Clinical trial NCT05510765: Improving Transportation Assets and the Effects on Wellness Metrics
Official title: ACTiN and Health Metrics: Improving Transportation Assets as a Critical Social Determinant of Health and the Effects on Wellness and Chronic Disease Metrics.
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Social Determinants of Health
Lead sponsor: Unified Potential, Inc.
Sponsor class: OTHER
First posted: 2022-08-22
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Prospective
Primary purpose: OTHER

Brief summary: 1. Implementation of an Advanced Connected Transportation Network (ACTiN), a novel, collaborative multinetwork transportation model for small cities and rural areas.
2. Evaluation of effectiveness in improving transportation assets for clients of a community-based nonprofit specializing in addressing social determinants of health (Lighthouse Community Health Services in Lynchburg, VA).
3. Simultaneous evaluation of wellness metrics based on the standards of the CMS Annual Wellness Visit and metrics associated with common chronic diseases.

Detailed description: 1. Implementation of a community transportation solution The project will be managed by Unified Potential, Inc., a 501c3 tax-exempt organization for transportation.

   * The solution requires implementation of four separate transportation "networks"
   * Public / Contracted / For-Hire Transportation
   * Workforce Transportation Network
   * Community Rideshare Network
   * Volunteer Transportation Network
2. Assessment of Personal Transportation Assets

   * Subjects asked to complete a survey upon intake, at six months, and at one year
   * Digital survey:
   * Can be completed by individual using provided smartphone app or at onsite desktop kiosk
   * Can be facilitated by a caregiver or other provider not involved in data analysis
3. Assessment of health and wellness metrics and chronic disease metrics if applicable

   * Dataset based on metrics assessed in the Center for Medicare and Medicaid Services (CMS) Annual Wellness Visit
   * All metrics quantified via either binary (yes/no) or through use of a validated scale (see below)
   * Data collected electronically at onsite or in-home provider visits at intake, six months, and one year

Eligibility criteria: Inclusion Criteria:

* Adult resident of the City of Lynchburg, Virginia
* Under-resourced at trial entry as defined by meeting eligibility for welfare, food stamps/SNAP, Medicaid, Housing Choice Voucher program, or income at or below 200% of the Federal Poverty Threshold.

Exclusion Criteria:

* None

Primary outcomes:
measure: Rides completed
timeFrame: 1 year
measure: Cost of transportation
timeFrame: 1 year
measure: Untreated disease(s)
timeFrame: 1 year
measure: Cancer screening success
timeFrame: 1 year
Secondary outcomes:
measure: Unmet transportation needs
timeFrame: 1 year
measure: Unmet medical transportation needs
timeFrame: 1 year
measure: Prescribed medications
timeFrame: 1 year
measure: Prescribed medications not utilized
timeFrame: 1 year
measure: Weight
timeFrame: 1 year
measure: BMI
timeFrame: 1 year
measure: Blood Pressure
timeFrame: 1 year
measure: Hgb A1c
timeFrame: 1 year
measure: ADL
timeFrame: 1 year
measure: IADL
timeFrame: 1 year
measure: Physical activity
timeFrame: 1 year
measure: Psychosocial assessment
timeFrame: 1 year
measure: Cognitive function
timeFrame: 1 year
measure: Depression screening
timeFrame: 1 year
measure: Other mental health conditions
timeFrame: 1 year
measure: Smoking assessment
timeFrame: 1 year
measure: Substance use
timeFrame: 1 year
Other outcomes:
Locations:
city: Lynchburg
country: United States
facility: Lighthouse Community Health Center
state: Virginia
Study officials:
affiliation: Medical Director, Lighthouse Community Health Center
name: John Salmon, MD
role: STUDY_DIRECTOR
References:
citation: Bradley EH, Elkins BR, Herrin J, Elbel B. Health and social services expenditures: associations with health outcomes. BMJ Qual Saf. 2011 Oct;20(10):826-31. doi: 10.1136/bmjqs.2010.048363. Epub 2011 Mar 29.
citation: Solberg LI. Theory vs Practice: Should Primary Care Practice Take on Social Determinants of Health Now? No. Ann Fam Med. 2016 Mar;14(2):102-3. doi: 10.1370/afm.1918. No abstract available.
citation: Hood CM, Gennuso KP, Swain GR, Catlin BB. County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. Am J Prev Med. 2016 Feb;50(2):129-35. doi: 10.1016/j.amepre.2015.08.024. Epub 2015 Oct 31.