Trial Outcomes & Findings for Implementing a Hospital-Based Walking Program (STRIDE): Function QUERI 2.0 (NCT NCT04868656)
NCT ID: NCT04868656
Last Updated: 2025-05-01
Results Overview
Penetration is defined as the percent of eligible hospitalizations with one or more STRIDE walks at 10 months. It is not possible to assess all eligibility criteria in the Electronic Health Record (e.g. able to walk at baseline); thus, with this more inclusive denominator, 100% penetration is not an appropriate goal. Based on preliminary data, we anticipate penetration to range from 0% (no program activity at 10-month outcome assessment) to 40% (estimated maximum achievable based on data from current STRIDE sites).
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
35 participants
Primary outcome timeframe
10 months (cumulative)
Results posted on
2025-05-01
Participant Flow
VA hospitals were enrolled in five successive cohorts from June 1, 2021 to October 3, 2022.
Unit of analysis: Hospital
Participant milestones
| Measure |
Foundational Support
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.
Implementation Strategy: Foundational Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We propose that low intensity implementation support that promotes adapting STRIDE for context and provides tools for ongoing STRIDE evaluation (defined as foundational support), will be sufficient for some but not all hospitals to successfully incorporate STRIDE into routine practice.
|
Enhanced Support
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.
Implementation Strategy: Enhanced Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We posit that monitoring hospitals' progress and adding, for hospitals with low adoption, higher intensity strategies (defined as Enhanced Support) that directly influence teams' capacity and skills to effectively self-organize and problem-solve will lead to higher implementation adoption, penetration, fidelity, and value.
|
|---|---|---|
|
Overall Study
STARTED
|
0 19
|
0 16
|
|
Overall Study
COMPLETED
|
0 19
|
0 16
|
|
Overall Study
NOT COMPLETED
|
0 0
|
0 0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Data was collected at the site level and these characteristics were not relevant and not collected.
Baseline characteristics by cohort
| Measure |
Foundational Support
n=19 Hospital
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.
Implementation Strategy: Foundational Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We propose that low intensity implementation support that promotes adapting STRIDE for context and provides tools for ongoing STRIDE evaluation (defined as foundational support), will be sufficient for some but not all hospitals to successfully incorporate STRIDE into routine practice.
|
Enhanced Support
n=16 Hospital
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.
Implementation Strategy: Enhanced Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We posit that monitoring hospitals' progress and adding, for hospitals with low adoption, higher intensity strategies (defined as Enhanced Support) that directly influence teams' capacity and skills to effectively self-organize and problem-solve will lead to higher implementation adoption, penetration, fidelity, and value.
|
Total
n=35 Hospital
Total of all reporting groups
|
|---|---|---|---|
|
Sex: Female, Male
Female
|
—
|
—
|
0 Hospital
Data was collected at the site level and these characteristics were not relevant and not collected.
|
|
Sex: Female, Male
Male
|
—
|
—
|
0 Hospital
Data was collected at the site level and these characteristics were not relevant and not collected.
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
NA Hospital
n=19 Hospital
|
NA Hospital
n=16 Hospital
|
NA Hospital
n=35 Hospital
|
|
Race (NIH/OMB)
Asian
|
NA Hospital
n=19 Hospital
|
NA Hospital
n=16 Hospital
|
NA Hospital
n=35 Hospital
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
NA Hospital
n=19 Hospital
|
NA Hospital
n=16 Hospital
|
NA Hospital
n=35 Hospital
|
|
Race (NIH/OMB)
Black or African American
|
NA Hospital
n=19 Hospital
|
NA Hospital
n=16 Hospital
|
NA Hospital
n=35 Hospital
|
|
Race (NIH/OMB)
White
|
NA Hospital
n=19 Hospital
|
NA Hospital
n=16 Hospital
|
NA Hospital
n=35 Hospital
|
|
Race (NIH/OMB)
More than one race
|
NA Hospital
n=19 Hospital
|
NA Hospital
n=16 Hospital
|
NA Hospital
n=35 Hospital
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
NA Hospital
n=19 Hospital
|
NA Hospital
n=16 Hospital
|
NA Hospital
n=35 Hospital
|
|
Region of Enrollment
United States : Northeast
|
3 Hospital
n=19 Hospital
|
3 Hospital
n=16 Hospital
|
6 Hospital
n=35 Hospital
|
|
Region of Enrollment
United States : Midwest
|
5 Hospital
n=19 Hospital
|
5 Hospital
n=16 Hospital
|
10 Hospital
n=35 Hospital
|
|
Region of Enrollment
United States : South
|
5 Hospital
n=19 Hospital
|
3 Hospital
n=16 Hospital
|
8 Hospital
n=35 Hospital
|
|
Region of Enrollment
United States : West
|
6 Hospital
n=19 Hospital
|
5 Hospital
n=16 Hospital
|
11 Hospital
n=35 Hospital
|
|
Facility Complexity Scores
1a
|
8 Hospital
n=19 Hospital
|
6 Hospital
n=16 Hospital
|
14 Hospital
n=35 Hospital
|
|
Facility Complexity Scores
1b, 1c, 2 , 3
|
11 Hospital
n=19 Hospital
|
10 Hospital
n=16 Hospital
|
21 Hospital
n=35 Hospital
|
|
Adjusted Length of Stay
Greater than or equal to 4.7 days
|
12 Hospital
n=19 Hospital
|
10 Hospital
n=16 Hospital
|
