Advancing Decisions About Virtual Service Encounters

NCT06539988 | Recruiting

• 1 other identifier: IIR 22-172
• Study Type: interventional
• Target: 600
• Locations: 1 country
• Sites: 1

Brief Summary

Expanded availability of virtual care encounters in Primary Care provides new opportunities to improve Veterans' outcomes by aligning encounter modalities with their needs and preferences. Yet, Veterans and their Primary Care physicians (PCPs) lack personalized information about the benefits and costs of different Primary Care modalities that is needed to maximize the value of Primary Care encounters. To address this problem, in this study the investigators will use surveys and interviews to identify what Veterans and PCPs perceive to be the benefits and optimal uses of different Primary Care encounter modalities. They will then supplement their existing system for communicating encounter costs to Veterans and PCPs with new interactive messaging about benefits and optimal uses of different encounter modalities. Finally, this novel Advancing Decisions about Virtual Service Encounters (ADViSE) intervention will be optimized through user-centered refinement before evaluating its effects on Veteran-centered outcomes, use of virtual care, and intermediate health outcomes in a randomized controlled trial (RCT).

Conditions

Health Care Costs; Delivery of Health Care

Keywords

Access; Behavior (patient); Behavior (provider); Rural Health; Patient preferences; Decision support; Telemedicine; Patient-centered Care; Communication (doctor-patient); Cost; Patient outcomes; Primary care; Satisfaction (patient); Virtual care

Outcome Measures

Primary Outcomes (1)

• Veterans' perceptions of the value of their healthcare

  Measured by survey at baseline and intervention end

  6 months prior to intervention and 6-months post intervention

Secondary Outcomes (17)

• VA Video Connect (VVC) encounters with assigned Patient Aligned Care Team (PACT)

  6 months prior to intervention and 6-months post intervention

• Face-to-Face (F2F) encounters with assigned Patient Aligned Care Team (PACT)

  6 months prior to intervention and 6-months post intervention

• Telephone encounters with assigned Patient Aligned Care Team (PACT)

  6 months prior to intervention and 6-months post intervention

• Veterans' satisfaction with healthcare

  6 months prior to intervention and 6-months post intervention

• Veterans' preferences for virtual care

  6 months prior to intervention and 6-months post intervention

Study Arms (2)

Receiving the optimized ADviSE Intervention

EXPERIMENTAL

6 months of selected text messages from a library developed and refined in previous study aims.

Behavioral: Clinician Coaching Sessions; Other: Personalized text messages to patients

Control period

NO INTERVENTION

Usual care.

Interventions

Clinician Coaching Sessions BEHAVIORAL

PCPs will receive interactive coaching sessions from a Clinician Coach 2 months into the intervention period and again at 4 months into the intervention period.

Receiving the optimized ADviSE Intervention

Personalized text messages to patients OTHER

Drawing upon a library of messages that have previously been developed and refined, Veterans will receive 6 months of optimized text messages. The frequency of text messages will be determined based on feedback from Veterans in earlier phases of the research.

Receiving the optimized ADviSE Intervention

Eligibility Criteria

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

You may qualify if:

• Having at least 3 Primary Care F2F, telephone, or VVC encounters in the previous 12 months
• Able to provide informed consent
• Willing and able to receive text messages from the VA Patient Engagement, Tracking, and Long-term Support (PETALS) platform

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Ann Arbor Healthcare System, Ann Arbor, MI

Ann Arbor, Michigan, 48105-2303, United States

RECRUITING

MeSH Terms

Conditions

Behavior; Patient Preference; Communication; Patient Satisfaction

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior

Study Officials

• Jeffrey T. Kullgren, MD MPH MS

  VA Ann Arbor Healthcare System, Ann Arbor, MI

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jeffrey T Kullgren, MD MPH MS

CONTACT

(734) 845-5290; Jeffrey.Kullgren@va.gov

Nora A Metzger, BA MSW

CONTACT

(734) 222-7682; nora.metzger2@va.gov

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: Stepped wedge cluster randomized controlled trial

Study Record Dates

• First Submitted: June 26, 2024
• First Posted: August 6, 2024
• Study Start: April 1, 2026
• Primary Completion (Estimated): September 30, 2027
• Study Completion (Estimated): June 30, 2028
• Last Updated: April 8, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)