Advancing Decisions About Virtual Service Encounters (ADViSE)
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 600
- 试验地点
- 2
- 主要终点
- Veterans' perceptions of the value of their healthcare
研究概览
简要总结
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).
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •Veteran exclusion criteria are a CDW diagnosis of mild cognitive impairment, dementia, or a psychotic disorder
研究组 & 干预措施
Receiving the optimized ADviSE Intervention
6 months of selected text messages from a library developed and refined in previous study aims.
干预措施: Clinician Coaching Sessions (Behavioral)
Receiving the optimized ADviSE Intervention
6 months of selected text messages from a library developed and refined in previous study aims.
干预措施: Personalized text messages to patients (Other)
Control period
Usual care.
结局指标
主要结局
Veterans' perceptions of the value of their healthcare
时间窗: 6 months prior to intervention and 6-months post intervention
Measured by survey at baseline and intervention end
次要结局
- Blood pressure (BP) < 140/90 among Veterans with diabetes(6 months prior to intervention and 6 months post intervention)
- Flu vaccine receipt among Veterans(6 months prior to intervention and 6 months post intervention)
- Copay costs for Veterans(6 months prior to intervention and 6 months post intervention)
- Face-to-Face (F2F) encounters with assigned Patient Aligned Care Team (PACT)(6 months prior to intervention and 6-months post intervention)
- Veterans' satisfaction with healthcare(6 months prior to intervention and 6-months post intervention)
- Veterans' preferences for virtual care(6 months prior to intervention and 6-months post intervention)
- Total healthcare-associated costs for Veterans(6 months prior to intervention and 6 months post intervention)
- Travel costs for Veterans(6 months prior to intervention and 6 months post intervention)
- Statin use among Veterans with ischemic heart disease(6 months prior to intervention and 6 months post intervention)
- Breast cancer screening among female Veterans(6 months prior to intervention and 6 months post intervention)
- Colon cancer screening among Veterans aged 45-75(6 months prior to intervention and 6 months post intervention)
- VA Video Connect (VVC) encounters with assigned Patient Aligned Care Team (PACT)(6 months prior to intervention and 6-months post intervention)
- Hemoglobin A1c level <8% among Veterans with diabetes(6 months prior to intervention and 6 months post intervention)
- Statin use among Veterans with diabetes(6 months prior to intervention and 6 months post intervention)
- Time costs for Veterans(6 months prior to intervention and 6 months post intervention)
- Telephone encounters with assigned Patient Aligned Care Team (PACT)(6 months prior to intervention and 6-months post intervention)
- Cervical cancer screening among female Veterans(6 months prior to intervention and 6 months post intervention)