title: An interdisciplinary knowledge translation intervention in long-term care: study protocol for the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial.
abstract: BACKGROUND
  Knowledge translation (KT) research in long-term care (LTC) is still in its early stages. This protocol describes the evaluation of a multifaceted, interdisciplinary KT intervention aimed at integrating evidence-based osteoporosis and fracture prevention strategies into LTC care processes.
  
  
  METHODS
  The Vitamin D and Osteoporosis Study (ViDOS) is underway in 40 LTC homes (n = 19 intervention, n = 21 control) across Ontario, Canada. The primary objectives of this study are to assess the feasibility of delivering the KT intervention, and clinically, to increase the percent of LTC residents prescribed ≥800 IU of vitamin D daily. Eligibility criteria are LTC homes that are serviced by our partner pharmacy provider and have more than one prescribing physician. The target audience within each LTC home is the Professional Advisory Committee (PAC), an interdisciplinary team who meets quarterly. The key elements of the intervention are three interactive educational sessions led by an expert opinion leader, action planning using a quality improvement cycle, audit and feedback reports, nominated internal champions, and reminders/point-of-care tools. Control homes do not receive any intervention, however both intervention and control homes received educational materials as part of the Ontario Osteoporosis Strategy. Primary outcomes are feasibility measures (recruitment, retention, attendance at educational sessions, action plan items identified and initiated, internal champions identified, performance reports provided and reviewed), and vitamin D (≥800 IU/daily) prescribing at 6 and 12 months. Secondary outcomes include the proportion of residents prescribed calcium supplements and osteoporosis medications, and falls and fractures. Qualitative methods will examine the experience of the LTC team with the KT intervention. Homes are centrally randomized to intervention and control groups in blocks of variable size using a computer generated allocation sequence. Randomization is stratified by home size and profit/nonprofit status. Prescribing data retrieval and analysis are performed by blinded personnel.
  
  
  CONCLUSIONS
  Our study will contribute to an improved understanding of the feasibility and acceptability of a multifaceted intervention aimed at translating knowledge to LTC practitioners. Lessons learned from this study will be valuable in guiding future research and understanding the complexities of translating knowledge in LTC.
authors.affiliation: Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada. kennedyc@hhsc.ca
authors.forename: Courtney C
authors.initials: CC
authors.lastname: Kennedy
authors.forename: George
authors.initials: G
authors.lastname: Ioannidis
authors.forename: Lora M
authors.initials: LM
authors.lastname: Giangregorio
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Adachi
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.forename: Suzanne N
authors.initials: SN
authors.lastname: Morin
authors.forename: Richard G
authors.initials: RG
authors.lastname: Crilly
authors.forename: Sharon
authors.initials: S
authors.lastname: Marr
authors.forename: Robert G
authors.initials: RG
authors.lastname: Josse
authors.forename: Lynne
authors.initials: L
authors.lastname: Lohfeld
authors.forename: Laura E
authors.initials: LE
authors.lastname: Pickard
authors.forename: Susanne
authors.initials: S
authors.lastname: King
authors.forename: Mary-Lou
authors.initials: ML
authors.lastname: van der Horst
authors.forename: Glenda
authors.initials: G
authors.lastname: Campbell
authors.forename: Jackie
authors.initials: J
authors.lastname: Stroud
authors.forename: Lisa
authors.initials: L
authors.lastname: Dolovich
authors.forename: Anna M
authors.initials: AM
authors.lastname: Sawka
authors.forename: Ravi
authors.initials: R
authors.lastname: Jain
authors.forename: Lynn
authors.initials: L
authors.lastname: Nash
authors.forename: Alexandra
authors.initials: A
authors.lastname: Papaioannou
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002118:Calcium / Q000008:administration & dosage; D019587:Dietary Supplements; D004363:Drug Utilization; D050723:Fractures, Bone / Q000517:prevention & control; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination; D007318:Inservice Training; D007857:Leadership; D008134:Long-Term Care / Q000458:organization & administration; D009735:Nursing Homes / Q000458:organization & administration*; D009864:Ontario; D010024:Osteoporosis / Q000517:prevention & control*; D010865:Pilot Projects; D017010:Reminder Systems; D057170:Translational Research, Biomedical / Q000458:organization & administration*; D014807:Vitamin D / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002118:Calcium