Conversational IT for Better, Safer Pediatric Primary Care

Phase 2

Completed

• Conditions: Medication Management; Preventive Care
• Interventions: Behavioral: Personal Health Partner and Counseling (PHP+C); Behavioral: Safety Training

• Registration Number: NCT01188629
• Lead Sponsor: Boston Medical Center

Brief Summary

Interactive telephony technologies offer a potentially highly effective, patient-centered communication modality by guiding parents at home through interactive discussions that can gather information and actively reinforce recommendations and treatments. Interactive telephony systems are particularly well suited for use in vulnerable populations since access to the telephone is nearly universal, and the system does not rely on reading printed text. The investigators propose to develop and evaluate an integrated patient-centered health information system, the Personal Health Partner (PHP). The PHP will use fully automated, interactive, conversations to gather personal health data and counsel parents before scheduled visits, exchange that data with the child's primary care clinician via the electronic health record (EHR), and offer personalized follow-up assessment and counseling after visits. The information technology-based approach to be evaluated in this project will link parents and children outside the clinical setting with their primary care center and will offer comprehensive assessments AND counseling to reinforce and support parental behavior change.

Detailed Description

A large gap exists between what is recommended for effective primary care of children and what actually takes place in pediatric primary care settings, especially in the areas of preventive care. Furthermore, although medication management (safety and effectiveness) issues have emerged as an important factor for children, little is known about how medication is actually used by families at home.

With growing use of the electronic health record (EHR) come new opportunities to link patient-centered information with clinical health information systems. Linkage of these systems has the potential to inform and activate parents, provide much richer data to drive decision support at the point-of-care, and to provide ongoing support for long-term behavior change following primary care visits. The use of conversational technologies as the foundation for the project offers a number of unique advantages especially the support of lower-literacy populations and near-universal access. Systems like the Personal Health Partner (PHP) represent a model for the future of ambulatory care and the sustainable, affordable delivery of higher quality and safer care by primary care clinicians in the future.

Study Timeline

• Study Start: 2007-07
• Study First Submitted: 2010-08-24
• Study First Submitted QC: 2010-08-24
• Study First Posted: 2010-08-25
• Primary Completion: 2011-02
• Study Completion: 2011-08
• Status Verified: 2015-11
• Last Update Submitted: 2015-11-16
• Last Update Posted: 2015-11-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 475

Inclusion Criteria

• Parents of children will be enrolled in the study if they meet a set of eligibility criteria which includes:

  1. Age 0 - 11 years old
  2. A primary care patient at Boston Medical Center
  3. An English speaking child and parent.

Exclusion Criteria

• Children will be considered ineligible for the study if they plan to move away from the Boston area in less than 3 months, or are participating in another primary care research project with content that overlaps the content within this study. Currently, there are no studies being conducted that would lead to exclusion.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Personal Health Partner and Counseling (PHP+C)	Personal Health Partner and Counseling (PHP+C)	-
Safety Training	Safety Training	-

Primary Outcome Measures

Name	Time	Method
Personal Health Partner (PHP) assessment with electronic health record (EHR) data exchange before pediatric primary care visits	2 week -1day before doctor's appointment and 1 week after appointment	PHP assessment with EHR data exchange before pediatric primary care visits will be associated with more comprehensive preventive and medication management assessments when compared to usual care

Secondary Outcome Measures

Name	Time	Method
Personal Health Partner (PHP) pre-visit counseling with post-visit reinforcement	2 week-1day before doctor's appointment and 1 week after appointment	PHP pre-visit counseling with post-visit reinforcement will be associated with increased preventive and medication management counseling; healthier parental behaviors; and increased parental activation when compared to parents receiving usual care.

Trial Locations

Locations (1)

Boston Medical Center; 🇺🇸 Boston, Massachusetts, United States