Hospital-Based Walking Program for Early Mobilization
(STRIDE Trial)

Recruiting in Palo Alto (17 mi)

Overseen byKelli Dominick Allen, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: VA Office of Research and Development

No Placebo Group

Trial Summary

What is the purpose of this trial?

Implementing a Hospital-Based Walking Program (STRIDE): Function QUERI 2.0 aims to compare implementation strategies for large-scale spread of STRIDE, a supervised walking program for hospitalized older Veterans. The overall goal is to implement, evaluate, and sustain STRIDE in 32 additional VA hospitals using a type III effectiveness-implementation hybrid design framework.

Research Team

Susan N. Hastings, MD MHSc

Principal Investigator

Durham VA Medical Center, Durham, NC

Courtney H Van Houtven, PhD

Principal Investigator

Durham VA Medical Center, Durham, NC

Kelli Dominick Allen, PhD

Principal Investigator

Durham VA Medical Center, Durham, NC

Eligibility Criteria

This trial is for hospitals that want to implement a walking program called STRIDE for older Veterans. Hospitals must sign an agreement to participate and have not been part of the previous Function QUERI study. The clinical outcomes will focus on patients aged 60 or above admitted to medicine wards offering the STRIDE program.

Inclusion Criteria

I am 60 or older and admitted to a ward that offers the STRIDE program.

Sites not meeting benchmarks for adoption of STRIDE will receive higher-intensity implementation support (Enhanced REP).

Site inclusion criteria includes submission of a signed participation agreement.

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Exclusion Criteria

The eight STRIDE sites that have previously participated in Function QUERI (ClinicalTrials.gov Identifier: NCT03300336) will be excluded from enrollment in this study.

Treatment Details

Interventions

Hospital-Based Walking Program (STRIDE) (Behavioural Intervention)
Implementation Strategy: Enhanced REP (Behavioural Intervention)
Implementation Strategy: Foundational REP (Behavioural Intervention)

Trial OverviewThe study aims to compare different strategies for implementing the STRIDE walking program in VA hospitals. It uses a type III hybrid design framework, assessing how well each strategy works in getting hospitals to adopt and sustain the walking program.

Participant Groups

2Treatment groups

Experimental Treatment

Active Control

Group I: Enhanced SupportExperimental Treatment1 Intervention

Enhanced Support begins with the same activities as Foundational Support. Hospitals that are randomized to Enhanced Support and do not meet STRIDE initial program benchmarks within 6 months will continue with Foundational support and also receive higher intensity support for a period of 4-6 months. Hospitals that have sustained their implementation will continue low-touch activities while those that have been randomized to the enhanced support arm and met the initial program benchmark at 6-months but have not sustained (did not meet the sustainment benchmark), will begin engaging in high-touch activities. The higher intensity support will consist of facilitation, a process of interactive problem solving and support that occurs in a context of a supportive interpersonal relationship. Facilitation will be provided by Function QUERI team members.

Group II: Foundational SupportActive Control1 Intervention

Foundational Support uses the Replicating Effective Program (REP) implementation strategy and includes 5 elements that were developed and tested in our prior Function QUERI work: STRIDE Toolkit; Online shared resources (SharePoint) access for clinical program training materials; Data dashboard to assist hospitals with tracking their own data; Diffusion Networks to promote peer-to-peer sharing and implementation support; and Microsoft TEAMS Channels.