Lifewise Preventive Video Education in Primary Care

Официальное название

Brief Lifestyle Medicine Preventive Randomized Prospective Interactive Educational Intervention in the Primary Care Clinic

Обзор

It is widely accepted that prevention is far more impactful than curative medicine and must be included in primary care. In a previous pilot study, we evaluated passive video preventive lifestyle education in the emergency department. The current study is a randomized prospective trial assessing the practicality and impact of a brief interactive educational video intervention to patients during primary care clinic visits.

Подробное описание

Background and Summary of Objectives: It is widely accepted that prevention is far more impactful than curative medicine concerning overall health efficacy. The primary care setting faces the challenges of increasingly important time constraints and conflicting priorities. However, prevention is a priority regarding the improvement in health outcomes. In a previous pilot study, we investigated the impact of a simple instructional video on patients' willingness to change in the emergency department setting. The initial intervention was passive, requiring subjects to watch a video without interaction. The current study evaluates the practicality and impact of bringing a brief interactive educational video intervention to patients at the primary care clinic visit.

Summary of Study Design This randomized, non-blinded prospective study of "just in time" education for adult patients presenting to the primary care clinic immediately following their primary care appointment.

Patients will be randomized to receive the interactive intervention video during this encounter with the practitioner in the clinic. The intervention is an interactive video with a duration of approximately 10-15 minutes. The video is interactive because it asks the patients to answer simple questions about the content in the video to keep them engaged with the content. For instance, if the participant indicates that they do not smoke, the video will "skip" the smoking cessation education and move directly to the other prevention domains. Before leaving the clinic, all patients will be presented with a questionnaire about their readiness and confidence to initiate lifestyle changes (transtheoretical stage of change measured on a "readiness ruler") and additional survey instruments. Most of these questions will come from existing validated scales, including the Gillespie \& Lenz behavior modification tool, the Pittsburgh Sleep Quality Index, and select questions from the US HCAHPS Patient Satisfaction Survey. They will be asked for access to their medical record and their willingness to be contacted for a follow-up survey.

Outcome measures:

The study's primary outcome will be the results of the Lifestyle Readiness to Change and Confidence to Change questionnaires. Secondary outcomes will include satisfaction with the primary care clinic visit using select questions from HCAHPS, and whether they intend to change any specific lifestyle behavior (dichotomous, yes/no) and, if yes, to specific which one(s), seeking medical care outside of the clinic visit as determined by a review of the patient's medical record at intervals of 30 days and six months. HIV will not be evaluated outside of its inclusion in the Charlson Comorbidity Index (CCI). A follow-up survey at approximately 3-12 months will evaluate new diagnoses related to chest pain and ask about the individual's lifestyle changes.

Вмешательства

• Другое Video preventive education
  Interactive video that teaches the subject about the overall importance of prevention, smoking cessation, proper diet, exercise, and sleep.

Первичные конечные точки

• Lifestyle Readiness to Change and Confidence to Change questionnaires [Срок оценки: Immediately following exposure to the intervention or not (both arms receive the questionnaires)]

Вторичные конечные точки (1)

• Satisfaction, intent to changve lifestyle behavior, follow up clinic visit [Срок оценки: 18 months]

Критерии участия

Критерии включения

• Adults between the ages of 18 and 80, inclusive.

Критерии исключения

• Non-English-speaking patient
• Unable or unwilling to consent to the study
• Unable or unwilling to hear a video on a smartphone or computer tablet
• The patient is in hospice care
• Patients with advanced dementia, in the opinion of the person administering the survey

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Профилактика

Центры проведения

США · 1 центр

• Trinity Health-Livonia Hospital and Affiliated Clinics — Livonia

Публикации

• Wood EB, Harrison G, Trickey A, Friesen MA, Stinson S, Rovelli E, McReynolds S, Presgrave K. Evidence-Based Practice: Video-Discharge Instructions in the Pediatric Emergency Department. J Emerg Nurs. 2017 Jul;43(4):316-321. doi: 10.1016/j.jen.2016.11.003. Epub 2017 Mar 28. PMID 28359707
• Stange KC, Flocke SA, Goodwin MA, Kelly RB, Zyzanski SJ. Direct observation of rates of preventive service delivery in community family practice. Prev Med. 2000 Aug;31(2 Pt 1):167-76. doi: 10.1006/pmed.2000.0700. PMID 10938218
• Schuling J, de Haan R, Limburg M, Groenier KH. The Frenchay Activities Index. Assessment of functional status in stroke patients. Stroke. 1993 Aug;24(8):1173-7. doi: 10.1161/01.str.24.8.1173. PMID 8342192
• Rising KL, Padrez KA, O'Brien M, Hollander JE, Carr BG, Shea JA. Return visits to the emergency department: the patient perspective. Ann Emerg Med. 2015 Apr;65(4):377-386.e3. doi: 10.1016/j.annemergmed.2014.07.015. Epub 2014 Aug 27. PMID 25193597
• Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997 Sep-Oct;12(1):38-48. doi: 10.4278/0890-1171-12.1.38. PMID 10170434
• Prochaska JO, DiClemente CC. Stages of change in the modification of problem behaviors. Prog Behav Modif. 1992;28:183-218. No abstract available. PMID 1620663
• Pickens GT, Moore B, Smith MW, McDermott KW, Mummert A, Karaca Z. Methods for estimating the cost of treat-and-release emergency department visits. Health Serv Res. 2021 Oct;56(5):953-961. doi: 10.1111/1475-6773.13709. Epub 2021 Aug 5. PMID 34350589
• Pathak S, Summerville G, Kaplan CP, Nouri SS, Karliner LS. Patient-Reported Use of the After Visit Summary in a Primary Care Internal Medicine Practice. J Patient Exp. 2020 Oct;7(5):703-707. doi: 10.1177/2374373519879286. Epub 2019 Oct 4. PMID 33294604

Идентификаторы

NCT: NCT06730737 · TrinityHealthLivonia

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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