Cardiovascular Disease, Diabetes, Mental Health Disorder, Substance Abuse Disorder
Conditions
Keywords
Community Based Organization, Reverse Innovation, Social Services, Referral, Chronic disease
Brief summary
Project CONNECT (Community-based Organizations Neighborhood Network: Enhancing Capacity Together) is a randomized controlled trial that involves 22 community-based organizations (CBOs) located in Baltimore, MD. Half of these organizations were randomly assigned to the intervention group using a constrained cluster randomization process. The remaining 11 are a part of the control intervention group. The intervention is a co-developed set of IT tools hypothesized to improve the connections among intervention CBOs, Johns Hopkins health care facilities and CBO clients.
Detailed description
see above
Interventions
OTHERCo-developed IT intervention
The IT-based intervention is being co-developed with the community based organizations in the intervention group, and comprises tools to improve referral and tracking of clients, use of volunteers, and direct communication with hospital staff members
Sponsors
Patient-Centered Outcomes Research Institute
Johns Hopkins Bloomberg School of Public Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
Community Based Organization; 501-C3 status; Located within zip codes surrounding Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center; Provides direct services to clients
Exclusion criteria
Part of Johns Hopkins Medicine or Baltimore City Agency
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Emergency Department Visits + Hospital Days | Pre-Intervention (09/01/2012 to 03/09/2014); Post-Intervention (03/10/2014-09/30/2015 | The change in the average number of monthly emergency department visits and days spent in the hospital from the pre- intervention to the post-intervention period for J-CHiP patients assigned to each of the CBOs, adjusted for baseline prognostic variables. |
Countries
United States
Participant flow
Recruitment details
We used the IRS Master file of Tax Exempt Organizations to identify all non-profit organizations in our zip codes of interest, and the used the NTEE (National Taxonomy of Exempt Entities) Classification System to exclude organizations that were not involved in the direct delivery of health and human services to adults.
Participants by arm
| Arm | Count |
|---|---|
| Intervention CBOs Will receive co-developed IT intervention developed together with intervention group community based members. Set of primarily web based tools to improve connection with clients, Johns Hopkins Medicine and one another, referrals, and volunteer services.
Co-developed IT intervention: The IT-based intervention is being co-developed with the community based organizations in the intervention group, and comprises tools to improve referral and tracking of clients, use of volunteers, and direct communication with hospital staff members | 2,637 |
| Control CBOs Community Based Organizations that are being followed for data collection only for the period of one year | 4,130 |
| Total | 6,767 |
Baseline characteristics
| Characteristic | Control CBOs | Total | Intervention CBOs |
|---|---|---|---|
| Age, Continuous | 62 years | 62 years | 62 years |
| Insurance Type Medicare | 2664 Participants | 4363 Participants | 1699 Participants |
| Insurance Type PPMCO | 1466 Participants | 2404 Participants | 938 Participants |
| Race/Ethnicity, Customized Race/Ethnicity African American | 2089 Participants | 3530 Participants | 1441 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Asian | 26 Participants | 48 Participants | 22 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Caucasian | 1704 Participants | 2672 Participants | 968 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Hispanic | 21 Participants | 36 Participants | 15 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Native American | 10 Participants | 11 Participants | 1 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Other | 167 Participants | 281 Participants | 114 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Unknown | 113 Participants | 189 Participants | 76 Participants |
| Sex/Gender, Customized Gender Female | 2584 Participants | 4269 Participants | 1685 Participants |
| Sex/Gender, Customized Gender Male | 1545 Participants | 2496 Participants | 951 Participants |
| Sex/Gender, Customized Gender Unknown | 1 Participants | 2 Participants | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Change in Emergency Department Visits + Hospital Days
The change in the average number of monthly emergency department visits and days spent in the hospital from the pre- intervention to the post-intervention period for J-CHiP patients assigned to each of the CBOs, adjusted for baseline prognostic variables.
Time frame: Pre-Intervention (09/01/2012 to 03/09/2014); Post-Intervention (03/10/2014-09/30/2015
Population: Data collected at the community-based organization level.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control CBOs | Change in Emergency Department Visits + Hospital Days | -0.0069 Diff in monthly hospital days+ED visits | Standard Deviation 0.513 |
| Intervention CBOs | Change in Emergency Department Visits + Hospital Days | 0.0113 Diff in monthly hospital days+ED visits | Standard Deviation 0.525 |
Comparison: The difference between the average sum of the number of days spent in the hospital and ED visits in the past month, pre- and post-intervention, adjusted for pre- intervention variables, was calculated for each patients. The average change scores among patients assigned to each CBO defined the CBO-level outcomes. We calculated a weighted average of the CBO outcomes separately for the iCBOs and cCBOs, defining the difference-in-differences statistic as the difference between the two averages.p-value: 0.6395% CI: [-0.12, 0.11]Randomization inference