EvidenceNOW: Research Design and Methods

Introduction

The Agency for Healthcare Research and Quality (AHRQ) EvidenceNOW: Advancing Heart Health in Primary Care grant initiative awarded grants to seven regional cooperatives to 1) help practices across the country use the latest evidence to improve cardiovascular health and to 2) study if and how external quality improvement support helps small- and medium-sized primary care practices use findings from patient-centered outcomes research (PCOR) to improve the heart health of their patients.  EvidenceNOW also aimed to 3) determine what works best in developing practices’ capacity for continuous improvement.  [For a comprehensive discussion of AHRQ’s design decisions for the EvidenceNOW initiative, refer to Meyers et al., 2018]

To achieve these goals, each cooperative was required to recruit at least 250 practices, determine the PCOR findings to be disseminated to practices, propose an evidence-based approach to QI support to practices, and design a rigorous evaluation to measure the effect of their external support interventions on the key outcomes of interest (refer to the RFA for additional details on the cooperatives’ requirements).

Additionally, a grant was awarded for an independent, national, cross-cutting evaluation (refer to the RFA for additional details). The national evaluation team, ESCALATES (Evaluating System Change to Advance Learning and Take Evidence to Scale), is looking across the EvidenceNOW cooperatives to determine the overall effect of the initiative. ESCALATES is also examining and comparing the effectiveness of the cooperatives’ interventions to determine which types of external support are most effective in improving the implementation of new medical evidence, under what circumstances, and for whom. To accomplish this, the national evaluation team and the cooperatives worked together to establish a core set of measures to create a harmonized dataset.

The EvidenceNOW initiative, as AHRQ’s largest single investment in primary care research, provides an opportunity to share approaches, resources and lessons learned for the benefit of other primary care researchers. These web pages describe the evaluation designs used in the EvidenceNOW regional and national evaluations, the methods, measures and data collection instruments used, and lessons learned for recruiting practices and other aspects of research administration.