Feasibility of automated pre-screening for lifestyle and behavioral health risk factors in primary care

Rose, Gail L.; Ferraro, Tonya A.; Skelly, Joan M.; Badger, Gary J.; MacLean, Charles D.; Fazzino, Tera L.; Helzer, John E.

doi:10.1186/s12875-015-0368-9

Cited by 67 publications

(11 citation statements)

References 45 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the two years following the launch, the center has used the system to recruit participants for eight research projects, including the successful completion of four NIH-funded projects, which recruited across the life span, from a project targeting youth ages [14][15][16][17][18][19], to a project targeting adults 65 years and older [23,24]. As of July 26, 2017, a total of 6,525 prospective participants had completed the pre-screening survey and there are currently 14,557 records entered into the Referral Tracking database.…”

Section: Uptakementioning

confidence: 99%

“…A 2011 systematic review concluded that pre-screening is the most effective part of the recruitment process addressed by CTRSS [13]. Pre-screening optimizes recruitment procedures by reserving staff time for interactions with participants who are likely to be enrolled [14]. Dividing recruitment into a series of different examinations of increasing complexity has also been shown to be successful in the recruitment for large trials [15,16], though few studies describe their pre-screening methods and subsequent record keeping.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Practical Do-It-Yourself Recruitment Framework for Concurrent eHealth Clinical Trials: Simple Architecture (Part 1) (Preprint)

Palac¹,

Alam²,

Kaiser³

et al. 2018

Preprint

View full text Add to dashboard Cite

Background: The ability to identify, screen, and enroll potential research participants in an efficient and timely manner is crucial to the success of clinical trials. In the age of the internet, researchers can be confronted with large numbers of people contacting the program, overwhelming study staff and frustrating potential participants. Objective: This article describes a "do-it-yourself" recruitment support framework (DIY-RSF), using tools readily available in many academic research settings, to support remote participant recruitment, pre-screening, enrollment, and management across multiple concurrent eHealth clinical trials. Methods: This work was conducted in an academic research center focused on developing and evaluating behavioral intervention technologies. A needs assessment consisting of unstructured individual and group interviews was conducted to identify barriers to recruitment and important features for the new system. Results: We describe a practical and adaptable recruitment management architecture that used readily available software, such as REDCap and standard statistical software (e.g. SAS, R), to create an automated recruitment framework that supported prescreening potential participants, consent to join a research registry, triaging for management of multiple trials, capture of eligibility information for each phase of a recruitment pipeline, and staff management tools including monitoring of participant flow and task assignment/reassignment features. The DIY-RSF was launched in July 2015. As of July 2017, the DIY-RSF has supported the successful

show abstract

Section: Uptakementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Practical Do-It-Yourself Recruitment Framework for Concurrent eHealth Clinical Trials: Simple Architecture (Part 1) (Preprint)

Palac¹,

Alam²,

Kaiser³

et al. 2018

Preprint

View full text Add to dashboard Cite

show abstract

“…A previous publication describes the IVR Screen in detail. 10 Respondents had the option of routing their IVR Screen results immediately to their Electronic Medical Record (EMR), which 95 % elected to do. Results were viewable by PCPs in the EMR and consisted of a simple list of each of the six items and the patient's response.…”

Section: Recruitment Proceduresmentioning

confidence: 99%

“…8,9 With the dual objective of increasing patient-provider communication about alcohol and offering an automated pre-visit BI to patients who might not otherwise receive one, we developed a system for alcohol screening and BI using Interactive Voice Response (IVR). The IVR performs pre-visit screening to identify individuals with unhealthy alcohol consumption, 10 offers a BI to those who screen positive, and encourages them to discuss alcohol at the upcoming visit. The current report focuses on evaluating the IVR-BI as an instrument for stimulating in-office dialogue about drinking behavior.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient–Provider Communication in Primary Care

