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Diabetes MellitusNCT04696653

A Quality Improvement Process to Support Delivery of Cardiovascular Care in Community Mental Health Organizations

A study testing Comprehensive Unit Based Safety Program (CUSP) in people with Diabetes Mellitus and Hypertension, run by Johns Hopkins University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This pilot study will examine whether an implementation strategy will improve delivery of evidence-based care for cardiovascular risk factors for people with serious mental illness. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Diabetes Mellitus, Hypertension, Dyslipidemias
What is being tested?
Comprehensive Unit Based Safety Program (CUSP)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
85 participants
Where
1 siteUnited States
Study dates
24 Feb 2021to 5 Apr 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Study population 1:
  • Psychiatric rehabilitation program and health home team staff, including providers and leadership are those employed by the psychiatric rehabilitation program or health home program.
  • English-speaking.
  • Study population 2:
  • People with serious mental illness participating in psychiatric rehabilitation health home programs.
  • English-speaking

Who cannot join

  • None

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Johns Hopkins Adult Psychiatric Rehabilitation Program

    Baltimore, Maryland, 21224

Other trials in United States

About this study

Official title: Using an Innovative Quality Improvement Process to Increase Delivery of Evidence-based Cardiovascular Risk Factor Care in Community Mental Health Organizations

This pilot study will examine whether an implementation strategy will improve delivery of evidence-based care for cardiovascular risk factors for people with serious mental illness.

Read the detailed description

In this pilot study, the investigators will work with health home programs and pilot test an adapted Comprehensive Unit Safety Program (CUSP) implementation strategy to improve mental health providers' delivery of evidence-based cardiovascular risk factor care for hypertension, dyslipidemia and diabetes for individuals with serious mental illness. The project will also characterize implementation processes, organizational and provider-level factors, and cardiovascular disease risk factor care and control.

Being tested
Comprehensive Unit Based Safety Program (CUSP)
Medical subject headings
Diabetes Mellitus, Hypertension, Dyslipidemias

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Comprehensive Unit Based Safety Program (CUSP)Other

    CUSP is a quality improvement strategy developed by the Johns Hopkins University Armstrong Institute for Patient Safety and Quality that is used to improve care delivery.

Study groups in NCT04696653
Study groupRoleWhat they receive
Comprehensive unit based safety (CUSP) intervention armOtherCUSP is a quality improvement strategy developed by the Johns Hopkins University Armstrong Institute for Patient Safety and Quality that is used to improve care delivery.
Receives: Other: Comprehensive Unit Based Safety Program (CUSP)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Quality Improvement Culture as Assessed by the Modified Version of the Validated Survey on Patient Safety

    Each of the items in the modified survey is scored individually on 1-5 Likert scales. An average score is calculated by summing responses across all items and dividing by the total number of items. The average score ranges from 1-5. A higher average score signifies an organizational culture that is more supportive of quality improvement.

    Measured: Baseline, 12 Months

  2. Self-efficacy as Assessed by an Adapted Version of Compeau & Higgins' Task-focused Self-efficacy Scale

    Each of the items (Hypertension, Dyslipidemia, Diabetes) are scored individually on a 1-10 Likert scale, where 1=not at all confident and 10=totally confident. An average score is calculated by summing responses across all items and dividing by the total number of items. The average score ranges from 1-10. A higher score signifies greater self-efficacy.

    Measured: Baseline, 12 Months

Secondary outcomes (28)
  1. Acceptability as Assessed by the Acceptability of Intervention Measure

    Validated 4-item instrument measuring intervention acceptability of the Evidence based practice and CUSP strategy using the Acceptability of Intervention Measure. Each of the items will be measured on a 5-point Likert scale, where 1=completely disagree and 5=completely agree. An average score is calculated by summing responses across all items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies greater acceptability.

    Measured: Baseline, 12 Months

  2. Appropriateness as Assessed by the Intervention Appropriateness Measure

    Four item instrument measuring intervention appropriateness of Evidence based practice and CUSP strategy using the Intervention Appropriateness Measure. Each of the items will be measured on a 5-point Likert scale, where 1=completely disagree and 5= completely agree. An average score is calculated by summing responses across all items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies greater appropriateness.

    Measured: Baseline, 12 Months

  3. Feasibility as Assessed by the Feasibility of Intervention Measure

    Four item instrument measuring intervention feasibility of Evidence based practice and CUSP strategy using the Feasibility of Intervention Measure. Each of the items will be measured on a 5-point Likert scale, where 1=completely disagree and 5=completely agree. An average score is calculated by summing responses across all items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies greater feasibility.

    Measured: Baseline, 12 Months

  4. Clients With Hypertension Control

    Measured with blood pressure (BP) readings reported by staff . Clients with control defined as a BP <130/80 mmHg.

    Measured: Baseline and 12 Months

  5. Clients With Dyslipidemia Control

    Measured with cholesterol readings reported by staff. Clients with controlled dyslipidemia defined as total cholesterol <200 mg/dL and low-density lipoprotein (LDL) <130 mg/dL.

    Measured: Baseline and 12 Months

  6. Clients With Diabetes Control

    Measured using HbA1c tests reported by staff . Clients with controlled diabetes defined as HbA1c<7.0.

    Measured: Baseline and 12 Months

  7. Clients Diagnosed With Diabetes Mellitus Who Received HBA1c Measurement

    The number of clients who have a HBA1c measurement reported by the participating staff.

    Measured: Baseline and 12 Months

  8. Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Lipid Panel

    Measured: Baseline, 6 and 12 months

  9. Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received Statin Therapy

    Measured: Baseline, 6 and 12 months

  10. Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Dilated Eye Exam

    Measured: Baseline, 6 and 12 months

  11. Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Foot Exam

    Measured: Baseline, 6 and 12 months

  12. Clients Diagnosed With Dyslipidemia Who Received a Lipid Panel

    The number of clients who have a lipid panel reported by the participating staff.

