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- Klinische proef NCT07652359
Empowering Monterey Bay Residents for Activated, Collaborative, and Equitable Care (EMBRACE)
EMBRACE - Empowering Monterey Bay Residents for Activated, Collaborative, and Equitable Care
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
This study will assess if an intervention that is delivered by a Stanford trained Research Assistant (RA) will help people better engage in their care with their clinicians.
A total of n=138 patients will be recruited for this study using flyers that will be distributed to our community partner organizations. Approximately 69 patients will be randomized into each study group.
Participants will receive either usual care or will be assigned into the intervention (EMBRACE). Participants assigned to the intervention will receive education provided by a trained RA who will meet with participants by phone for 30 minutes once a month for 6 months to: 1) discuss the importance of shared decision-making, advance care planning, and goal concordant care, and 2) encourage to engage in SDM with their clinicians.
All participants in the study will receive 4 surveys: at baseline (at time of enrollment), 1, 3, and 6 months after study enrollment by telephone, mail, or through a secure REDCap online link delivered to participants.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Manali I Patel, MD, MPH, MS
- Telefoonnummer: (650) 736-2768
- E-mail: manalip@stanford.edu
Studie Locaties
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California
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Palo Alto, California, Verenigde Staten, 94304
- Werving
- Stanford University
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Contact:
- Manali I. Patel, MD, MPH, MS
- E-mail: manalip@stanford.edu
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Participants must be receiving clinical care by a primary care physician in the Monterey area
- Participants must be 18 years or older.
- Participants must speak either English or Spanish.
- Participants must be able to consent verbally in English or Spanish to all study procedures.
- Participants must self-identify as a racial/ethnic minorities OR identify as having low-income status OR have public health insurance
Exclusion Criteria:
- Patients unable to respond to survey questions in either English or Spanish.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Onderzoek naar gezondheidsdiensten
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verdrievoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Geen tussenkomst: Usual Care
This arm is the control group.
They will receive usual care from their regular provider and care team with no change in their care plans as a result of the intervention.
Outcomes will be assessed at each of the following times: baseline, 3-months, and 6-months post-enrollment.
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Experimenteel: EMBRACE plus usual care
Participants assigned to the intervention will receive education provided by a trained RA who will meet with participants by phone for 30 minutes once a month for 6 months to: 1) discuss shared decision-making and 2) encourage to engage in SDM with their clinicians.
Outcomes will be assessed at each of the following times: baseline, 3-months, and 6-months.
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For those in the experimental group, a Research Assistant will provide health education and support as described in the Intervention arm.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Patiëntactivatie met behulp van de enquête "Patiëntactiveringsmaatregel".
Tijdsspanne: 3 maanden na inschrijving
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Elke patiënt ontvangt bij inschrijving en 3 maanden na inschrijving voor het onderzoek een gevalideerde patiëntactiveringsenquête met behulp van de "Patient Activation Measure".
Dit is een gevalideerde maatregel van Insignia Health.
Antwoorden zijn: sterk mee oneens, mee oneens, mee eens, sterk mee eens, waarbij hogere activering correleerde met antwoorden mee eens en sterk mee eens.
Elk item wordt gescoord op een 4-puntsschaal (1 helemaal mee oneens tot 4 helemaal mee eens, met als extra optie "niet van toepassing").
Hogere scores duiden op een grotere activering van de patiënt.
Voor de PAM-10 is de minimumscore 0 (indien niet van toepassing) en de maximumscore 40.
Ruwe scores worden omgezet in activeringsniveaus volgens de scorerichtlijnen van Insignia Health voor: niveau 1 Niet betrokken en overweldigd, niveau 2 Bewust worden maar nog steeds worstelen, niveau 3 Actie ondernemen en controle krijgen, niveau 4 "Gedrag handhaven en verder gaan.
Scores voor elke groep worden gemiddeld 3 maanden na inschrijving voor de studie.
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3 maanden na inschrijving
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Patiëntactivatie met behulp van de enquête "Patiëntactiveringsmaatregel".
Tijdsspanne: 6 maanden na inschrijving
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Elke patiënt ontvangt bij inschrijving en 6 maanden na inschrijving voor het onderzoek een gevalideerde patiëntactiveringsenquête met behulp van de "Patient Activation Measure".
Dit is een gevalideerde maatregel van Insignia Health.
Antwoorden zijn: sterk mee oneens, mee oneens, mee eens, sterk mee eens, waarbij hogere activering correleerde met antwoorden mee eens en sterk mee eens.
Elk item wordt gescoord op een 4-puntsschaal (1 helemaal mee oneens tot 4 helemaal mee eens, met als extra optie "niet van toepassing").
Hogere scores duiden op een grotere activering van de patiënt.
Voor de PAM-10 is de minimumscore 0 (indien niet van toepassing) en de maximumscore 40.
Ruwe scores worden omgezet in activeringsniveaus volgens de scorerichtlijnen van Insignia Health voor: niveau 1 Niet betrokken en overweldigd, niveau 2 Bewust worden maar nog steeds worstelen, niveau 3 Actie ondernemen en controle krijgen, niveau 4 "Gedrag handhaven en verder gaan.
Scores voor elke groep worden gemiddeld 6 maanden na inschrijving voor de studie.
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6 maanden na inschrijving
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Quality of shared decision-making using the "Shared Decision Making" questionnaire
Tijdsspanne: 3-months post-enrollment
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The SDM-Q-9, a questionnaire assessing patient involvement in shared decision-making (SDM), is scored by summing the responses to its nine items, each on a 6-point Likert scale (0 completely disagree to 5 completely agree).
