Encouraging Annual Wellness Visits Among Keystone ACO Beneficiaries
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 41,472
- 试验地点
- 2
- 主要终点
- Proportion of patients who completed an AWV visit
研究概览
简要总结
Annual Wellness Visits (AWVs) are a type of detailed healthcare checkup to which Medicare beneficiaries are entitled, free of charge, once per year. The purpose of the current study is to assess what content and communication modality results in the most effective messaging campaign to encourage Medicare beneficiaries to schedule their AWVs.
详细描述
Annual Wellness Visits (AWVs) are a type of detailed healthcare checkup to which Medicare beneficiaries are entitled, free of charge, once per year. The Keystone Affordable Care Organization (KACO), of which Geisinger is a part, is working to increase the number of eligible patients who take advantage of AWVs via mail and telephone outreach.
The purpose of the current study is to assess what content and communication modality results in the most effective messaging campaign. Patients will either receive a phone call or a mailed postcard, or they will be part of a no-contact control condition. Furthermore, the content of the postcard will vary in terms of humor and salience, as well as whether telehealth is mentioned as an AWV option.* Although telehealth is a great option for patients who are unable to attend an in-person visit, the latter is preferable in terms of quality of care. Furthermore, insurance coverage for telehealth visits may not extend indefinitely beyond the COVID-19 pandemic. Highlighting the telehealth option may help attract patients who would not otherwise get an AWV, increasing the effectiveness of the intervention. On the other hand, it may unintentionally nudge patients who would otherwise have scheduled an in-person visit to opt for telehealth instead.
The following research questions will assess effectiveness in increasing patient scheduling of an AWV:
- Are postcards effective compared with a no-contact control condition?
- How effective are postcards when compared with phone calls, a presumably more intrusive type of intervention?
- Is a humorous cartoon, accompanied by language using examples to make salient the future health risks that could be prevented, more effective than stock photography of similar patient-doctor situations (typically used in outreach), accompanied by prevention language that is less specific?
- Is it more effective to highlight the availability of telehealth video visits than not to mention that option?
- Are in-person AWVs are scheduled at least as frequently when the telehealth option is highlighted as when it is not?
Included in the study will be patients from 7 KACO partner sites: Caring Community Health Center, Evangelical Community Hospital, Geisinger, Geisinger-Hm Joint Venture, Holy Spirit, Wayne Memorial Hospital, and Wright Center. Generalized linear mixed models (GLMMs) will examine the primary study outcomes as a function of the study arms (between-subjects), with partner site included as a random effect, assuming high intraclass correlation coefficients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Health Services Research
- 盲法
- Double (Participant, Care Provider)
盲法说明
Participants (i.e., patients) will not be informed specifically of their assignment to different arms throughout the study. Providers who conduct AWVs will not be randomized to study arms or informed of patient assignment.
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •KACO Medicare beneficiary
- •Haven't had an AWV or due for their next one
- •For phone call condition only: patients of Evangelical Community Hospital, Wayne Memorial Hospital, and the Wright Center
排除标准
- •Patient has already been called about AWV or had a visit scheduled
- •For "patient initiated contact" outcome only: patients of Wayne Memorial Hospital or who have not been assigned to a partner site. This is because postcards received by these patients will not include a specific phone number to call.
- •For telehealth conditions only: patients of Wayne Memorial Hospital
结局指标
主要结局
Proportion of patients who completed an AWV visit
时间窗: 3 months after start of intervention
Patient completed an AWV
Proportion of patients who scheduled an AWV appointment
时间窗: 1 month after start of intervention
Patient scheduled an AWV appointment
次要结局
- Proportion of patients who scheduled an AWV appointment(3 months after start of intervention)
- Proportion of patients who initiated contact(3 months after start of intervention)
- Proportion of visits that were in-person vs. tele-visit(3 months after start of intervention)
研究者
Amir Goren
Program Director, Behavioral Insights Team
Geisinger Clinic