Trial Design

Stepped Wedge Trial

ACTEAST is being carried out as a Stepped Wedge Trial.  As shown in the Figure below, the Improvement Collaborative (Intervention) is rolled out in phases/waves, thus the clusters are for when sites receive the intervention, not if they receive the intervention. Each cluster is given the intervention at different times, and sites are assigned to the cluster based on their province.

Sites
Lead in Phase
(May/20-
Oct/20)
Phase 1
(Nov/20-
Apr/21)
Phase 2
(May/21-
Oct/21)
Phase 3
(Nov/21-
Apr/22)
Phase 4
(May/22-
Oct/22)
Cluster 1
[NS; n=10]
Retrospective
Data Collection
Intervention Yes Yes Yes
Cluster 2
[NB,PEI; n=13]
Retrospective
Data Collection
No Intervention Yes Yes
Cluster 3
[NL; n=10]
Retrospective
Data Collection
No No Intervention Yes

The yellow periods are patients treated without the intervention (pre-intervention). The green periods are patients treated with the intervention (post-intervention). In the evaluation, the orange and green periods are compared for each of our key measures