    Measured: Baseline and 12 Months

  13. Teamwork Within Teams as Assessed by the Implementation Climate Scale

    Four items measuring teamwork. Each of the items will be measured on a 5-point Likert scale, where 1=strongly disagree and 5=strongly agree. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies better teamwork within units.

    Measured: Baseline, 12 Months

  14. Supervisor/Manager Expectations and Actions Promoting Quality as Assessed by the Implementation Climate Scale

    Four items measuring the degree to which a provider's supervisor promotes quality improvement. Each of the items will be measured on a 5-point Likert scale, where 1=strongly disagree and 5=strongly agree. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies greater promotion of quality improvement.

    Measured: Baseline, 12 Months

  15. Organizational Learning Assessed by the Implementation Climate Scale

    Three items measuring organizational learning environment. Each of the items will be measured on a 5-point Likert scale, where 1=strongly disagree and 5=strongly agree. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies greater organizational learning.

    Measured: Baseline, 12 Months

  16. Management Support for Patient Safety as Assessed by the Implementation Climate Scale

    Three items measuring the degree to which organization management supports quality improvement. Each of the items will be measured on a 5-point Likert scale, where 1=strongly disagree and 5=strongly agree. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies greater management support for quality improvement.

    Measured: Baseline, 12 Months

  17. Overall Perceptions of Quality Improvement Culture as Assessed by the Implementation Climate Scale

    Three items measuring the perception's of the organization's quality improvement culture. Each of the items will be measured on a 5-point Likert scale, where 1=strongly disagree and 5=strongly agree. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies better quality improvement culture.

    Measured: Baseline, 12 Months

  18. Feedback and Communication About Error as Assessed by the Implementation Climate Scale

    Three items measuring feedback and communication about quality improvement. Each of the items will be measured on a 5-point Likert scale, where 1=never and 5=always. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies better feedback and communication.

    Measured: Baseline, 12 Months

  19. Communication Openness as Assessed by the Implementation Climate Scale

    Three items measuring perceptions of communication openness in the organization. Each of the items will be measured on a 5-point Likert scale, where 1=never and 5=always. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies better communication openness.

    Measured: Baseline, 12 Months

  20. Frequency of Events Reported as Assessed by the Implementation Climate Scale

    Three items assessing the degree to which mistakes are reported at the organization. Each of the items will be measured on a 5-point Likert scale, where 1=never and 5=always. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies more frequent mistake reporting.

    Measured: Baseline, 12 Months

  21. Teamwork Across Teams as Assessed by the Implementation Climate Scale

    Four items assessing teamwork across units. Each of the items will be measured on a 5-point Likert scale, where 1=strongly disagree and 5=strongly agree. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies better teamwork across units.

    Measured: Baseline, 12 Months

  22. Staffing as Assessed by the Implementation Climate Scale

    Two items assessing staffing capacity. Each of the items will be measured on a 5-point Likert scale, where 1=strongly disagree and 5=strongly agree. An average score is calculated by summing responses across items and dividing by the total number of items. The average score ranges from 1-5. A higher score signifies better staffing capacity.

    Measured: Baseline, 12 Months

  23. Clients With Hypertension Who Had a Blood Pressure Measurement

    The number of clients who have a blood pressure measurement reported by the participating staff.

    Measured: Baseline and 12 Months

  24. Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Urine-protein-creatinine Test

    Measured: Baseline, 6 and 12 months

  25. Change in the Percent of Individuals Diagnosed With Dyslipidemia Who Are on a Statin Medication

    Measured: Baseline, 6 and 12 months

  26. Change in the Percent of Individuals Diagnosed With Hypertension Who Received Lifestyle Counseling

    Measured: Baseline, 6 and 12 months

  27. Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received Lifestyle Counseling

    Measured: Baseline, 6 and 12 months

  28. Change in the Percent of Individuals Diagnosed With Dyslipidemia Who Received Lifestyle Counseling

    Measured: Baseline, 6 and 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jan 2021
  2. Study start24 Feb 2021
  3. Primary completion21 Nov 2022
  4. Study completion5 Apr 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
85 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04696653
Sponsor's protocol ID
IRB00269855
Other IDs
P50MH115842
Status last verified
Sep 2025
First submitted
4 Jan 2021
Last updated
26 Sep 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Murphy KA, Gennusa J, Dalcin AT, Cook C, Goldsholl S, Fink T, Daumit GL, Wang NY, Thompson D, McGinty EE. Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers. Front Psychiatry. 2025 Jan 31;16:1446985. doi: 10.3389/fpsyt.2025.1446985. eCollection 2025.

    PubMed 39958153
  • McGinty EE, Thompson D, Murphy KA, Stuart EA, Wang NY, Dalcin A, Mace E, Gennusa JV 3rd, Daumit GL. Adapting the Comprehensive Unit Safety Program (CUSP) implementation strategy to increase delivery of evidence-based cardiovascular risk factor care in community mental health organizations: protocol for a pilot study. Implement Sci Commun. 2021 Mar 4;2(1):26. doi: 10.1186/s43058-021-00129-6.

    PubMed 33663620

Questions about this trial

What is this clinical trial studying?

A study testing Comprehensive Unit Based Safety Program (CUSP) in people with Diabetes Mellitus and Hypertension, run by Johns Hopkins University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Sep 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quality Improvement Culture as Assessed by the Modified Version of the Validated Survey on Patient Safety (time frame: Baseline, 12 Months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04696653, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Sep 2025.

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