Intermountain Stewardship in Community Outpatient Settings-Resources & Engagement-Pediatrics

NCT07334795 | Active Not Recruiting

• 1 other identifier: HSII_IHC_IMP-PS2
• Study Type: observational
• Target: 259,000
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this implementation project is to detail the process of implementing the best practice of antibiotic stewardship in the pediatric population across the Intermountain Health medical system. The main questions it aims to answer are:

• How can a large healthcare system drive high adherence to antibiotic stewardship across a large and diverse number of sites?
• How do determinants of implementation and needed strategies vary by context?
• What is the utility of a higher-resource implementation effort (named "Boost) focusing on outlier sites? Data will be collected on number of children reached, adherence changes over time, types of implementation strategies employed, and characteristics of sites, prescribers, and patients.

Conditions

Antibiotic; Antibiotic Prescribing for Acute Respiratory-tract Infections; Respiratory Infection (for Example, Pneumonia, Bronchitis); Antibiotic Duration

Outcome Measures

Primary Outcomes (2)

• Guideline-adherent Broad vs. Narrow Spectrum Antibiotic Prescribing

  Rates of narrow-spectrum antibiotic (AB) prescriptions as a proportion of all antibiotics prescribed in aggregate and within each of these diagnoses: Acute otitis media, Group A streptococcal pharyngitis, Acute sinusitis, and Pneumonia.

  Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation.

• Guideline-adherent Duration of Antimicrobial Therapy

  Rate of AB prescriptions with guideline-adherent number of days prescribed as proportion of all AB prescriptions in aggregate and for each of the target ARTI diagnoses.

  Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation.

Secondary Outcomes (3)

• Rate of Treatment Failure

  Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation

• Adoption (Staff): Adherence to Protocols

  Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation

• Adoption (Organization): Adherence to Protocols

  Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation.

Study Arms (2)

Children with ARTIs, Wave 1

Children under 18 treated in Wave 1 of antibiotic stewardship for the following conditions: acute otitis media (AOM), Group A Streptococcal (GAS) pharyngitis, acute sinusitis, and community-acquired pneumonia (CAP)

Other: Implementation strategies including training & education, EMR tools, audit & feedback reports, and facilitation

Children with ARTIs, Wave 2

Children under 18 treated in Wave 2 of antibiotic stewardship for the following conditions: acute otitis media (AOM), Group A Streptococcal (GAS) pharyngitis, acute sinusitis, and community-acquired pneumonia (CAP)

Other: Implementation strategies including training & education, EMR tools, audit & feedback reports, and facilitation

Interventions

Implementation strategies including training & education, EMR tools, audit & feedback reports, and facilitation OTHER

o facilitate improved adherence to guideline-based prescribing, we plan a variety of implementation strategies to be employed in tandem including training \& education, EMR tools (e.g., Smart sets, express lanes, preference lists), audit and feedback reports and dashboards, and facilitation.

Children with ARTIs, Wave 1; Children with ARTIs, Wave 2

Eligibility Criteria

• Age: 6 Months - 17 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

All children meeting eligibility criteria and treated at any facility within the Intermountain region specified (wave 1 \& wave 2) between January 1, 2026 and December 31, 2028.

You may qualify if:

• Age 6 months through 17 years
• ARTI diagnosis (acute otitis media (AOM), Group A Streptococcal (GAS) pharyngitis, acute sinusitis, and community-acquired pneumonia (CAP))

You may not qualify if:

• Age \<6months or \>18 years
• No ARTI diagnosis

Sponsors & Collaborators

• Intermountain Health Care, Inc.: lead

Study Sites (1)

Intermountain Medical Center

Murray, Utah, 84107, United States

Location

MeSH Terms

Conditions

Respiratory Tract Infections; Pneumonia; Bronchitis

Interventions

Educational Status

Condition Hierarchy (Ancestors)

Infections; Respiratory Tract Diseases; Lung Diseases; Bronchial Diseases; Lung Diseases, Obstructive

Intervention Hierarchy (Ancestors)

Socioeconomic Factors; Population Characteristics

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 31, 2025
• First Posted: January 12, 2026
• Study Start: January 15, 2026
• Primary Completion (Estimated): January 15, 2029
• Study Completion (Estimated): January 15, 2029
• Last Updated: March 27, 2026

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)