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oai:figshare.com:article/33967966 2026-10-01T15:17:52Z category_27130 category_27109 category_29245 portal_225 item_type_11 month_year_10_2026

Disability documentation implementation protocol (Oshita et al., 2026) Jennifer Oshita (25091353) Christina R. Studts (13870903) Carol Haywood (25091364) Alicia Wong (2208751) Jennifer Duffecy (8203263) Megan A. Morris (13870835) People with disability Health systems Communication studies communication disability documentation accomodations primary care pragmatic Type III hybrid implementation-effectiveness trial health disparities disability accomodations Documentation of Communication Disability Collection and Accommodations in Primary Care Settings electronic health record health systems implementation communication sciences and disorders disability clinical trials <p dir="ltr"><b>Purpose: </b>Routine collection of patients’ communication disability (CD) status is instrumental for monitoring and addressing health disparities, including the provision of disability accommodations. Few health systems routinely collect patients’ CD status. This article describes the study protocol for the “Documentation of Communication Disability Collection and Accommodations in Primary Care Settings” (DECA) study, a pragmatic Type III hybrid implementation-effectiveness trial evaluating an implementation guide and practice facilitation on the adoption of CD status documentation. We additionally evaluate the study’s pragmatic design using Pragmatic Explanatory Continuum Indicator Summary-2–Provider Strategies (PRECIS-2-PS).</p><p dir="ltr"><b>Method:</b> The intervention includes documenting CD status and accommodation needs in the electronic health record (EHR) and providing requested accommodations. The implementation strategies are a tailored implementation guide and a practice facilitator providing implementation planning, problem solving, and quality monitoring. This quasi-experimental, stepped-wedge design includes 10 clinics across five health systems. The study employs a concurrent mixed-methods design. The primary outcome is Reach, operationalized as the proportion of patients with clinic visits during the study period who have CD status documented in the EHR. Secondary outcomes include the percentage of patients with accommodations documented in the EHR and the qualitative evaluation of adoption, implementation, and maintenance. Using PRECIS-2-PS domains, we rated the DECA study design elements as moderately to highly pragmatic, with design trade-offs made to balance real-world applicability with scientific rigor.</p><p dir="ltr"><b>Conclusion: </b>The DECA study will offer pragmatic evidence on the implementation effectiveness of an implementation guide and practice facilitation supporting health systems in identifying which patients have a CD and what accommodations they need.</p><p dir="ltr"><b>Supplemental Material S1. </b>Standards for Reporting Implementation Studies: the StaRI checklist for completion.</p><p dir="ltr">Oshita, J., Studts, C., Haywood, C., Wong, A., Duffecy, J., & Morris, M. A. (2026). Implementation of communication disability documentation and accommodations in primary care: A pragmatic type III hybrid implementation-effectiveness trial protocol. <i>Journal of Speech, Language, and Hearing Research</i>. Advance online publication. <a href="https://doi.org/10.1044/2026_JSLHR-26-00080" target="_blank" rel="noreferrer">https://doi.org/10.1044/2026_JSLHR-26-00080</a></p> 2026-10-01T15:17:52Z Text Online resource 10.23641/asha.33967966.v1 https://figshare.com/articles/online_resource/Disability_documentation_implementation_protocol_Oshita_et_al_2026_/33967966 CC BY 4.0