Training in the 21st Century: Using Virtual Role-Plays to Improve Nurse Communication for Medication Adherence

Study Overview
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Brief Summary
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This study will utilize a three-phase approach that is informed by a theory-driven implementation framework to: 1) conduct a needs analysis in order to identify individual-, health care team-, and practice-level barriers and facilitators to conducting adherence counseling in safety-net primary care practices; 2) develop a virtual communication simulation designed to improve the quality of adherence counseling by allowing nurses repeated opportunities to practice discussing medication adherence with virtual patients; and 3) conduct a pilot study to evaluate the feasibility, acceptability and preliminary efficacy of the simulation on changes in: a) nurses' collaborative communication skills, b) medication adherence, and c) reduction in BP in a sample of 20 patients with uncontrolled hypertension (HTN) who are non-adherent to their medications.

Official Title
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Training in the 21st Century: Using Virtual Role-Plays to Improve Nurse Communication for Medication Adherence

Conditions
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High Blood Pressure, Hypertension

Intervention / Treatment
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* Behavioral: Audiotaped Counseling Session


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: PCPs and nurses will be enrolled if they fulfill the following criteria: male or female healthcare provider (MD/DO, NP, and Registered Nurse) practicing at the clinic age 18 years or older. No exclusions will be made based on provider race/ethnic origin. We will oversample males to examine differential communication skills based on gender. Patient eligibility criteria include: receiving care at the participating clinic having uncontrolled HTN (BP>140/90 mmHg) at two visits in the past year being prescribed at least one antihypertensive medication and are non-adherent are ≥age 18 years fluent in English Exclusion Criteria: Unable to give consent Have a diagnosis of cognitive dysfunction or significant psychiatric comorbidity, Participating in another HTN-related study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Communication Simulation<br>Nurses will use simulation over 12 weeks while fidelity is monitored using the NIH Behavior Change Consortium Treatment Fidelity Guidelines. | Behavioral: Audiotaped Counseling Session<br>* Patients and nurses will complete audio taped counseling session at least 3 months following the baseline visit. Patients will rate quality of nurse communication skills<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility measured by documenting total available and eligible nurses and patients approached to enroll 1 participant through final study visit |  | 6 Months | 
| Acceptability measured by % of nurses who complete the simulation |  | 6 Months |