Teaching Improved Communication To Adolescents and Clinicians
Condition: Communication Improvement Between Adolescent and Clinician
Study type: Interventional

Summary: 
      The purpose of this pilot study is to evaluate the feasibility, acceptability, and
      preliminary efficacy of an intervention aimed at improving how adolescent patients and their
      clinicians communicate about behavior change.
    

Detailed description: 
      The investigators propose a randomized pilot trial across two health systems, Duke University
      and University of Michigan to evaluate the effect of Feedback Guides on clinician-adolescent
      communication about high-risk behaviors.

        -  The investigators consent clinicians prior to any patient recruitment.

        -  When a patient aged 12-21 years arrives for an annual visit and is a patient of a
           consented clinician, the front desk staff will provide the teen with an iPad tablet.

        -  As part of standard clinical care, all teens will complete the Rapid Assessment for
           Adolescent Preventive Services (RAAPS) questionnaire on the tablet privately (either in
           waiting room or in clinic room while waiting for the provider).

        -  The patient and parent will then review a study explanation and informed consent on the
           tablet and sign electronically if they agree to participate. The study clinician will
           review the informed consent with the patient and answer any questions.

        -  Participating teens will then complete a brief baseline survey and those randomized to
           the intervention arm will print the visit conversation guides using a wireless study
           printer connected to the tablet. The guides will print in a designated nursing area and
           clinic staff will add the printed guides to visit-related paperwork for the patient and
           clinician to use during the visit.

        -  The teen patient audio records the encounter on the tablet.

        -  The patient completes post-visit patient survey on tablet.

        -  The clinician completes a post-visit survey on paper.

        -  The patient returns tablet to clinic staff.

        -  The iPad will be connected to a study workstation, where the iTunes application will be
           used to transfer the audio file from the Voice Memos app to the workstation and then to
           it's final destination on the file server. Once the transfer has been confirmed, using
           iTunes, the audio file will be deleted from both the iPad and the workstation, including
           any residual versions of the audio file.

        -  Three months after the encounter, staff will provide participating patients a link to a
           REDCap survey (not the survey itself). The link will be sent using the preferred method
           selected by the patient through a question in the baseline survey - email or short
           message service (SMS). To protect the confidentiality of the responses, we will also
           provide the participant a code to access the REDCap follow-up survey. This will prevent
           others from accessing the survey results.
    

Intervention name(s): Communication Intervention
Intervention type(s): Behavioral
Intervention description(s): In this study, Investigators are testing the feasibility, acceptability, and preliminary efficacy of a systems intervention that asks adolescents to report their risk behaviors before their encounter. Both clinicians and patients will receive a Feedback Guide that gives them tips on effective ways to communicate about these behaviors.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Interventional: to evaluate the effect of Feedback Guides on clinician-adolescent communication about hight-risk behaviors.
Control: standard of care
Masking: None (Open Label)
Primary purpose: Other
Keywords: communication between adolescent patients and their clinician