Re-thinking the Role of Peers And Training Patients [RePeAT]

Study Overview
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Brief Summary
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This study, Re-thinking the role of Peers And Training Patients [RePeAT], is designed to test the feasibility of training peer-coaches to prepare limited health literacy (LHL) patients to engage in shared-decision making (SDM) for cardiovascular disease (CVD) risk-reduction.

Detailed Description
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The investigators will use a 2-arm pilot RCT design to assess the feasibility, and acceptability of the intervention. Up to 60 primary care patients will be randomly assigned to participate in the peer-coaching or control group. Patients will be randomized at a 1:1 ratio, stratified by the clinician. Half of the subjects (n=30) will be assigned to the peer-coaching intervention, and the other half will be assigned to the control group.

Official Title
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Re-thinking the Role of Peers And Training Patients [RePeAT]

Conditions
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Cardiovascular Diseases

Intervention / Treatment
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* Behavioral: Peer Coach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A patient of Highland Family Medicine practice At least 40 years old and no more than 75 years old Be at ≥10% risk for CVD as calculated using the ASCVD Risk Estimator Plus No plans to leave the practice in the next 12 months English speaking Limited Health Literacy (self-report) Exclusion Criteria: Have experienced a prior cardiac or vascular event such as myocardial infarction (MI) or cerebrovascular accident (CVA) or have had a CVD procedure such as installation of a stent or angioplasty Gave peripheral vascular disease, intermittent claudication or peripheral arterial disease Lack of capacity to consent

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 75 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: . Patients will be randomized at a 1:1 ratio, stratified by the clinician.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Peer Coach<br>The research coordinator will set up a time for the subject to have a brief discussion with a peer coach from the study team approximately 1 week after randomization. During the coaching session, the peer coach will encourage the subject to mention their heart health goals to their primary care clinician during their next primary care appointment. The peer coach will also help the subject brainstorm ways to remove any barriers that may prevent them from having the discussion with their clinician. The peer coaching session and the subsequent medical appointment will be audio-recorded. | Behavioral: Peer Coach<br>* Peer coaching session to support shared decision making among patient with limited health literacy.<br>|
| No Intervention: Control<br>The subject will not be asked to meet with the peer coach or anyone from the study team prior to their next visit with their primary care clinician. Their subsequent primary care appointment will be audio-recorded. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ABCS Discussion | The investigators will qualitatively code the office visit to determine if subjects engaged in a discussion with their clinician about their ABCS options/preferences. | patient-clinician office visit, approximately 1 week after the peer coaching session | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Peer Coach Fidelity | The investigators will qualitatively code the peer coaching sessions to determine if peer coaches used Teach-back during their session and if the coaching session was done with fidelity. | post-coaching, approximately 1-2 weeks prior to the patient-clinician office visit |