The raw scores range from 0 to 45, with higher scores indicating greater perceived SDM.
The change in shared-decision making from baseline to 3 months will be measured.
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3-months post-enrollment
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Quality of shared decision-making using the "Shared Decision Making" questionnaire
Tijdsspanne: 6-months post-enrollment
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The SDM-Q-9, a questionnaire assessing patient involvement in shared decision-making (SDM), is scored by summing the responses to its nine items, each on a 6-point Likert scale (0 completely disagree to 5 completely agree).
The raw scores range from 0 to 45, with higher scores indicating greater perceived SDM.
The change in shared-decision making at baseline to 6 months will be measured.
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6-months post-enrollment
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Patient Quality of Life Using the "Functional Assessment of Cancer Therapy - General Survey"
Tijdsspanne: 3-months post-enrollment
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Each patient will the validated "Functional Assessment of Cancer Therapy - General Survey (FACT-G)," which is a 27-item survey with response options including: not at all, a little bit, somewhat, quite a bit, or very much.
Five items also allow for a response of 'prefer not to answer.' Scoring for the FACT-G will be done in accordance with the FACT-G Scoring Guidelines (Version 4), available here: https://www.facit.org/measures-scoring-downloads/fact-g-scoring-downloads.
In summary, scoring is for four subscales included within the survey, including (1) Physical Well-Being (score range: 0-28), (2) Social Family Well-Being (score range: 0-28), (3) Emotional Well-Being (score range: 0-24), and (4) Functional Well-Being (score range: 0-28).
A total score is created from the sum of the subscale scores and has a minimum of zero and maximum of 108, where a higher score indicates greater quality of life.
The change in quality of life at baseline to 3 months will be measured.
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3-months post-enrollment
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Patient Quality of Life Using the "Functional Assessment of Cancer Therapy - General Survey"
Tijdsspanne: 6-months post-enrollment
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Each patient will the validated "Functional Assessment of Cancer Therapy - General Survey (FACT-G)," which is a 27-item survey with response options including: not at all, a little bit, somewhat, quite a bit, or very much.
Five items also allow for a response of 'prefer not to answer.' Scoring for the FACT-G will be done in accordance with the FACT-G Scoring Guidelines (Version 4), available here: https://www.facit.org/measures-scoring-downloads/fact-g-scoring-downloads.
In summary, scoring is for four subscales included within the survey, including (1) Physical Well-Being (score range: 0-28), (2) Social Family Well-Being (score range: 0-28), (3) Emotional Well-Being (score range: 0-24), and (4) Functional Well-Being (score range: 0-28).
A total score is created from the sum of the subscale scores and has a minimum of zero and maximum of 108, where a higher score indicates greater quality of life.
The change in quality of life at baseline to 6 months will be measured.
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6-months post-enrollment
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Feeling Heart and Understood Using the "Ambulatory Palliative Care Patients' Experience of Feeling Heard and Understood"
Tijdsspanne: 3-months post-enrollment
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The "Feeling Heard and Understood" Survey is a self-report instrument designed to assess participants' subjective experiences of being listened to and understood in clinical care settings.
The survey consists of Likert-scale items that capture the quality and emotional impact of these experiences.
Participants rate statements on a 5-point scale ranging from "Strongly Disagree" to "Strongly Agree."
Composite scores are calculated by averaging item responses, with higher scores indicating a greater perceived sense of being heard and understood.
The change in feeling heard and understood at baseline to 3 months will be measured.
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3-months post-enrollment
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Feeling Heart and Understood Using the "Ambulatory Palliative Care Patients' Experience of Feeling Heard and Understood"
Tijdsspanne: 6-months post-enrollment
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The "Feeling Heard and Understood" Survey is a self-report instrument designed to assess participants' subjective experiences of being listened to and understood in clinical care settings.
The survey consists of Likert-scale items that capture the quality and emotional impact of these experiences.
Participants rate statements on a 5-point scale ranging from "Strongly Disagree" to "Strongly Agree."
Composite scores are calculated by averaging item responses, with higher scores indicating a greater perceived sense of being heard and understood.
The change in feeling heard and understood at baseline to 6 months will be measured.
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6-months post-enrollment
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Preference-Concordant Care using the "Preference Concordant Care" Survey
Tijdsspanne: 3-months post-enrollment
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The Preference Concordant Care survey is a patient-reported instrument designed to assess the extent to which healthcare delivery aligns with a patient's individual preferences, values, and goals of care.
The tool utilized Likert-style questions to evaluate six key domains: understanding of preferences, alignment of care, communication, provider advocacy, outcome satisfaction, and responsiveness to changes in patient values over time.
Higher scores across domains indicate stronger alignment of care with the patient's stated preferences.
The change in preference-concordant care at baseline to 3 months will be measured.
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3-months post-enrollment
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Preference-Concordant Care using the "Preference Concordant Care" Survey
Tijdsspanne: 6-months post-enrollment
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The Preference Concordant Care survey is a patient-reported instrument designed to assess the extent to which healthcare delivery aligns with a patient's individual preferences, values, and goals of care.
The tool utilized Likert-style questions to evaluate six key domains: understanding of preferences, alignment of care, communication, provider advocacy, outcome satisfaction, and responsiveness to changes in patient values over time.
Higher scores across domains indicate stronger alignment of care with the patient's stated preferences.
The change in preference-concordant care at baseline to 6 months will be measured.
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6-months post-enrollment
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Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Manali I Patel, MD, MPH, MS, Stanford University
Studie record data
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Studieregistratiedata
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Andere studie-ID-nummers
- 80353
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