Non-Inferiority of Peer Comparison Interventions

Completed

• Conditions: Respiratory Tract Infections
• Interventions: Behavioral: Peer Comparison

• Registration Number: NCT05575115
• Lead Sponsor: University of Southern California

Brief Summary

The objective of this study is to test the hypothesis that the Peer Comparison intervention in the Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections (BEARI) trial (Meeker et al. 2016) promoting antibiotic stewardship did not adversely impact physician job satisfaction as measured in the study exit survey at trial completion. Detrimental impacts on job satisfaction is a phenomenon that was observed in a randomized controlled trial using a Peer Comparison intervention with different characteristics from the BEARI trial. (Reiff et al. 2022) The BEARI trial sample size, intraclass correlation, and measurement of job satisfaction are comparable to Reiff et al. 2022.

Detailed Description

This secondary analysis includes all providers from the Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections (BEARI) trial who completed the exit survey following 18 month trial completion. The objective of this study is to test the hypothesis that the Peer Comparison intervention in the BEARI trial (Meeker et al. 2016) promoting antibiotic stewardship did not adversely impact physician job satisfaction. Detrimental impacts on job satisfaction is a phenomenon that was observed in a randomized controlled trial using a Peer Comparison intervention with different characteristics from the BEARI trial. (Reiff et al. 2022) The BEARI trial sample size, intraclass correlation, and measurement of job satisfaction are comparable to Reiff et al. 2022.

The differences in Peer Comparison interventions between BEARI and Reiff et al. include the following:

1. Differences in physicians' control and agency over patient adherence to screening recommendations vs. their own antibiotic prescribing

2. Relatedly, in the antibiotic stewardship study, there were achievable benchmarks for improvement, including a feedback and ranking framework allowing all physicians to attain the highest status and thus obtain positive feedback.

3. Differences in framing and presentation of messages

The investigators define a clinically significant detrimental effect on job satisfaction as 27% of individuals reducing job satisfaction ratings by one point on a 5-point likert scale. This shift is equivalent to a mean difference of 0.32 and a Cohen's d of 0.36. This difference corresponds to approximately a ⅓ reduction in job satisfaction on a 5-point likert scale.

H0: The BEARI Peer Comparison intervention had a clinically and statistically significant detrimental effect on physician job satisfaction. Control-PeerComparison\>=0.32

HA: The Peer Comparison intervention had no clinically significant negative impact on physician job satisfaction. Control-PeerComparison\<0.32

The investigators will conduct a traditional hypothesis test Control-PeerComparison= 0.0 as a secondary analysis.

Study Timeline

• Study Start: 2011-11-01
• Primary Completion: 2014-04-01
• Study Completion: 2014-09-01
• Status Verified: 2022-10
• Study First Submitted: 2022-10-05
• Study First Submitted QC: 2022-10-07
• Last Update Submitted: 2022-10-07
• Study First Posted: 2022-10-12
• Last Update Posted: 2022-10-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 201

Inclusion Criteria

• All providers included in the BEARI trial

Exclusion Criteria

• N/A

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Peer Comparison	Peer Comparison	Providers from the BEARI trial who received the Peer Comparison intervention.

Primary Outcome Measures

Name	Time	Method
Job satisfaction	18 months	Impact of BEARI Peer Comparison intervention on Job Satisfaction, as measured by the following question completed as part of the BEARI trial exit survey: "Please indicate how much you agree or disagree with the following statement. Overall, I am satisfied with my current job."