Working…
COVID-19 is an emerging, rapidly evolving situation.
Get the latest public health information from CDC: https://www.coronavirus.gov.

Get the latest research information from NIH: https://www.nih.gov/coronavirus.
ClinicalTrials.gov
ClinicalTrials.gov Menu

Using Multimedia Patient Feedback to Reduce Disparities in VA Healthcare

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00914485
Recruitment Status : Completed
First Posted : June 5, 2009
Results First Posted : March 9, 2015
Last Update Posted : April 27, 2015
Sponsor:
Information provided by (Responsible Party):
VA Office of Research and Development ( US Department of Veterans Affairs )

Brief Summary:
The proposed research will provide important insight into two serious problems for veterans' healthcare: 1) mixed effectiveness of communication improvement interventions in the VA to date, and 2) persistence of racial/ethnic disparities in VA healthcare.

Condition or disease Intervention/treatment Phase
Primary Care Behavioral: Provider Communication Skills Training Not Applicable

Detailed Description:

The proposed research will provide important insight into two serious problems for veterans' healthcare: 1) mixed effectiveness of communication improvement interventions in the VA to date, and 2) persistence of racial/ethnic disparities in VA healthcare. We have identified 4 "best acts" of physician communication that patients believe to be most important in a clinical interaction. We propose to develop and evaluate a physician communication intervention that focuses specifically on these acts. In addition, our abundance of pilot study data from patients of various races/ethnicities enables us to create an intervention applicable to communication that spans patient race/ethnicity. Evaluating this intervention with physicians and patients in 2 independent VA primary care settings will help determine whether a patient-driven communication focus that incorporates input from patients of varied race/ethnicity can help "close the gap" in health outcomes between white and minority veterans.

We aim to (1) demonstrate the efficacy of using "best acts" of physician communication as content for an intervention to improve physician communication skills overall and reduce variation in communication with white versus racial/ethnic minority patients, and (2) assess the impact of patient experiences of "best acts" on patients' perceptual and behavioral outcomes.

We have collected data from over 200 primary care patients as they viewed a video of themselves and their physician interacting during a clinic visit. From these data, we are developing an educational intervention for physicians that focuses specifically on the 4 "best acts" we have identified. Scripts of the 4 "best acts" will be developed, and standardized patients at Baylor College of Medicine will perform the acts, which will be video recorded. We will then conduct a 2-site longitudinal observational study of 16 primary care physicians (8 at each site) and 36 patients of each physician. At the first site at 3-month intervals, physicians will attend an instruction session consisting of viewing a video of one best act and participating in group discussion, role-playing re-enactment of the act, and formulation of bulleted "take-away" points to facilitate subsequent recall. Once completed, the sequence of sessions will occur at the second site. At both sites, clinical interactions of participating physicians and patients will be audio recorded, and audio recordings will be analyzed for frequency of occurrence of the 4 "best acts." After each study visit, each patient will complete validated surveys measuring patients' perceptions of their physician on 4 affective dimensions known to impact patients' subsequent perceptual and behavioral outcomes. Efficacy will be assessed across patient demographics.

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 369 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Using Multimedia Patient Feedback to Reduce Disparities in VA Healthcare
Study Start Date : December 2009
Actual Primary Completion Date : February 2013
Actual Study Completion Date : March 2013

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Provider Communication Skills Training
Provider clinical communication training intervention
Behavioral: Provider Communication Skills Training
Consists of 4 separate 1-hour sessions, 1 per "best act," in which physicians view 3 video-recorded performances of each act performed by trained actors of varied race/ethnicity.




Primary Outcome Measures :
  1. Change in Provider Use of Best Acts From Baseline to Post-Intervention [ Time Frame: Baseline, 18 months ]
    Mean per-patient use of "best acts" learned during provider communication skills intervention, post-intervention minus baseline.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Any patient included in the regular panel of a participating physician at either study site who is a returning patient for that physician. Since 2 of the patient perceptual measures included require the pre-existence of a relationship with a specific physician, we will only enroll patients who have been seen by their physician before.

Exclusion Criteria:

  • Physical disabilities that prohibit unassisted participation in research protocol:

    • legal blindness
    • dementia
    • severe post-traumatic stress disorder
    • schizophrenic disorder
    • Alzheimer's disease
    • bipolar disorder
    • and severe anxiety and/or mood disorders (must be documented in patient's medical record or attested to by patient, physician or charge nurse).
  • Also, no patients new to VA primary care or to a given participating physician will be enrolled.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00914485


Locations
Layout table for location information
United States, Louisiana
Southeast Louisiana Veterans Health Care System, New Orleans, LA
New Orleans, Louisiana, United States, 70112
United States, Texas
Michael E. DeBakey VA Medical Center, Houston, TX
Houston, Texas, United States, 77030
Sponsors and Collaborators
US Department of Veterans Affairs
Investigators
Layout table for investigator information
Principal Investigator: P. Adam Kelly, PhD MBA BS Southeast Louisiana Veterans Health Care System, New Orleans, LA
Layout table for additonal information
Responsible Party: US Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00914485    
Other Study ID Numbers: IIR 07-194
First Posted: June 5, 2009    Key Record Dates
Results First Posted: March 9, 2015
Last Update Posted: April 27, 2015
Last Verified: April 2015