Avatar Contraception Communication Training

Improving Clinician Communication About Contraception Using Teen and Parent Avatars

In order to support the desire of most adolescents to delay pregnancy (parenting) until their own adulthood, pediatricians must be comfortable and skilled in having reproductive health conversations with adolescents and the mothers of adolescents. Advocates for Youth (AFY), a national, youth-facing, well-established, non-profit, is known for innovative sexual and reproductive health programs. AFY successfully implemented a virtual simulation for schoolteachers to practice sex education scenarios by interacting with culturally diverse student avatars. We will partner with AFY to adapt their novel simulation-based approach to train medical residents in using SDM with youth and parent avatars. Our long-term goal is to build clinician confidence in SDM and actual skills via simulation training with dyadic avatars. We will also explore how evaluation of clinician communication skills varies from youth-, parent-, and clinician-viewpoints.

Study Overview

• Status: Not yet recruiting
• Conditions: Communication
• Intervention / Treatment: Behavioral: avatar communication training

Detailed Description

Specific Aims seek to (1) iteratively adapt and refine the simulation training (1a) and measurement tools (1b) with three community advisory boards (CAB) of separate groups of teens, parents, and clinicians; and (2) conduct a proof-of-concept pre-post evaluation of clinician confidence in counseling dyads after one-time exposure to the simulation (n=100 medical residents). We will record residents' communications in the simulation and a subset of clinicians, parents, and adolescents from each CAB will evaluate residents' SDM skills via the Person-Centered Contraception Counseling (PCCC) scale. Hypothesis: Most medical residents (75%) will self-report improvement or stability in confidence with high acceptability of the simulation training. We will explore 1) overall concordance between self- and expert-reported evaluation outcomes (SDM skills, PCCC scale); 2) compare the distribution of each evaluation item by evaluator; and 3) explore correlations between scales by evaluator. Impact: This proof-of-concept study, co-developed and co-evaluated with community members and families, fills a gap in communication training to inform a future fully powered ORBIT stage 3 efficacy trial to test actual triadic communication in the real-world with comparator groups of medical residents across national training programs.

• Study Type: Interventional
• Enrollment (Estimated): 166
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jenny KR Francis, MD, MPH; Phone Number: 214-456-6792; Email: jenny.francis@utsouthwestern.edu
• Study Contact Backup: Name: Jenny KR Francis, MD, MPH; Phone Number: 214-456-6792; Email: jkrfrancis@gmail.com

Study Locations

• United States
  • Texas
    • Dallas, Texas, United States, 75390-0966
      • UT Southwestern Medical Center
      • Contact: Jenny KR Francis, MD, MPH; Phone Number: 214-456-6792; Email: jenny.francis@utsouthwestern.edu
      • Contact: Jenny KR Francis, MD, MPH; Phone Number: 214-456-6792; Email: jkrfrancis@gmail.com
      • Principal Investigator: Jenny KR Francis, MD, MPH
    • Dallas, Texas, United States, 75207
      • Childrens Health Adolescent and Young Adult Medicine (AYA) Clinic
      • Contact: Jenny K Francis, MD; Phone Number: 214-456-6792; Email: jenny.francis@utsouthwestern.edu
      • Contact: May KR Lau, MD; Phone Number: 214-456-9099; Email: may.lau@utsouthwestern.edu
      • Principal Investigator: Jenny KR Francis, MD, MPH

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria (providers):

• Providers (medical residents, fellows, attendings)
• Recruited from the Adolescent and Young Adult (AYA) Medicine Clinic at Children's Medical Center of Dallas.

Exclusion Criteria:

• Unable to speak or read in Spanish/English

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Avatar training; One hundred physician learners will train with the avatar communication training tool as a behavioral intervention. Before the training (T0), the learners will complete a pre-survey to assess their baseline confidence. At the start of training, after a brief introduction and orientation to the tool, the learners will complete a 10-min uninterrupted scenario with a teen-parent avatar dyad about a contraception scenario. After the initial scenario (T1), the learner will pause and complete an assessment to evaluate use of SDM (Shared decision making) skills and PCCC (person-centered contraceptive counseling). Then, the learner will train for an hour with the tool. At the end (T2), the learner will complete another uninterrupted scenario and evaluate their confidence, SDM, and PCCC skills.

Behavioral: avatar communication training; Avatar simulates a mother and a daughter for the pediatrician to practice communication about contraception.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Questionnaire	Multiple questions will be aggregated to arrive at one reported value to determine "improvement or stability in confidence" in shared decision-making communication.	Change from baseline (T0) at 0 hours, and end of training (T2) at 2 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability Questionnaire	Weiners implementation outcome measure Acceptability of Intervention Measure (AIM). Items are measured on a 5-point Likert scale (Completely Disagree-Completely Agree). Score is calculated mean with the higher score meaning acceptability.	At end of study (T2) at 2-hours
Questionnaire	Self-reported evaluation of a behavioral outcome (SDM (shared decision-making) skills and PCCC (person-centered contraception counseling) from start (T1) to end of training (T2)	Change from start (T1) at 20 minute to end of training (T2) at 2 hours
Questionnaire	Expert evaluation of behavioral outcome (SDM (shared decision-making) skills and PCCC (person-centered contraception counseling) from start (T1) to end of training (T2)	Change from start (T1) at 20 minute to end of training (T2) at 2 hours

Collaborators and Investigators

• Sponsor: University of Texas Southwestern Medical Center
• Investigators: Principal Investigator: Jenny KR Francis, MD, UTSouthwestern

Study record dates

Study Major Dates

• Study Start (Estimated): April 1, 2026
• Primary Completion (Estimated): June 30, 2030
• Study Completion (Estimated): June 30, 2030

Study Registration Dates

• First Submitted: May 16, 2023
• First Submitted That Met QC Criteria: August 15, 2023
• First Posted (Actual): August 16, 2023

Study Record Updates

• Last Update Posted (Estimated): September 3, 2025
• Last Update Submitted That Met QC Criteria: August 26, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Adolescent; Training; Contraception
• Additional Relevant MeSH Terms: Behavior; Communication
• Other Study ID Numbers: Pending funding

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: This study will collect 100 pre-post-surveys from clinicians in training, and 300 survey evaluations of video recordings. The study protocol, data tracking forms, survey, code book, data dictionary and a glossary of domain-specific terms will be shared in a portable document format (PDF).
• IPD Sharing Time Frame: 12mo after collection and available per Institutional Review Board standards
• IPD Sharing Access Criteria: All deidentified study data that are not designated as restricted use will be made available as public use data to the research community via DSDR.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No