Background: More than 61 million people in the United States live with disabilities and need effective rehabilitation interventions. A key barrier to uptake of patient-centered outcomes research (PCOR)/comparative clinical effectiveness research (CER) results by rehabilitation clinicians is inadequate research reporting. Research publications often do not describe treatments in ways that enable adoption into practice. The Rehabilitation Treatment Specification System (RTSS), developed with PCORI funding, defines treatments in terms of the clinician actions and selections thought to drive changes in functioning (“active ingredients”), providing the information that clinicians need to implement effective interventions.
Proposed Solution to the Problem: The project team’s prior stakeholder engagement efforts demonstrate both enthusiasm for the RTSS and a need for training materials, implementation tools, and support from RTSS experts to facilitate its use. The project will establish consensus around needed materials, tools, and supports, and create a plan for their future development. The project will be coordinated at Kessler Foundation, a nonprofit research organization in New Jersey, and by members of the American Congress of Rehabilitation Medicine (ACRM)’s Rehabilitation Treatment Specification Networking Group (RTS-NG).
Objectives: This project will develop a consensus-based plan to create training materials, implementation tools, and supports that will enable RTSS-based research reporting and facilitate clinician uptake of PCOR/CER research results. Specific aims are to:
- Refine Cochrane Rehabilitation workgroup recommendations on the use of the RTSS as a means of improving research reporting with stakeholder input
- Identify (a) materials/tools/supports that are needed to facilitate use of the RTSS in research reporting and research uptake and (b) metrics to evaluate their effectiveness
- Develop a plan to create and evaluate the proposed materials/tools/supports
Activities: Two types of convenings will take place via Zoom: 1) whole group meetings, involving “producers” of PCOR/CER (researchers, journal reviewers/editors) and “users” of PCOR/CER (front-line clinicians, clinical educators); and 2) workgroup meetings in which “producers” and “users” meet separately to discuss recommendations.
Projected Outcomes and Outputs:
Short-term outcomes during the project period include a stakeholder-informed action plan for developing materials/tools to enable RTSS-based research reporting of rehabilitation interventions.
Medium-term outcomes (0-2 years post-project period) include the development of tools/materials/supports that enable researchers to develop RTSS-based treatment descriptions.
Long-term outcomes (3+ years post-project period) include improved information available to clinicians about how to implement effective rehabilitation interventions, and reduction of the >15-year research-to-practice gap.
Patient and Stakeholder Engagement Plan: The project team will engage stakeholders directly involved in the publication and use of research reports: (1) PCOR/CER investigators, (2) journal editors/reviewers, (3) health professions educators, and (4) front-line clinicians. Stakeholders will recommend types of materials/tools/supports to be created, their prioritization, and plans for future production. Convenings will take place as a whole group (once per quarter) and in separate workgroups (about once per month). Patient partners with disabilities will be represented on the Steering Committee.
Project Collaborators: Project activities will be coordinated by Jeanne M. Zanca, MPT, PhD at Kessler Foundation. Members of the ACRM RTS-NG will help implement the project.