Tailored Patient-Provider Communication (TPPC): Evaluating the Impact of TPPC in Dermatology Patients

Study Overview
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Brief Summary
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The impact of tailored patient-provider communication to improve clinical trial recruitment, patient knowledge, and patient engagement will be studied. Tailored patient-provider communication refers to the individualization of patient-provider communication using patients' preferred methods of communication. This involves the utilization of social messaging such as e-mail or text and/or social media platforms. These communication methods purport to and meet individual patient needs whilst ensuring that information is received and in a format that is familiar to each patient. The primary outcomes of the proposed research is to evaluate the impact of tailored patient-provider communication on patient response rates (speed and number), clinical trial recruitment rates, patient knowledge, and patient engagement.

Detailed Description
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This is a 3-month, pragmatic, single-blinded randomized controlled trial evaluating the impact of tailored patient-provider communication on patient engagement and clinical outcomes of adult dermatology patients compared to non-tailored patient-provider communication. The pragmatic trial will compare patient engagement and clinical outcomes between the two models. The rationale for proposing a pragmatic trial is to test whether tailored patient-provider communication works in real life. This design allows for a large spectrum of everyday clinical settings in order to maximize applicability and generalizability. The pragmatic approaches are especially pronounced along the inclusive eligibility criteria, experimental intervention flexibility, and primary outcome being highly relevant to patients and providers alike. The investigators will recruit from approximately 32,310 adult patients from target populations, southern California to enroll 134 participants in the study. In addition to recruiting from the general population, the investigators will place a specific emphasis on recruiting patients living in rural and underserved communities; the investigators will also recruit from a full range of dermatological diseases. Patient recruitment and enrollment will begin the first month of year one and continue through the fourth month of year one. The expected duration of this pragmatic, single-blinded randomized controlled equivalency trial for each participant will be a maximum of 3 months, including an initial baseline visit. No additional follow-up visits beyond this are expected for this research study. Patients will be randomized to receive patient education via tailored or non-tailored patient-provider communication. The study team will know which form of communication each patient will receive while study participants will not know the different types of communication being studied. Patients randomized to either study population groups can be assessed remotely or in-person at the screening/baseline visit. At month 3, all patients will take high-quality photographs of their skin and submit these pictures to our dermatologist online. Any additional in-person or remote visits will be determined by providers and patients just as they would occur in the real-world. Primary and secondary outcomes will be monitored at months 0, 1.5, and 3.

Official Title
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Tailored Patient-Provider Communication (TPPC): A Pragmatic Single-Blinded Trial Evaluating the Impact of TPPC in Dermatology Patients Compared to Standard Patient-Provider Communication.

Conditions
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Psoriasis, Atopic Dermatitis, Acne

Intervention / Treatment
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* Other: Tailored Patient-Provider Communication
* Other: Non-Tailored Patient-Provider Communication


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Provide signed and dated informed consent form Speak English or Spanish Male or female, at least 18 years of age Have an active, physician-diagnosed dermatological condition Have access to an electronic device that is capable of capturing images with a minimum resolution of 1024x768 pixels Have access to at least one form of social messaging (e-mail, SMS, WhatsApp, or Facebook) which can connect online Exclusion Criteria: Does not have an active dermatological condition at the beginning of the study Does not live in southern California Unable to fulfill the required tasks of the study

Ages Eligible for Study
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Minimum Age: 18 Years

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: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Tailored patient-provider communication versus non-tailored patient-provider communication on patient recruitment to clinical trials and patient engagement.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tailored Delivery of Education<br>Communication will be tailored as the mode of weblink delivery will be customized to patient preference. | Other: Tailored Patient-Provider Communication<br>* Every 1.5 months, patients randomized to the tailored patient-provider communication model will receive weblinks directing patients to disease-specific educational videos and associated questionnaires. Communication will be tailored as the mode of weblink delivery will be customized to patient preference. Patients can choose messages to be delivered via e-mail, SMS, WhatsApp, or Facebook. For example, if one patient determines SMS messaging as their preferred communication mode, then this patient will receive a weblink via SMS directing the patient to customized educational videos and questionnaires. Weblinks delivered via tailored patient-provider communication will be enabled by Wecudos.<br>|
| Placebo Comparator: Non-tailored Delivery of Education<br>Communication will be non-tailored such that patients will not be able to choose their preferred mode of communication and will receive hardcopy. | Other: Non-Tailored Patient-Provider Communication<br>* Every 1.5 months, patients randomized to the non-tailored patient-provider communication model will receive weblinks directing patients to disease-specific educational videos and associated questionnaires. Communication will be non-tailored such that patients will not be able to choose their preferred mode of communication and will receive hardcopy. Patients will receive hardcopy on how to access psoriasis education. Weblinks delivered via non-tailored patient-provider communication will be enabled by Wecudos.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Response Rates | Patient response rate will determine the first step of patient engagement and assesses a patients willingness to 'interact' with the weblink delivered. Patient response rates will be measured by click rates. Click rates will be calculated using the proportions of patients in both study populations who choose to click on the weblinks delivered throughout the study, regardless of whether or not questionnaires are completed. The time elapsed from when the weblink is sent and when the weblink is clicked will also be recorded. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Activation | Measured by the proportion of patients achieving patient activation level 3 or 4 on the Patient Activation Measure 13-item measurement (PAM-13). The PAM-13 score is a validated scale consisting of 13 questions that will determine patient 'activation', or 'empowerment' of a patient to participate in their healthcare. The higher the score, the higher the activation level. Patients in level 1 may still believe their nurse or doctor will fix them. Patients in level 2 may understand they must be involved in their healthcare but lack the knowledge and confidence to take care of their conditions. Patients in level 3 are beginning to gain confidence to take on self-management behaviors and need to experience small successes to build a sense of self-efficacy and increase activation. Patients in level 4 have the confidence and skills to manage their health but may need help with maintaining their progress during stressful times. | 3 months | 
| Patient Experience | Measured by the proportion of patients who report 'good' or 'very good' on the Armstrong Viewer Assessment (AVA). The AVA is a validated scale that will be used to determine patient experience with the educational materials viewed. Patients will be asked to complete this single question questionnaire after watching each educational video. This will ask how each participant felt about the video using a 5-point Likert scales between 0-4, where 0=very poor, 1=poor, 2=fair, 3=good, and 4=very good. | 3 months | 
| Patient Drop-out Rate | Patient drop-out rate will determine the proportion of patients who 'accept' the delivered weblinks. | 3 months |