22 Hospital
n=35 Hospital
|
|
Adjusted Length of Stay
Less than 4.7 days
|
7 Hospital
n=19 Hospital
|
6 Hospital
n=16 Hospital
|
13 Hospital
n=35 Hospital
|
|
Prior Mobility Program Experience
Yes
|
6 Hospital
n=19 Hospital
|
5 Hospital
n=16 Hospital
|
11 Hospital
n=35 Hospital
|
|
Prior Mobility Program Experience
No
|
13 Hospital
n=19 Hospital
|
11 Hospital
n=16 Hospital
|
24 Hospital
n=35 Hospital
|
PRIMARY outcome
Timeframe: 10 months (cumulative)Population: Data collected at the site level
Penetration is defined as the percent of eligible hospitalizations with one or more STRIDE walks at 10 months. It is not possible to assess all eligibility criteria in the Electronic Health Record (e.g. able to walk at baseline); thus, with this more inclusive denominator, 100% penetration is not an appropriate goal. Based on preliminary data, we anticipate penetration to range from 0% (no program activity at 10-month outcome assessment) to 40% (estimated maximum achievable based on data from current STRIDE sites).
Outcome measures
| Measure |
Foundational Support
n=19 Hospital
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.
Implementation Strategy: Foundational Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We propose that low intensity implementation support that promotes adapting STRIDE for context and provides tools for ongoing STRIDE evaluation (defined as foundational support), will be sufficient for some but not all hospitals to successfully incorporate STRIDE into routine practice.
|
Enhanced Support
n=16 Hospital
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.
Implementation Strategy: Enhanced Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We posit that monitoring hospitals' progress and adding, for hospitals with low adoption, higher intensity strategies (defined as Enhanced Support) that directly influence teams' capacity and skills to effectively self-organize and problem-solve will lead to higher implementation adoption, penetration, fidelity, and value.
|
|---|---|---|
|
Penetration
|
4.3 percentage of eligible hospitalizations
Standard Deviation 4.7
|
2.2 percentage of eligible hospitalizations
Standard Deviation 3.0
|
SECONDARY outcome
Timeframe: 10 months (cumulative)Population: Data collected at the site level
Fidelity will be the percentage of eligible hospital days with "full dose" of the program, defined as two or more documented walks or one walk for more than five minutes.
Outcome measures
| Measure |
Foundational Support
n=19 Hospital
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.
Implementation Strategy: Foundational Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We propose that low intensity implementation support that promotes adapting STRIDE for context and provides tools for ongoing STRIDE evaluation (defined as foundational support), will be sufficient for some but not all hospitals to successfully incorporate STRIDE into routine practice.
|
Enhanced Support
n=16 Hospital
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.
Implementation Strategy: Enhanced Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We posit that monitoring hospitals' progress and adding, for hospitals with low adoption, higher intensity strategies (defined as Enhanced Support) that directly influence teams' capacity and skills to effectively self-organize and problem-solve will lead to higher implementation adoption, penetration, fidelity, and value.
|
|---|---|---|
|
Fidelity
|
35 percentage of eligible hospital days
Standard Deviation 10
|
40 percentage of eligible hospital days
Standard Deviation 14
|
SECONDARY outcome
Timeframe: 10 months (cumulative)Population: Data collected at the site level
Program adoption is a binary outcome defined for each hospital as equal to or more than 5 patients with a STRIDE walk or not.
Outcome measures
| Measure |
Foundational Support
n=19 Hospitals
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.
Implementation Strategy: Foundational Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We propose that low intensity implementation support that promotes adapting STRIDE for context and provides tools for ongoing STRIDE evaluation (defined as foundational support), will be sufficient for some but not all hospitals to successfully incorporate STRIDE into routine practice.
|
Enhanced Support
n=16 Hospitals
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.
Implementation Strategy: Enhanced Support: The goal is to test implementation intensification approaches for STRIDE hospitals that have not met implementation program benchmarks, specifically Foundational Support vs. Enhanced Support. We posit that monitoring hospitals' progress and adding, for hospitals with low adoption, higher intensity strategies (defined as Enhanced Support) that directly influence teams' capacity and skills to effectively self-organize and problem-solve will lead to higher implementation adoption, penetration, fidelity, and value.
|
|---|---|---|
|
Adoption
|
13 Hospitals with Program Adoption
|
9 Hospitals with Program Adoption
|
Adverse Events
Foundational Support
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Enhanced Support
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Dr. Susan N. Hastings, MD, M.H.Sc
Durham VA Medical Center
Phone: (919) 286-6936
Email: [email protected]
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place