Advancing Decisions About Virtual Service Encounters
- Conditions
- Health Care CostsDelivery of Health Care
- Interventions
- Behavioral: Clinician Coaching SessionsOther: Personalized text messages to patients
- Registration Number
- NCT06539988
- Lead Sponsor
- VA Office of Research and Development
- Brief Summary
Expanded availability of virtual care encounters in Primary Care provides new opportunities to improve Veterans' outcomes by aligning encounter modalities with their needs and preferences. Yet, Veterans and their Primary Care physicians (PCPs) lack personalized information about the benefits and costs of different Primary Care modalities that is needed to maximize the value of Primary Care encounters. To address this problem, in this study the investigators will use surveys and interviews to identify what Veterans and PCPs perceive to be the benefits and optimal uses of different Primary Care encounter modalities. They will then supplement their existing system for communicating encounter costs to Veterans and PCPs with new interactive messaging about benefits and optimal uses of different encounter modalities. Finally, this novel Advancing Decisions about Virtual Service Encounters (ADViSE) intervention will be optimized through user-centered refinement before evaluating its effects on Veteran-centered outcomes, use of virtual care, and intermediate health outcomes in a randomized controlled trial (RCT).
- Detailed Description
The investigators will evaluate, in a stepped wedge cluster RCT, the effectiveness of the optimized ADViSE intervention, which will use interactive text messages for Veterans and point-of-care (POC) information and brief coaching for PCPs to help Veterans and their clinicians make well-informed decisions about available encounter types to meet each Veteran's needs and optimize the perceived value of their healthcare. A mixed methods stepped wedge cluster RCT will be conducted in which the optimized ADViSE intervention will be rolled out to PCPs and Veterans in each of 6 VA Ann Arbor Healthcare System (VAAAHS) Patient Aligned Care Teams (PACTs) in a randomly assigned order. For each Veteran participant, pre-post differences in outcomes during the 6-month intervention period will be compared to a 6-month pre-intervention control period.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 600
- Veteran inclusion criteria are having an upcoming face-to-face (F2F), telephone, or VA Video Connect (VVC) appointment in the next 8 to 12 weeks
- Having at least 3 Primary Care F2F, telephone, or VVC encounters in the previous 12 months
- Able to provide informed consent
- Willing and able to receive text messages from the VA Patient Engagement, Tracking, and Long-term Support (PETALS) platform
- Veteran exclusion criteria are a CDW diagnosis of mild cognitive impairment, dementia, or a psychotic disorder
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Receiving the optimized ADviSE Intervention Clinician Coaching Sessions 6 months of selected text messages from a library developed and refined in previous study aims. Receiving the optimized ADviSE Intervention Personalized text messages to patients 6 months of selected text messages from a library developed and refined in previous study aims.
- Primary Outcome Measures
Name Time Method Veterans' perceptions of the value of their healthcare 6 months prior to intervention and 6-months post intervention Measured by survey at baseline and intervention end
- Secondary Outcome Measures
Name Time Method Blood pressure (BP) < 140/90 among Veterans with diabetes 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
Flu vaccine receipt among Veterans 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
Copay costs for Veterans 6 months prior to intervention and 6 months post intervention Measured using CDW data
Face-to-Face (F2F) encounters with assigned Patient Aligned Care Team (PACT) 6 months prior to intervention and 6-months post intervention Measured using CDW data
Veterans' satisfaction with healthcare 6 months prior to intervention and 6-months post intervention Measured by survey at baseline and intervention end
Veterans' preferences for virtual care 6 months prior to intervention and 6-months post intervention Measured by survey at baseline and intervention end
Total healthcare-associated costs for Veterans 6 months prior to intervention and 6 months post intervention Sum of copay costs, travel costs, and time costs measured using CDW data
Travel costs for Veterans 6 months prior to intervention and 6 months post intervention Measured using CDW data
Statin use among Veterans with ischemic heart disease 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
Breast cancer screening among female Veterans 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
Colon cancer screening among Veterans aged 45-75 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
VA Video Connect (VVC) encounters with assigned Patient Aligned Care Team (PACT) 6 months prior to intervention and 6-months post intervention Measured using Corporate Data Warehouse (CDW) data
Hemoglobin A1c level <8% among Veterans with diabetes 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
Statin use among Veterans with diabetes 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
Time costs for Veterans 6 months prior to intervention and 6 months post intervention Measured using CDW data
Telephone encounters with assigned Patient Aligned Care Team (PACT) 6 months prior to intervention and 6-months post intervention Measured using CDW data
Cervical cancer screening among female Veterans 6 months prior to intervention and 6 months post intervention Electronic quality measure (eQM) measured using CDW data
Trial Locations
- Locations (1)
VA Ann Arbor Healthcare System, Ann Arbor, MI
🇺🇸Ann Arbor, Michigan, United States