Ask Questions (ASQ):Implementation of a Communication Intervention

Study Overview
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Brief Summary
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This clinical trial implements a communication intervention to improve patient-oncologist communication in the outpatient medical oncology setting. A communication brochure called the ASQ brochure may help patients prepare for the doctor visit by thinking through the questions that patients and patients' family want to ask the doctor.

Detailed Description
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Patient-centered communication is critical to providing high-quality care. In patient-provider clinical interactions, providers are responsible for several aspects of patient-centered communication. However, to reach the goal of providing the best possible treatments, patients should also actively participate by asking questions and expressing their concerns. Question prompt lists, simple lists of questions provided to patients before clinic visits to help them prepare for the appointment, have been tested in several medical contexts and patient populations, including among an underserved, minority population in Detroit, and have been shown to contribute to improved outcomes related to better communication quality. Using a RE-AIM framework, this descriptive, mixed methods, single-arm intervention study assesses the implementation of an evidence-based communication intervention (question prompt list), the ASQ brochure. The ASQ brochure is designed to improve patient-oncologist communication and other outcomes by improving patient self-efficacy for managing patient-physician interactions. Investigators will recruit 225 patients and implement the ASQ brochure at seven Karmanos Cancer Center network sites. Participants are newly diagnosed patients with (Stages I-IV) cancer for which systemic therapy is likely a recommended treatment.

Official Title
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Ask Questions (ASQ): Implementation of a Communication Intervention to Improve Patient-Oncologist Communication in the Outpatient Medical Oncology Setting

Conditions
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Stage II Breast Cancer, Stage III Breast Cancer, Stage IV Breast Cancer, Stage II Colorectal Cancer, Stage III Colorectal Cancer, Stage IV Colorectal Cancer, Stage II Lung Cancer, Stage III Lung Cancer, Stage IV Lung Cancer, Stage II Prostate Cancer, Stage III Prostate Cancer, Stage IV Prostate Cancer, Stage II Ovarian Cancer, Stage III Ovarian Cancer, Stage IV Ovarian Cancer, Stage II Cervical Cancer, Stage III Cervical Cancer, Stage II Bladder Cancer, Stage III Bladder Cancer, Stage IV Bladder Cancer, Stage II Kidney Cancer, Stage III Kidney Cancer, Stage IV Kidney Cancer

Intervention / Treatment
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* Behavioral: Behavioral Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults 18 years of age or older Have a first appointment to see a medical oncologist at a Karmanos Cancer Institute (KCC) site for medical/systemic treatment for a new, confirmed diagnosis of stages I-IV cancer Speak and read English well enough to be able to understand consent documents Given the diverse population seen at KCI, we will make attempts to recruit a representative sample. Our strategy will be simply to ask recruiters to make special attempts to recruit a representative sample. If that strategy fails after the first 10 patients we will build in requirements that at least 25% of the patients self-identify as non-White Exclusion Criteria: Not specified

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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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: Health services research (ASQ brochure)<br>Patients receive ASQ brochure and complete questionnaires over 30 minutes at baseline, over 10 minutes pre-clinic visit, and over 30 minutes post-clinic visit. | Behavioral: Behavioral Intervention<br>* Complete questionnaires<br>* Other names: Questionnaire Administration;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-efficacy in managing patient-physician interactions | 20 items, 5-point Likert scale | Baseline (Time 1) to pre-clinic visit (TIme 2) post-clinic visit (TIme 3) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in knowledge related to the patient's cancer and treatment | 6 investigator-developed questions; 5-point Likert scale (strongly disagree - strongly agree) | Baseline (Time 1) to pre-clinic visit (TIme 2) post-clinic visit (TIme 3) | 
| Change in trust in physicians | generally (before) and in a specific physician (after): (5 items20 Likert scale) | Baseline (Time 1) to post-clinic visit (Time 3) | 
| Change in distress | Distress thermometer (one item, Likert scale (no distress - extreme distress) | Baseline (Time 1) to pre-clinic visit (TIme 2) post-clinic visit (TIme 3) | 
| Perceptions of the Question Prompt List | 10 items, 5-point Likert scale | Post-meeting (Time 3) |