Nudging Healthcare Organizations to Adopt New Care Delivery Practices

NCT04176146 | Completed

• 2 other identifiers: Dartmouth IRB protocol #287631U19HS024075
• Study Type: interventional
• Target: 2,387
• Locations: 1 country
• Sites: 1

Brief Summary

This two-arm, parallel group randomized controlled trial will assess the impact of written social norms messaging (i.e., behavioral 'nudges') on healthcare organization administrators' decision to access online resources that support the adoption of evidence-based healthcare delivery practices. The healthcare delivery practices include the use of population screening tools, clinical practice guidelines, and shared decision making training.

Conditions

Delivery of Health Care

Outcome Measures

Primary Outcomes (1)

• Percentage of participants who access the technical assistance resource webpage

  The percentage of participants who access the technical assistance webpage will be determined by email and webpage analytics. The primary analysis will be intention to treat (i.e., among all participants sent a letter); a secondary analysis will be a 'per protocol' analysis (i.e., among all participants whose letter was not sent back as undeliverable). Exploratory sub-group analyses will be conducted by each strata characteristic (e.g., whether organization category influences the likelihood of accessing the webpage).

  Up to 2 months after letter is sent

Secondary Outcomes (3)

• Number of unique resource views on technical assistance resource webpage

  Up to 2 months after letter is sent

• Percentage of participants who request connection to peer organizations via the technical assistance resource webpage

  Up to 2 months after letter is sent

• Perceived effect of letter on administrators' intentions

  Up to 4 months after letter is sent

Study Arms (2)

Nudge Letter

EXPERIMENTAL

Participants receive a letter that highlights their performance vs. peer organizations on up to seven care delivery practices featured in the National Survey of Healthcare Organizations and Systems (NSHOS). The letter includes a link to access technical assistance resources and is sent alongside the participant's NSHOS respondent report.

Behavioral: Peer comparison and social norms messaging

Control Letter

NO INTERVENTION

Participants receive a letter with a link to technical assistance resources; the letter is sent alongside the participant's NSHOS survey respondent report.

Interventions

Peer comparison and social norms messaging BEHAVIORAL

This group will receive a letter noting that their organization has not implemented at least one common care delivery practice that a majority their peers have already implemented. The letter will also note the percentage of peer organizations that have implemented the practice. This is done using peer comparison data and social norms messaging.

Nudge Letter

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participant responded to NSHOS survey and reported that their organization had not implemented at least one of up to seven pre-determined care delivery practices, out of the following eight practices featured in the NSHOS: Screening for opioid use specifically; Screening for substance use disorders; Screening for depression; Screening for interpersonal violence; Method for identifying high-cost patients; Use of evidence-based guidelines for congestive heart failure; Use of evidence-based guidelines for sepsis (included in letters to healthcare system administrators, but not hospitals or physician practices); Training for shared decision making (included in letters to hospitals and physician practices but not healthcare systems)

You may not qualify if:

• Did not respond to NSHOS survey
• Participant responded to NSHOS survey and reported that their organization had already implemented each of seven pre-determined care delivery practices, out of the following eight practices featured in the NSHOS: Screening for opioid use specifically; Screening for substance use disorders; Screening for depression; Screening for interpersonal violence; Method for identifying high-cost patients; Use of evidence-based guidelines for congestive heart failure; Use of evidence-based guidelines for sepsis (included in letters to healthcare system administrators, but not hospitals or physician practices); Training for shared decision making (included in letters to hospitals and physician practices but not healthcare systems)

Sponsors & Collaborators

• Dartmouth-Hitchcock Medical Center: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

Dartmouth Hitchcock Medical Center

Lebanon, New Hampshire, 03766, United States

Location

Study Officials

• Amber E Barnato, MD, MPH, MS

  Dartmouth College

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Health Policy and Clinical Practice and of Medicine

Study Record Dates

• First Submitted: November 14, 2019
• First Posted: November 25, 2019
• Study Start: December 9, 2019
• Primary Completion: February 9, 2020
• Study Completion: June 8, 2020
• Last Updated: June 26, 2020

Record last verified: 2020-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)