Four Conversations RCT
12 de dezembro de 2018 atualizado por: Duke University
Four Conversations Randomized Controlled Trial
The purpose of this study is to see whether patients with metastatic breast cancer, their caregivers, and their healthcare providers can improve in shared decision making (SDM) and preparedness around end of life (EOL) planning through participation in Reimagine's online Four Conversations™ program.
The goal is to close clinical practice gaps and enhance the quality of care for patients with metastatic breast cancer through increased competence and performance of healthcare providers and healthcare systems.
Visão geral do estudo
Status
Concluído
Condições
Intervenção / Tratamento
Tipo de estudo
Intervencional
Inscrição (Real)
357
Estágio
- Não aplicável
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Locais de estudo
-
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North Carolina
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Durham, North Carolina, Estados Unidos, 27710
- Duke University Medical Center
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Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
18 anos e mais velhos (Adulto, Adulto mais velho)
Aceita Voluntários Saudáveis
Não
Gêneros Elegíveis para o Estudo
Tudo
Descrição
Inclusion Criteria:
- Diagnosed with metastatic breast cancer (MBC), caregiver to patient with MBC who is enrolled in this study, or MBC provider
- Age ≥ 18 years
- Internet access through a computer, laptop, tablet, or other mobile device
- Able/willing to have an online interaction with a Reimagine Pillar Guide
- Providing informed consent
- Able to read/write English
Exclusion Criteria:
- None
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Cuidados de suporte
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: Four Conversations Intervention
Subjects in this arm will participate in Reimagine's online Four Conversations program during the initial study period of four weeks.
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The online Four Conversations program consists of tutorial videos, printable documents, and live sessions with a counselor to educate subjects on shared decision making and care planning for those with advanced disease.
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Outro: Waitlisted Control
Subjects in this arm will continue to receive standard care from their healthcare providers during the initial study period (i.e.
no intervention).
After four weeks, subjects will then participate in Reimagine's online Four Conversations program.
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The online Four Conversations program consists of tutorial videos, printable documents, and live sessions with a counselor to educate subjects on shared decision making and care planning for those with advanced disease.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in patient/caregiver and provider preparedness for decision making as measured by the Preparation for Decision Making Scale
Prazo: Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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The Preparation for Decision Making Scale is a reliable and validated self-reported measure of the patient/caregiver or provider's perception of how useful a decision support intervention is in preparing the respondent to communicate with others making a health decision.
Items are summed and scored, then divided by 10; scores can be converted to a 0-100 scale.
Higher scores indicate higher perceived level of preparation for decision making.
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Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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Change in patient/caregiver decision making self-efficacy as measured by the Decision Self-efficacy Scale
Prazo: Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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The Decision Self-efficacy Scale is a reliable and validated instrument that measures self-confidence or belief in one's abilities in decision making, including shared decision making (SDM).
Items are summed, divided by 11, and multiplied by 25.
Scores range from 0 to 100 (very confident).
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Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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Change in patient self-conflict as measured by the Decisional Conflict Scale
Prazo: Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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The Decisional Conflict scale is a reliable and validated measure of the state of uncertainty about a course of action.
Items are summed, divided by 16, and multiplied by 25.
Scores range from 0 to 100 (high decisional conflict).
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Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in provider end of life (EOL) care knowledge as measured by revised City of Hope EOL Knowledge Assessment
Prazo: Baseline, Post-Intervention (Week 4)
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The content of the City of Hope End of Life Knowledge Assessment was revised to reflect the program curriculum.
Correctly answered questions will be awarded one point, summed, and a total score generated.
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Baseline, Post-Intervention (Week 4)
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Change in patient and caregiver quality of life (QOL) as measured by the PROMIS Global Scale
Prazo: Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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The PROMIS Global Scale is a reliable and validated measure of general perceptions of health.
Items are predictive of care utilization and mortality.
The scale produces two health scores: physical and mental.
Items are summed and converted to t-scores.
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Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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Change in patient/caregiver and provider end of life (EOL) conversations as measured by EOL Conversations
Prazo: Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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The EOL Conversations are author-developed questionnaires incorporating items from the Survey on Advanced Care Planning Conversations.
Points are totaled and summed.
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Baseline, Week 4 (waitlisted control only), Post-Intervention (Week 4 or 8)
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Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Feasibility as measured by completion of advance directive documents
Prazo: Post-Intervention (Week 4 or 8)
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Post-Intervention (Week 4 or 8)
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Feasibility as measured by the patient's completion of Reimagine's Worries to Wishes Treatment Plan
Prazo: Post-Intervention (Week 4 or 8)
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Post-Intervention (Week 4 or 8)
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Feasibility as measured by Reimagine's Four Conversations program usage, as measured by clickstream data from Reimagine's website and Reimagine staff report
Prazo: Intervention period (4 weeks)
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Clickstream data associated with viewing videos and other web content (e.g., social community) on the Reimagine website will be collected and analyzed through a web analytics software package.
Session attendance will be collected by the Reimagine staff (specially trained counselors called Pillar Guides) and sent to the study team for analysis following each of the online meetings.
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Intervention period (4 weeks)
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Feasibility as measured by satisfaction with Reimagine's Four Conversations program, as measured by the Program Satisfaction & Evaluation questionnaire
Prazo: Post-Intervention (Week 4 or 8)
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The Program Satisfaction & Evaluation questionnaire was developed by the study team to assess perceived helpfulness of the program in terms of outcomes and patient-provider communication.
Points are totaled and summed.
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Post-Intervention (Week 4 or 8)
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Investigadores
- Investigador principal: Sophia K Smith, PhD, Duke University School of Nursing
Publicações e links úteis
A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.
Publicações Gerais
- Ryan RE, Connolly M, Bradford NK, Henderson S, Herbert A, Schonfeld L, Young J, Bothroyd JI, Henderson A. Interventions for interpersonal communication about end of life care between health practitioners and affected people. Cochrane Database Syst Rev. 2022 Jul 8;7(7):CD013116. doi: 10.1002/14651858.CD013116.pub2.
- Smith SK, Westbrook K, MacDermott K, Amarasekara S, LeBlanc M, Pan W. Four Conversations: A Randomized Controlled Trial of an Online, Personalized Coping and Decision Aid for Metastatic Breast Cancer Patients. J Palliat Med. 2020 Mar;23(3):353-358. doi: 10.1089/jpm.2019.0234. Epub 2019 Oct 22.
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo (Real)
15 de dezembro de 2016
Conclusão Primária (Real)
21 de outubro de 2018
Conclusão do estudo (Real)
21 de outubro de 2018
Datas de inscrição no estudo
Enviado pela primeira vez
24 de outubro de 2016
Enviado pela primeira vez que atendeu aos critérios de CQ
24 de outubro de 2016
Primeira postagem (Estimativa)
25 de outubro de 2016
Atualizações de registro de estudo
Última Atualização Postada (Real)
13 de dezembro de 2018
Última atualização enviada que atendeu aos critérios de controle de qualidade
12 de dezembro de 2018
Última verificação
1 de dezembro de 2018
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- Pro00070790
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
NÃO
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