One-4-ALL Initiative

Study Overview
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Brief Summary
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This study aims to improve health outcomes of individuals and populations, enhance the patient experience, reduce the per capita cost of care, and ensure the well-being of our healthcare providers (quadruple aim). These goals are increasingly difficult to achieve, given the challenges of changes to workflow, staffing shortages, and increased costs brought on by the COVID-19 pandemic. Further, the pandemic brought to light the critical need to transform healthcare access for our racially and culturally minoritized and low-income families that have long been victims of health disparities, specifically with poorer health outcomes.

Detailed Description
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The overall objective is to successfully implement a patient app that will be used by families to 1) increase throughput for all patients, including minoritized, low-income, and low health literacy patients, and 2) reduce administrative burdens on providers. To evaluate this hypothesis, the following specific aims will be examined: Aim 1: Document modifiable factors that negatively and positively impact providers' ability to provide high-quality patient care in a post-pandemic healthcare system while addressing health disparities through implementation science. Aim 2: Create a boarding pass' experience for providers and patients using technology (app) which allows patients and their families to fully prepare for their clinical visits and bridge care between home, primary care providers, and specialty care. Aim 3: Investigate multilevel contextual factors related to app implementation, to inform future strategies to promote scalability and sustainability of app in all specialties.

Official Title
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Transforming Healthcare in Post-Pandemic Recovery: Innovation in Process & Technology to Increase Patient Throughput While Reducing Clinician Burden and Addressing Health Disparities (One-4-ALL Initiative)

Conditions
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Literacy, Burden, Caregiver, Health Care Utilization

Intervention / Treatment
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* Behavioral: One-4-ALL Initiative
* Behavioral: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All guardians of patients and the providers (surgeons, doctors, nurses, etc) that serve these patients. Exclusion Criteria: None.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This is a randomized controlled trial to examine pre-post differences between individuals that use the app versus the standard of care.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: One-4-ALL Initiative<br>The health app arm will pilot the intervention and key outcome measures will be compared between the Health App group and the placebo control. | Behavioral: One-4-ALL Initiative<br>* We can successfully implement a patient app that will be used by families to 1) increase throughput for all patients, including minoritized, low-income, and low health literacy patients, and 2) reduce administrative burdens on providers.<br>|
| Placebo Comparator: Control<br>Will receive standard care. | Behavioral: Control<br>* Patients will receive standard of care.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health care quality | Health care quality will be assessed using six domains; safety, effective, patient-centered, timely, efficient, and equitable. Likert scale 1-5, higher score is best. | post-intervention (12 weeks) | 
| Provider satisfaction | Provider job satisfaction including level of burden and overall job satisfaction. Likert scale 1-5, higher score is best. physical and mental health | post-intervention (12 weeks) | 
| Patient satisfaction | Patient's satisfaction of the program tool. Likert scale 1-5, higher score is best. literacy of the patient & their family, patient & family anxiety pre-surgery. | post-intervention (12 weeks) | 
| Acceptability of program tool | Patient's ability to engage and understand the program tool. Likert scale 1-5, higher score is better. | post-intervention (12 weeks) |