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When implemented in usual care the web support needs to be translated to common foreign languages.
Depending on its efficacy and feasibility, the intervention will be attuned in light of results of the study and additionally be implemented in usual pediatric diabetes care.
This paper describes the protocol for a cluster randomised controlled trial to test the clinical effectiveness and cost-effectiveness of WWWT when implemented in usual primary care.
95 In contrast to effectiveness research, which examines health outcomes from treatments when implemented in usual clinical care, efficacy research examines key clinical outcomes such as symptom reduction from protocol-implemented treatment in well controlled studies.
Since the intervention is brief and based on concepts and skills that spiritual counsellors are familiar with, it can be easily implemented in usual patient care and incorporated in guidelines on spiritual care [ 2].
Fundamental prognosis research is vital in addressing the "second gap" in translation, 35 in which evidence from randomised trials of effective treatments may fail to be implemented in usual clinical practice (far right of translational pathway toward improved clinical outcomes).
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However, the diabetes prevention programs evaluated have tended to use resource-intensive behavior change strategies that may be difficult to implement in usual health care practice, given resource and infrastructure limitations (2, 3).
The streamlining of the process, the experienced expert teams and minimising the contact moments with the patients due to the written questionnaire as proposed in this study increases the feasibility that CMRs can be implemented successfully in usual care.
This paper reports a randomized controlled clinical trial of an intervention implemented in the context of usual prenatal outpatient care.
In April 2009, the AGnES-concept was implemented into usual care for areas with an imminent or already existing undersupply with GPs.
These legislative efforts require improvements in the evidence base about the effect of implementing SDM in usual clinical settings.
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