The Getting Real About The Talk (GReAT) Project - A Qualitative, Patient-Centered Evaluation of the Factors for Successfully Having 'The Talk' and Implementation for Attending and Trainee Physicians

Study Overview
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Brief Summary
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The killing of young black men by police officers is a major public health issue and is a clear health disparity. Black men are 21 times more likely to be fatally shot by a police officer than white men. Homicide is the second-leading cause of death of black males, ages 15-34. It is disconcerting to consider that this statistic includes homicide by police officer. Pediatricians have an opportunity to contribute to violence prevention efforts and social justice advocacy for young black men in regards to interactions with police officers. We seek to engage residents in social justice advocacy by preparing them to discuss safely navigating police encounters with young black males. Adverse police encounters can result in poor mental health outcomes, physical trauma, and death. We will develop a conversation script with input from existing expert resources, black male youth, and their caregivers. The script will be patient-centered and will be used to facilitate a conversation about safely navigating encounters with police officers. Utilizing a train-the-trainer model, attending pediatric physicians will be trained to use the script in their practice as well as model and demonstrate how to use the script for pediatric residents. We hypothesize that pediatric residents trained in the conversation script will be empowered to facilitate discussions on safely navigating police encounters in the primary care clinic setting and will exhibit increased comfort and greater levels of self-efficacy from baseline measures.

Official Title
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Getting Real About The Talk (GReAT) Project

Conditions
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Self Efficacy

Intervention / Treatment
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* Behavioral: Violence Prevention Conversation Script to Discuss Safely Navigating Police Encounters


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Resident physician trainee at a designated academic medical center-based primary care clinic serving predominately black youth in Philadelphia Exclusion Criteria: Non-resident physician trainee Resident physician preference to not participate Not affiliated with the designated academic medical center-based primary care clinic
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Cohort of residents trained in the conversation script who will utilize the script at pediatric clinic visits. Will evaluate baseline feelings of comfort and self-efficacy prior to being trained in the script (pre-intervention measures). After being trained in the conversation script (the intervention), the following will be measured (post-intervention measures): frequency of facilitating conversations on safely navigating police encounters in clinical practice, feelings of comfort and self-efficacy. | Behavioral: Violence Prevention Conversation Script to Discuss Safely Navigating Police Encounters<br>* A conversation script to facilitate conversations on safely navigating police encounters as anticipatory guidance and violence prevention strategy. The conversation script will be created using expert recommendations from existing resources and using recommendations (determined from focus groups) from black male youth and their caregivers. The script will be patient-centered.<br>|
| No Intervention: Control<br>Cohort of residents at another clinical site with a similar community demographic make-up who do not receive the intervention. In the control group, we will measure frequency of facilitating conversations on safely navigating police encounters in clinical practice, feelings of comfort and self-efficacy. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resident physician Self-Efficacy | Likert-type, self-reported Self-efficacy instrument. The items on the survey instrument will assess for feelings of self-efficacy pre-intervention (baseline) and 6 months post-intervention. Respondents will select their level of agreement with each item on the survey, selecting within a range from strongly disagree to strongly agree. Strongly agree indicates the highest level of agreement with each statement on the survey. Respondents who predominately select strongly agree for the items on the survey express greater levels of self-efficacy with delivering the intervention. | Change from Baseline Feelings of Self-Efficacy at 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resident physician Comfort Level | Likert-type, self-reported instrument assessing comfort with delivering the intervention. The items on the survey instrument will assess for comfort pre-intervention (baseline) and 6 months post-intervention. Respondents will select their level of agreement with each item on the survey, selecting within a range from strongly disagree to strongly agree. Strongly agree indicates the highest level of agreement with each statement on the survey. Respondents who predominately select strongly agree for the items on the survey express greater levels of comfort with delivering the intervention. | Change from Baseline Comfort Level at 6 months | 
| Frequency of delivering the script in clinical practice | Self-response to the following question: In the past 6 months, how many times have you delivered the conversation script (the intervention) to African-American male youth ages 9-18? Respondents will answer by selecting between the following choices: 0 times, 1-5 times, 5-10 times, 10-15 times, and greater than 15 times. | Change from Baseline Frequency of Delivering the Script at 6 months |