Controlling Hypertension Outcomes by Improved Communication & Engagement (CHOICE)
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Purpose
This proposed randomized control study will test the feasibility of two communication enhancement interventions: one with veterans who have had a stroke and now demonstrate poorly controlled hypertension; the other with VA primary care providers who provide routine outpatient medical care to these veterans. This study will intervene with both members of the provider-patient dyad in an attempt to improve the self-management of hypertension by improving communication during visits to the VA outpatient clinic, specifically by enabling veterans to communicate their questions and concerns about chronic disease self-management to their providers more effectively, and to help providers improve their ability to communicate more effectively with this population of veterans.
| Condition | Intervention |
|---|---|
|
Hypertension Stroke |
Behavioral: Four Habits Model |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Health Services Research |
| Official Title: | Controlling Hypertension Outcomes by Improved Communication & Engagement (CHOICE) |
- self-management of hypertension [ Time Frame: 12 months ] [ Designated as safety issue: No ]
| Enrollment: | 40 |
| Study Start Date: | August 2010 |
| Study Completion Date: | September 2011 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm 1
A health educator will meet with each participating veteran in the intervention arm prior to the 2nd visit to develop a plan for enhancing communication about self-management of hypertension. The PI will provide the Four Habits communication training to the 5 primary care providers in the intervention arm. Two clinic visits between each participating provider-patient pair will be videotaped and coded. |
Behavioral: Four Habits Model
The providers randomized to the intervention arm will be trained in Habit 1 of the Four Habits Model.
|
|
No Intervention: Arm 2
Two clinic visits between each participating provider-patient pair will be videotaped and coded.
|
Detailed Description:
The communication intervention has two goals; (a) coaching to enhance veteran's abilities to communicate their questions and concerns about self-management for hypertension to their physician; and (b) improving provider's communication skills for enhancing and encouraging self-management of hypertension.
A health educator will meet with each participating veteran in the intervention arm prior to the 2nd visit to develop a plan for enhancing communication about self-management of hypertension.
The PI will provide the Four Habits communication training to the 5 primary care providers in the intervention arm. Two clinic visits between each participating provider-patient pair will be videotaped and coded.
This proposed project will enroll 10 VA primary care providers to participate in the randomized control trial and 30 veterans (3 veterans from the panel of each of the 10 participating providers) who have had a stroke and now demonstrate poorly controlled hypertension. The evaluation will determine if there is a difference, as well as compare the content of the provider-patient conversations around hypertension management, between the two groups. It will also involve a business case analysis to evaluate return on investment to the VHA.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Veteran:
- Veteran is a patient of the enrolled provider
- History of prior stroke
- Poorly controlled hypertension with at least one measurement >140/90 mm Hg in the past 12 months
- Complete a 6-item screen for cognitive and language impairment with a score of 3 or higher
- Sign the VA Media consent for use of picture and/or voice
Provider:
- Primary care provider, Medicine Service
- Sign VA media consent for use of picture and/or voice
Exclusion Criteria:
- Life expectancy is less than 6 months
- Non-English language patients
- Inability to provide informed consent
Contacts and Locations| United States, Indiana | |
| Richard Roudebush VA Medical Center | |
| Indianapolis, Indiana, United States, 46202-2884 | |
| Richard Roudebush VA Medical Center, Indianapolis | |
| Indianapolis, Indiana, United States, 46202-2884 | |
| Principal Investigator: | Richard M. Frankel, PhD | Richard Roudebush VA Medical Center |
More Information
No publications provided
| Responsible Party: | Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT01134887 History of Changes |
| Other Study ID Numbers: | RRP 09-190 |
| Study First Received: | May 28, 2010 |
| Last Updated: | April 18, 2013 |
| Health Authority: | United States: Federal Government |
Keywords provided by Department of Veterans Affairs:
|
hypertension physician-patient relations communication |
Additional relevant MeSH terms:
|
Hypertension Stroke Vascular Diseases Cardiovascular Diseases |
Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013