Disability documentation implementation protocol (Oshita et al., 2026)

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="doi.org/10.1044/2026_JSLHR-26-00080" target="_blank" rel="noreferrer">doi.org/10.1044/2026_JSLHR-26-00080</a></p>