NCT02721446

Brief Summary

The purpose of this study is to find out which types of written stroke messages may help high risk stroke patients take action to improve their health.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
641

participants targeted

Target at P75+ for not_applicable stroke

Timeline
Completed

Started Jun 2016

Typical duration for not_applicable stroke

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 9, 2016

Completed
20 days until next milestone

First Posted

Study publicly available on registry

March 29, 2016

Completed
2 months until next milestone

Study Start

First participant enrolled

June 1, 2016

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2018

Completed
Last Updated

August 17, 2018

Status Verified

August 1, 2018

Enrollment Period

2.2 years

First QC Date

March 9, 2016

Last Update Submit

August 16, 2018

Conditions

Outcome Measures

Primary Outcomes (1)

  • Proportion of patients responding to mailings in each of four intervention groups

    The primary outcome is the proportion responding to the mailings in each of the four intervention groups. Investigators will calculate the denominator as the number of patients that were sent a mailing (mailing was not returned as undeliverable and patient did not opt out) and the numerator as the number of these mailings that generate a telephone call response. Investigators will track whether the response occurs after the first, second, or third mailing to estimate the utility of subsequent mailings.

    Eight months with 132 mailings per intervention group per month

Study Arms (2)

VHA Cohort

OTHER

Investigators will use Veteran Health Administration (VHA) electronic health record (EHR) data to construct patient-level Framingham stroke risk scores using previously validated methodology. Investigators will establish a cohort of live patients with at least one primary care visit 12 months prior to study initiation (Oct 1, 2015). Investigators will obtain EHR data for Framingham measurements of age, sex, systolic blood pressure (SBP), blood pressure treatment (yes/no), total cholesterol, high-density lipoprotein cholesterol, and smoking status in the prior 12 month period. SBP will be obtained from outpatient primary care visits only; if \> 1 SBP is available the investigators will use the average of the last 2 outpatient SBPs prior to study initiation.

Behavioral: StandardBehavioral: IncentiveBehavioral: SalienceBehavioral: Incentive + Salience

Eskenazi Health System Cohort

OTHER

Investigators will use EHR data from Indiana Network for Patient Care (INPC) to identify a cohort of live patients with at least one primary care visit in the prior 12 months. Investigators will use identical methods to construct Framingham risk score variables from the EHR data.

Behavioral: StandardBehavioral: IncentiveBehavioral: SalienceBehavioral: Incentive + Salience

Interventions

StandardBEHAVIORAL

Investigators will develop a "standard" informational stroke risk message that will not undergo iterative review. This will inform the patient that based on information in the healthcare system, the patient is at higher risk of stroke than many others receiving care in the patient's healthcare system; it will describe options for working with their health care team to reduce the risk of stroke; and encourage the patient to call the health navigator to discuss these options and make a decision about next steps to take to reduce the patient's risk of stroke.

Eskenazi Health System CohortVHA Cohort
IncentiveBEHAVIORAL

Investigators anticipate that the baseline incentive stroke risk message will inform the patient that they are at higher risk of stroke than many others receiving care in the patient's healthcare system, and will provide information about obtaining an incentive if the patient calls to make contact with a health navigator who will help them plan a next step to reduce their stroke risk. The investigators also anticipate including information that all patients who call will also be entered in a random drawing to receive an additional incentive, with up to six patients receiving this incentive.

Eskenazi Health System CohortVHA Cohort
SalienceBEHAVIORAL

Investigators anticipate that the baseline salience stroke risk message will inform the patient that they are at higher risk of stroke than many other patients receiving care in the patient's healthcare system, and will specifically focus on the patient's own risk factors (rather than all stroke risk factors). The salience message will also include visual depictions of stroke patients that are gender and ethnically matched to each subject. This is intended to prompt action by emphasizing that stroke is a real possibility for "patients like me."

Eskenazi Health System CohortVHA Cohort

Combined message of incentive plus salience.

Eskenazi Health System CohortVHA Cohort

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • High risk stroke patients 18 years of age or older, as determined by calculation of a Framingham Stroke Risk Score
  • At least one primary care visit 12 months prior to study initiation with the Richard L. Roudebush VA Medical Center (VHA) or Sidney \& Lois Eskenazi (EHS) Health System primary care clinics

You may not qualify if:

  • Patients with at least one primary care provider visit in the prior 12 months in both the VA and EHS systems

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Richard L. Roudebush VA Medical Center

Indianapolis, Indiana, 46202, United States

Location

Related Publications (1)

  • Groves CC, Damush TM, Myers LJ, Baye F, Daggy JK, Perkins AJ, Martin H, Mounsey L, Clark DO, Williams LS. Enhancing Stroke Awareness and Activation Among High-Risk Populations: A Randomized Direct Mail Intervention in Diverse Healthcare Settings. Circ Cardiovasc Qual Outcomes. 2025 May;18(5):e011425. doi: 10.1161/CIRCOUTCOMES.124.011425. Epub 2025 Mar 24.

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Study Officials

  • Linda S Williams, MD

    Richard L. Roudebush VA Medical Center

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 9, 2016

First Posted

March 29, 2016

Study Start

June 1, 2016

Primary Completion

August 1, 2018

Study Completion

August 1, 2018

Last Updated

August 17, 2018

Record last verified: 2018-08

Data Sharing

IPD Sharing
Will not share

Locations