be compared. Patient and provider perceptions of factors that could influence future remote UI treatment scalability will also be assessed. All primary care practices will receive practice facilitation with a PURSUIT toolkit that includes (1) 1-2 visits with a practice facilitator; (2) mobile-health or mHealth application training (MAT); 3) online resource hub; and (4) health information technology (HIT) assistance. PURSUIT's future goal is to disseminate the most effective modality for delivering nonsurgical UI treatment for women Veterans nationally within the VHA.
PURSUIT aims to recruit 62 practices to participate in the trial implementation at 50 practices. Specifically, Community-Based Outpatient Clinics (CBOCs) from VA Integrated Service Network (VISN) 7 will be targeted, spanning the states of Alabama, Georgia, and South Carolina. The project will focus on VISN 7 CBOCs, serving at least 50 women Veterans with primary care services, will be recruited through connections with local women's health providers. The team estimates outreach to approximately 50,000 women Veterans and estimates that 30 percent (n=15,000) of these women will have UI symptoms, and, among those, 15 percent (n=2,500) will participate.
Study Type
OBSERVATIONAL
Enrollment
2,500
Mobile health application for cell phones and computers that delivers evidence-based behavioral treatment for urinary incontinence, specifically tailored to women Veterans
The toolkit has 4 components: (1) Practice Facilitation Visits, (2) Mobile-health or mHealth Application Training (MAT) training, (3) Access and education on the Data Dashboard, and (4) Health information technology (HIT) assistance.
Birmingham VA Healthcare System
Birmingham, Alabama, United States
Atlanta VA Health Care System
Decatur, Georgia, United States
Urinary incontinence (UI) screening rates
This will include measuring changes, over time, in UI diagnoses for women Veterans. These changes will be measured by pulling data on UI ICD-9 and ICD-10 codes collected via the program's clinical data dashboard.
Time frame: Baseline and 6 months post-Baseline
Change, over time, in usage of the provider clinical data dashboard
This will include capturing the unique number of clinic site "champions" (i.e. designated women's health provider) who engage with this program's clinical data dashboard. Dashboard engagement will be measured as the number of unique site champions who use the dashboard divided by the total number of site champions involved in this program.
Time frame: Baseline and 6 months post-Baseline
Enrollment rates of women Veterans for MyHealtheBladder
Women receiving behavioral urinary incontinence treatment on MyHealtheBladder
Time frame: 2-, 4-, and 6-months post-Baseline
International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)
4-item tool to measure UI symptoms, scored on scale from 0-21 with a higher score indicating worse symptoms
Time frame: Baseline and 2-months post-Baseline
Pelvic Floor Muscle Exercise (PFME) Adherence
2-item questionnaire to explore adherence to completing PFMEs
Time frame: 2-months post-Baseline
System Usability Scale
10-item questionnaire, using 5-point Likert scale, to gauge the usability of MHB. Scoring range is 0-100 with a higher score indicating the system is more usable,
Time frame: 2-months post-Baseline
Satisfaction and Perception of Improvement
3-item tool for feedback on participant satisfaction and perceived symptom improvement
Time frame: 2-months post-Baseline
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