Nudging Healthcare Organizations to Adopt New Care Delivery Practices
24 de junio de 2020 actualizado por: Amber Barnato, Dartmouth-Hitchcock Medical Center
Accelerating the Use of Evidence-based Innovation in Health Care Systems
This two-arm, parallel group randomized controlled trial will assess the impact of written social norms messaging (i.e., behavioral 'nudges') on healthcare organization administrators' decision to access online resources that support the adoption of evidence-based healthcare delivery practices.
The healthcare delivery practices include the use of population screening tools, clinical practice guidelines, and shared decision making training.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
The purpose of this study is to assess if behavioral 'nudges' impact the likelihood of healthcare organization administrators accessing technical assistance resources to support uptake of care delivery practices that: (1) have the potential to improve patient outcomes; and (2) have already been adopted by most healthcare organizations. A 'nudge' is a change in the way information is presented that attempts to steer people in a certain direction but does not restrict their choices.
The investigator will conduct a randomized controlled trial of written messages to healthcare administrators at three types of healthcare organizations - physician practices, hospitals and healthcare systems - from among 3,402 administrators who completed Dartmouth's National Survey of Healthcare Organizations and Systems (NSHOS) in 2017-2018.
In Fall 2019 the investigator will mail a customized report to all NSHOS respondents that compares their organizations' survey responses to their peer organizations. The investigator will randomize the 2,387 respondents whose organizations have not implemented one or more of up to seven chosen care delivery practices to cover letters with or without social norms messaging. The written messaging in the 'control condition' cover letter lists the practices for which the NSHOS team has prepared technical assistance materials in support of practice adoption, and contains a link to these online resources. The 'intervention condition' additionally highlights the organization's performance compared to its peers in adopting the practices using visual data display and explicit social norms messaging.
Tipo de estudio
Intervencionista
Inscripción (Actual)
2387
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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New Hampshire
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Lebanon, New Hampshire, Estados Unidos, 03766
- Dartmouth Hitchcock Medical Center
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Participant responded to NSHOS survey and reported that their organization had not implemented at least one of up to seven pre-determined care delivery practices, out of the following eight practices featured in the NSHOS: Screening for opioid use specifically; Screening for substance use disorders; Screening for depression; Screening for interpersonal violence; Method for identifying high-cost patients; Use of evidence-based guidelines for congestive heart failure; Use of evidence-based guidelines for sepsis (included in letters to healthcare system administrators, but not hospitals or physician practices); Training for shared decision making (included in letters to hospitals and physician practices but not healthcare systems)
Exclusion Criteria:
- Did not respond to NSHOS survey
- Participant responded to NSHOS survey and reported that their organization had already implemented each of seven pre-determined care delivery practices, out of the following eight practices featured in the NSHOS: Screening for opioid use specifically; Screening for substance use disorders; Screening for depression; Screening for interpersonal violence; Method for identifying high-cost patients; Use of evidence-based guidelines for congestive heart failure; Use of evidence-based guidelines for sepsis (included in letters to healthcare system administrators, but not hospitals or physician practices); Training for shared decision making (included in letters to hospitals and physician practices but not healthcare systems)
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Investigación de servicios de salud
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Nudge Letter
Participants receive a letter that highlights their performance vs. peer organizations on up to seven care delivery practices featured in the National Survey of Healthcare Organizations and Systems (NSHOS).
The letter includes a link to access technical assistance resources and is sent alongside the participant's NSHOS respondent report.
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This group will receive a letter noting that their organization has not implemented at least one common care delivery practice that a majority their peers have already implemented.
The letter will also note the percentage of peer organizations that have implemented the practice.
This is done using peer comparison data and social norms messaging.
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Sin intervención: Control Letter
Participants receive a letter with a link to technical assistance resources; the letter is sent alongside the participant's NSHOS survey respondent report.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Percentage of participants who access the technical assistance resource webpage
Periodo de tiempo: Up to 2 months after letter is sent
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The percentage of participants who access the technical assistance webpage will be determined by email and webpage analytics.
The primary analysis will be intention to treat (i.e., among all participants sent a letter); a secondary analysis will be a 'per protocol' analysis (i.e., among all participants whose letter was not sent back as undeliverable).
Exploratory sub-group analyses will be conducted by each strata characteristic (e.g., whether organization category influences the likelihood of accessing the webpage).
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Up to 2 months after letter is sent
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Number of unique resource views on technical assistance resource webpage
Periodo de tiempo: Up to 2 months after letter is sent
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The number of unique resources viewed from the webpage, as determined by website analytics.
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Up to 2 months after letter is sent
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Percentage of participants who request connection to peer organizations via the technical assistance resource webpage
Periodo de tiempo: Up to 2 months after letter is sent
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The number of unique organizations that request to be matched with other healthcare organizations that have successfully implemented one of the care delivery practices, in order to learn from their experiences (there will be a clickable link on the webpage for organizations to request this connection).
This will be determined by website analytics.
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Up to 2 months after letter is sent
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Perceived effect of letter on administrators' intentions
Periodo de tiempo: Up to 4 months after letter is sent
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Effect of letter on administrators' intentions and actions, measured by qualitative interviews in a sub-sample of participants.
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Up to 4 months after letter is sent
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Amber E Barnato, MD, MPH, MS, Dartmouth College
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
9 de diciembre de 2019
Finalización primaria (Actual)
9 de febrero de 2020
Finalización del estudio (Actual)
8 de junio de 2020
Fechas de registro del estudio
Enviado por primera vez
14 de noviembre de 2019
Primero enviado que cumplió con los criterios de control de calidad
22 de noviembre de 2019
Publicado por primera vez (Actual)
25 de noviembre de 2019
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
26 de junio de 2020
Última actualización enviada que cumplió con los criterios de control de calidad
24 de junio de 2020
Última verificación
1 de junio de 2020
Más información
Términos relacionados con este estudio
Otros números de identificación del estudio
- Dartmouth IRB protocol #28763
- 1U19HS024075 (Subvención/Contrato de la AHRQ de EE. UU.)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
NO
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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