Teen CHAT: Improving Physician Communication With Adolescents About Healthy Weight

Study Overview
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Brief Summary
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The purpose of this study is to teach primary care physicians effective ways to counsel overweight and obese adolescent patients to attain a healthy weight. Fifty physicians and up to 660 adolescent patients from Duke University Health System (DUHS) Primary Care Clinics will take part in this study. Patients will be identified by research study staff and asked if they would be willing to have their clinic visit audio recorded for research purposes. There are three phases of data collection. First, baseline encounters (n=200, 4 per physician) are audio recorded. Then, half of the physicians will be randomized to receive a tailored web-based intervention containing information about evidence-based techniques to help adolescents attain a healthy weight. A new set of 200 encounters (4 per physician) will be audio recorded. Then, all physicians will receive a Summary Report that outlines the adolescent's high risk behaviors that contribute to weight (sweetened beverages, fast food, breakfast, physical activity, screen time, and sleep) and a new set of 200 encounters will be audio recorded. Data will be collected by trained data technicians, in-person and over the phone. Data is collected on laptop computers and then downloaded into password protected electronic files on a secure network server. All participants (adolescent patients and physicians) will be assigned a code number that is the sole identifier on all study data forms. Prior to and after coding, digital files will be stored in password protected directories to which only the data technicians and project manager have access. The web-based intervention will be password protected.

Official Title
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Teen CHAT: Improving Physician Communication With Adolescents About Healthy Weight

Conditions
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Communication, Obesity, Nutrition, Physical Activity, Sleep

Intervention / Treatment
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* Behavioral: Web-based intervention targeting MD communication; Summary Report


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for MDs: Specialty is Family Practice or Pediatrics Located in participating clinic Not planning to leave clinic in the next two years Inclusion Criteria for teen patients: English-speaking BMI z-score >85th percentile age 12-18 not pregnant have parental consent to participate if over 18 have visit at least 7 days in the future have access to a telephone Exclusion Criteria for teen patients: BMI z-score <85th percentile not English speaking pregnant <12 or older than 18 incompetent for interview seen primarily by non-physician provider

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum 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: Health Services Research
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Motivational Interviewing intervention<br>Web-based intervention targeting MD communication and Summary Report | Behavioral: Web-based intervention targeting MD communication; Summary Report<br>* Web-based intervention targeting MD communication; Summary Report detailing 6 risk factors for adolescent overweight/obesity developed by study team<br>* Other names: Tailored Summary Report;|
| No Intervention: Control<br>MD receives Summary Report only | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physician communication |  | after CD-ROM phase | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Summary Report | Assess whether summary report increases whether physicians address six health risk behaviors | After Summary Report Phase | 
| Adolescent Nutrition, Physical Activity, and BMI Z-score | Examine whether patients whose MD was in the MI education arm improved their nutrition, physical activity, and BMI z-score 3 months post-visit more than patients whose MD was in the control arm. | 3 months post-visit |