- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT01037920
An Intervention to Improve Communication Between Physicians and Minority Patients With Hypertension
The objective of the project is a test-of-concept of an intervention to reduce the effects of the perception of discrimination on the care of patients with chronic illness. Perception of discrimination manifests itself as stereotype threat. We hypothesize that stereotype threat impairs communication between minority patients and their physicians because of increased stress and diminished trust, resulting in interactions that are less successful at enhancing patient self-efficacy, in turn resulting in lower rates of adherence with anti-hypertensive medication.
The intervention is a self-affirmation exercise performed prior to a patient-physician visit. A similar intervention has been shown to reduce the racial gap in academic performance in middle school classrooms.
We will explore the mechanistic effects of the intervention by analysis of audiotapes of patient-provider visits following the intervention. We will measure the effect of the intervention on minority hypertensive patients' adherence with antihypertensive medication and blood pressure.
We will enroll 200 African American and Latino patients with hypertension and randomize 100 patients to perform the exercise and 100 patients to perform a null control exercise before the visit. We will assess change in patient's adherence with antihypertensive medications and in blood pressure over the six months following the index visit. In order to better understand the effects of the intervention we will measure subject's mood following the exercise, and self-reported stress levels, trust in the physician, and medication self-efficacy following the visit. We will also assess the quality of the patient-provider interaction from detailed analysis of audiotapes and from patient questionnaires. Following a subsequent patient-physician visit, we will conduct telephone interviews with patients to assess for persistence of any effects of the intervention.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Studietype
Registrering (Faktiske)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiesteder
-
-
Colorado
-
Denver, Colorado, Forente stater, 80204
- Denver Health Medical Center
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- diagnosis of hypertension
- age > 21 years
- use of Denver Health as their usual source of care and pharmacy services
- self-described race/ethnicity of African American or Latino
- ability to provide informed consent
Exclusion Criteria:
- pregnancy-related hypertension
- end-stage renal disease
- unable to speak or write English at at least a 6th grade level.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Helsetjenesteforskning
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Eksperimentell: Intervention
subjects in the intervention arm will complete a self-affirmation exercise prior to a physician visit
|
The intervention exercise asks subjects to reflect on a list of 11 personal values and to circle 2 or 3 items that are most important to them.
Subjects are asked then to write a few sentences to describe why they are important.
|
Aktiv komparator: Control
subjects in the intervention arm will complete a sham exercise prior to a physician visit
|
The control exercise is the same as the intervention exercise except that subjects reflect and write about values important to someone else.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
---|---|
medisinoverholdelse
Tidsramme: 6 måneder
|
6 måneder
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
Blood pressure
Tidsramme: 3-6 months
|
3-6 months
|
Samarbeidspartnere og etterforskere
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- R21HL089623 (U.S. NIH-stipend/kontrakt)
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
Kliniske studier på Hypertensjon
-
University Hospital of CologneUkjentNAFLD; Hypertensjon, White-Coat Hypertension, Masked HypertensionTyskland
-
Karolinska InstitutetFullførtWhite Coat Hypertension
-
Clinical Hospital Centre ZagrebEuropean Society of HypertensionUkjentWhite Coat Hypertension | Blodtrykk | LivsstilsrisikoreduksjonIsrael, Hellas, Belgia, Tyskland, Armenia, Østerrike, Bulgaria, Kroatia, Tsjekkia, Estland, Italia, Libanon, Litauen, Nederland, Polen, Portugal, Romania, Serbia, Spania, Sverige, Ukraina, Storbritannia
-
Regional Hospital HolstebroFullførtSunn | White Coat Hypertension | Essensiell hypertensjonDanmark
-
Columbia UniversityAgency for Healthcare Research and Quality (AHRQ)Aktiv, ikke rekrutterendeWhite Coat Hypertension | Hypertensjon, viktigForente stater
-
University of Alabama at BirminghamTroy UniversityFullførtHypertensjon | Hypertensjon, motstandsdyktig mot konvensjonell terapi | Ukontrollert hypertensjon | Hypertensjon, hvit pelsForente stater
-
PD Dr. Grégoire WuerznerSwiss National Science FoundationFullførtHypertensjon | Overvekt | White Coat Hypertension | Resistent hypertensjonSveits
-
University Hospital, ToursFullførtPTFE-dekkede stenter versus nakne stenter i TIPS (Transjugulær Intra-hepatisk Porto-systemisk shunt)Cirrhotic Portal HypertensionFrankrike
-
Sun Yat-sen UniversityFullførtHepatocellulært karsinom (HCC) | Cirrhotic Portal HypertensionKina
Kliniske studier på Self-affirmation exercise
-
University of WashingtonNational Institute of Nursing Research (NINR); East Carolina UniversityHar ikke rekruttert ennåImplanterbar defibrillatorbruker | Stressreaksjon | Ptsd | Stressmestring | Sosial kognitiv teoriForente stater
-
Karamanoğlu Mehmetbey UniversityKaraman Training and Research HospitalFullført
-
VA Office of Research and DevelopmentFullførtObstruktiv søvnapnéForente stater
-
University of MichiganNational Institutes of Health (NIH); National Institute on Aging (NIA); Blue...Fullført
-
University of MichiganFullført
-
University of VictoriaSwitch Research; Mathematics of Information Technology and Complex SystemsRekrutteringMental Helse | SelvpleieCanada
-
University of ZurichFullførtUnderstreke | Følelse av mestringsevneSveits
-
Istanbul Sehir UniversityUniversita di Verona; World Health OrganizationAvsluttetUnderstreke | Psykologisk stressTyrkia
-
Mental Health Services in the Capital Region, DenmarkTrygFonden, DenmarkRekrutteringSelvskadende oppførselDanmark
-
Hunter College of City University of New YorkNational Institute on Minority Health and Health Disparities (NIMHD); National...FullførtVold, seksuellForente stater