Stratified Targeted Engagement From Primary Care to Physical Therapy (STEPPT)
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorSan Diego State University
About this trial
The goal of this clinical trial is to learn if a health system intervention called "Stratified Targeted Engagement from Primary Care to Physical Therapy (STEPPT)" can improve how often doctors refer Hispanic patients with spine pain to physical therapy (referral rate) and how often patients attend physical therapy after being referred (adherence rate). The main questions this study aims to answer are 1) does STEPPT improve physical therapy referral and adherence rates compared to usual care for Hispanic patients with spine pain who seek care in a Federally Qualified Health Center (FQHC) serving low income communities, and 2) how consistently do FQHC providers and staff deliver STEPPT to patients who may benefit? STEPPT will train doctors and other health care providers to educate participants on the benefits of physical therapy for spine pain and participants will receive culturally tailored handouts and videos to teach them about their spine pain and what to expect in physical therapy. Patients will also receive personalized assistance to schedule their physical therapy appointment and address potential barriers for attending the appointment.
Eligibility criteria
Qualifiers
18 years or older.
Identify as either Hispanic or Non-Hispanic ethnicity, inclusive of all races.
Seeking care for spine pain at an Adult or Adult Walk-in primary care clinic within the participating Federally Qualified Health Center (FQHC).
New or existing spine pain problem: A new spine pain problem is defined by a new ICD code for neck or back pain added to the problem list during a visit with a primary care physician. An existing spine pain problem is defined by an existing ICD code for neck or back pain on the problem list that is associated with a physician referral for any service during the visit related to the neck or back pain problem.
Disqualifiers
Spine pain associated with a non-musculoskeletal etiology (e.g., infection, cancer, urological disorders, pregnancy, etc.)
Patients requiring urgent medical intervention (e.g., fracture, cauda equina syndrome, etc)
Active physical therapy referral for spine pain at the time of the index encounter.
Previously referred to physical therapy through the STEPPT Care Pathway.
Trial design
Treatments tested in this trial
- Engagement of clinic leadership (System Intervention - Usual Care)
- Engagement of clinic leadership (System Intervention - STEPPT)
- Patient Registry (System Intervention - STEPPT)
- Delivery of Patient Education Materials (System Intervention - Usual Care)
- Delivery of Patient Education Materials (System Intervention - STEPPT)
- Referral Specialist Training (System Intervention - Usual Care)
- Patient Health Navigator Training (System Intervention - STEPPT)
- Care Navigation (System Intervention - STEPPT)
- Care navigation audit and feedback (System Intervention - STEPPT)
- Primary Care Provider training (Provider Intervention - STEPPT)
- Nurse/Medical Assistant Training (Provider Intervention - STEPPT)
- Provider feedback on PT referral and adherence (Provider Intervention - STEPPT)
- Patient education on spine pain condition (Patient Intervention - Usual Care)
- Patient education on spine pain condition (Patient Intervention - STEPPT)
- Patient Education on Physical Referral by Providers (Patient Intervention - Usual Care)
- Patient Education on Physical Referral by Providers (Patient Intervention - STEPPT)
- Electronic Patient Education on Physical Therapy Referral (Patient Intervention - STEPPT)
- Patient education on physical therapy referral by Referral Specialist (Patient Intervention - Usual Care)
- Patient education on physical therapy referral by Patient Health Navigator (Patient Intervention - STEPPT)
- Care Navigation (System Intervention - Usual Care)
- Monitoring of PT referral and adherence rates (System Intervention - STEPPT)
- Monitoring of PT referral and adherence rates (System intervention - Usual Care)
Treatment groups
17,587 Participants
are divided into 2 treatment groupsSponsors and collaborators
San Diego State University
Lead sponsor
National Institute on Minority Health and Health Disparities (NIMHD)
Collaborator
Family Health Centers of San Diego
Collaborator
Source ClinicalTrials.gov