Summary

for people ages 18 years and up (full criteria)
healthy people welcome
at San Diego, California and other locations
study started
estimated completion:
Ming Tai-Seale

Description

Summary

This large scale multi-center cluster randomized controlled trial (RCT) is designed to assess the comparative effectiveness of three interventions in diverse ambulatory care settings and patient populations. Findings will help healthcare systems decide which approach to adopt to empower patients and enable providers to engage in patient centered communication. The specific aims are to: 1. Engage with patients and healthcare providers who have used the tools in the pilot study (ClinicalTrials.gov Identifier NCT02522286) at the Sutter Health Palo Alto Medical Foundation (PAMF), as well as new stakeholders at University of California San Diego Health System and Meyers Primary Care Institute at University of Massachusetts and Reliant Medical Group, to further refine and adapt these patient-centered interventions to be integrated into real world primary care clinics. 2. Conduct a large scale cluster RCT with three arms, to evaluate the comparative effectiveness of three interventions: OPEN with in-person SPI training (High Touch), OPEN with online SPI training (High Tech), and ASK. Primary outcomes will include patient perceptions of how well their PCPs have engaged them in patient centered communication. The investigators will also measure patients' confidence in managing their health, intention to follow through with care plans, and downstream behaviors in following through with care plans, use of services such as phone calls, secure messaging, and additional visits. 3. Identify the strategy that has the most potential for sustained impact and replication within and across healthcare systems. The investigators will analyze the fidelity to the intervention protocols, including consistency of delivery as intended and the time/effort involved in implementing the interventions. The investigators will also assess the extent to which the programs become institutionalized. The investigators anticipate that this multi-level healthcare system intervention will result in significant improvement in: patient satisfaction with how PCP has engaged them in the visit, confidence in selfcare; patients' intention to adhere to care plan, and clinical indicators. Furthermore, more effective communication would lower health service utilization after the visit. The investigators further expect that the intervention will affect physicians', medical assistants' and nurses' experience as well as healthcare system leaders' intention to implement in routine practice.

Official Title

Improving Patient-Centered Communication in Primary Care: A Cluster Randomized Controlled Trial of the Comparative Effectiveness of Three Interventions

Keywords

Patient Engagement Physician's Role Physician-Patient Relations Patient Activation Virtual standardized patient coaching Standardized patient instructor coaching Patient centered communication OPEN High Touch OPEN High Tech ASK

Eligibility

You can join if…

Open to people ages 18 years and up

For patient participants:

  • Adults 18 years and older,
  • Have an activated account to the patient portal of the electronic health record
  • Able to read/write in English or Spanish
  • Have an appointment with their PCP, who has volunteered to be participate in the study, during the data collection period
  • Willing and able to provide informed consent and complete brief questionnaires online.

For health care team (primary care providers, nurse and medical assistants) participants:

  • Employed at one of the participating study clinics
  • Willing and able to provide informed consent and complete brief questionnaires online.

You CAN'T join if...

For patient participants:

  • People who don't speak English or Spanish
  • People who do not have an active My Chart/My Health Online account.
  • Younger than 18 years old.

Locations

  • University of California San Diego Health System not yet accepting patients
    San Diego California 92093 United States
  • Palo Alto Medical Foundation Research Institute not yet accepting patients
    Mountain View California 94040 United States

Lead Scientist

  • Ming Tai-Seale
    Professor, Family Medicine and Public Health. Authored (or co-authored) 67 research publications

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
University of California, San Diego
ID
NCT03385512
Study Type
Interventional
Last Updated