NCT06529094 · VA Office of Research and Development
Implementing a Decision Support Tool to Prevent Community-Acquired Pressure Injury in Spinal Cord Injury (SCI) in the Spinal Cord Injury Clinic
(CAPP-FIT)
What this study is about
Spinal cord injury (SCI) is a permanent condition affecting every aspect of life including health, daily activities, and participation and quality of life. Persons with SCI are at high risk of pressure injury (PrI) throughout their lives due to loss of sensation, nerve damage and immobility.
View original scientific description
Spinal cord injury (SCI) is a permanent condition affecting every aspect of life including health, daily activities, and participation and quality of life. Persons with SCI are at high risk of pressure injury (PrI) throughout their lives due to loss of sensation, nerve damage and immobility. PrIs are local areas of damage to the skin and underlying soft tissue caused by pressure and shear commonly located over bony prominences. While most PrIs are hospital- or nursing home-acquired, in people with SCI, PrIs typically develop in the community. Community-acquired pressure injuries (CAPrIs) are common, devastating, and costly. This grant proposal will assess how well a decision support tool, called the Community Acquired Pressure Injury Prevention Field Implementation Tool (CAPP-FIT), is used in the clinic and how well it prevents CAPrIs. The CAPP-FIT will be implemented at seven sites across the country in a staggered fashion. The CAPP-FIT includes: 1) an automated Veteran survey to identify risks, actions, and resources needed to prevent CAPrIs and 2) a companion Provider Report immediately available in the electronic health record listing Veteran responses to survey items with recommended evidence-based provider actions. The Veteran survey can be completed via a secured email on the computer or phone. There are three aims in the proposal: Aim 1 is implementing the CAPP-FIT at the seven geographically diverse VA SCI clinics. After CAPP-FIT implementation, each site will determine how the CAPP-FIT will be maintained in clinical practice to support sustainability. Aim 2 assesses how well the CAPP-FIT prevents CAPrIs and CAPrI-associated hospitalizations and assesses provider and Veteran satisfaction. Aim 3 assesses how well the CAPP-FIT is implemented in the SCI clinic.
Interventions
BEHAVIORAL
Provider training
Provider participants will complete TMS training, CAPP-FIT demonstration and simulation in use of the CAPP-FIT with a standardized patient.
BEHAVIORAL
CAPP-FIT intervention with RA facilitation
After consent and survey completion, RA to email/text CAPP-FIT link to Veteran the day before established clinic visit. RA to remain available to answer questions to help Veteran participant complete Veteran Survey and submit the responses through eScreening. The Provider Report will appear in CPRS with a Provider notification. RA to meet Veteran participant in the clinic after the clinic visit to complete the Veteran satisfaction survey.
BEHAVIORAL
CAPP-FIT implementation during maintenance phase
Providers will attend focus group after Arm 2 to determine sustainability of CAPP-FIT use in clinic workflow. Clinic provider will act on that determination for 10 months during maintenance phase.
Primary outcome measures
Incidence of new community acquired pressure injury 6 months post CAPP-FIT implementation
Time frame: 6 months
New CAPrI incidence within 6 months of first CAPP-FIT survey measured for each unique patient
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- Veteran participant eligibility criteria include:
- assigned provider in SCI clinic who is willing to participate in the study
- has a scheduled appointment in the SCI clinic
- ability to complete survey
Exclusion criteria
- active diagnosis of dementia
Where
- Long Beach, California
- Palo Alto, California
- Tampa, Florida
- Hines, Illinois
- St Louis, Missouri
- Cleveland, Ohio
- Houston, Texas
Collaborators
VA Palo Alto Health Care System, VA Long Beach Healthcare System, Saint Louis VA Medical Center, James A. Haley Veterans' Hospital, Louis Stokes VA Medical Center, Michael E. DeBakey VA Medical Center, Iowa City Veterans Affairs Medical Center, San Diego Veterans Healthcare System, Edward Hines Jr. VA Hospital
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
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Will I receive a placebo instead of treatment?
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Data: ClinicalTrials.gov · synced Nov 14, 2025 · Source of record for eligibility and locations