et al. 2016

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Brief interventions for unhealthy drinking in primary care settings are efficacious, but underutilized. Efforts to improve rates of brief intervention though provider education and office systems redesign have had limited impact. Our novel brief intervention uses interactive voice response (IVR) to provide information and advice directly to unhealthy drinkers before a physician office visit, with the goals of stimulating in-office dialogue about drinking and decreasing unhealthy drinking. This automated approach is potentially scalable for wide application. OBJECTIVE: We aimed to examine the effect of a pre-visit IVR-delivered brief alcohol intervention (IVR-BI) on patient-provider discussions of alcohol during the visit. DESIGN: This was a parallel group randomized controlled trial with two treatment arms: 1) IVR-BI or 2) usual care (no IVR-BI). PARTICIPANTS: In all, 1,567 patients were recruited from eight university medical center-affiliated internal medicine and family medicine clinics. INTERVENTIONS: IVR-BI is a brief alcohol intervention delivered by automated telephone. It has four components, based on the intervention steps outlined in the National Institute of Alcohol Abuse and Alcoholism guidelines for clinicians: 1) ask about alcohol use, 2) assess for alcohol use disorders, 3) advise patient to cut down or quit drinking, and 4) follow up at subsequent visits. MAIN MEASURES: Outcomes were patient reported: patient-provider discussion of alcohol during the visit; patient initiation of the discussion; and provider's recommendation about the patient's alcohol use. KEY RESULTS: Patients randomized to IVR-BI were more likely to have reported discussing alcohol with their provider (52 % vs. 44 %, p = 0.003), bringing up the topic themselves (20 % vs. 12 %, p < 0.001), and receiving a recommendation (20 % vs. 14 %, p < 0.001). Other predictors of outcome included baseline consumption, education, age, and alcohol use disorder diagnosis. CONCLUSIONS: Providing automated brief interventions to patients prior to a primary care visit promotes discussion about unhealthy drinking and increases specific professional advice regarding changing drinking behavior.

show abstract

“…A prior publication has shown the feasibility of IVR Bpre-screening^in helping both patients and providers decide where to focus the bulk of their time during the upcoming visit. 7 Rose and colleagues identified patients who screened positive for at-risk alcohol use, and randomly divided them into two groups, one who received an automated telephone brief intervention (IVR-BI) and a no-intervention control. 6 The BI followed the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines, in which patients were asked about alcohol use, assessed for problems, advised (and assisted) to cut down, and encouraged to arrange follow-up care.…”

mentioning

confidence: 99%

Thinking Outside the Visit: Digitally Extending the Reach of Behavioral Health

Satterfield

2016

J GEN INTERN MED

View full text Add to dashboard Cite

O ver 50 % of premature morbidity and mortality is attributable to behavioral causes, and by 2020, behavioral health disorders will surpass physical diseases as the main cause of disability worldwide. [1][2][3] Chemical addictions are particularly problematic, with tobacco smoking alone accounting for over 400,000 preventable deaths per year in the United States. 4 Hazardous alcohol consumption is the third leading behavioral cause of death, and costs over $230 billion annually. 1,2 Obesity has reached epidemic rates, with associated morbidity and mortality from diabetes, cardiovascular disease, and other illnesses. The consequences of a medication-only approach to chronic pain are being acutely felt, as the health care system struggles to respond to an emerging opioid crisis.Primary care clinics offer the ideal setting for identifying and intervening with patients who engage in behaviors that harm their health. Patients can be screened and identified in the early stages of an emerging problem and counseled to change and/or referred to specialty care. 5 Conversations about physical activity, nutrition, fitness, and non-pharmacological pain management can be started in primary care, and patients can be prepared to accept referrals to behavioral health providers.Although effective behavioral counseling strategies have been validated for use in primary care, most busy practices simply do not have the resources or skill sets to deliver behavior change counseling. Commonly cited obstacles include competing demands on provider time, competing patient medical comorbidities, lack of staff, insufficient resources (including billing reimbursements), and lack of provider skill or confidence. When behavioral counseling is attempted, it is often done in an uncoordinated, non-longitudinal way that leaves patients feeling unsupported and unsatisfied. Consequently, the self-help industry is flourishing, resulting in a proliferation of non-evidence-based tools, where patients attempt to change their behaviors on their own without the benefit of a medical professional who may better understand the health implications of their behavior and could better tailor interventions to the patient's preferences and needs.The emerging healthcare climate affords an unprecedented opportunity to address substance use and other behavioral health issues in innovative, efficient, and effective ways. The Affordable Care Act (ACA) and accreditation standards for patient-centered medical homes (PCMH) reflect the importance and value now placed on preventive and integrated behavioral health interventions. Team-based practice models have expanded the range of providers who are able to deliver these services, while increasing the need for tools to coordinate care. Patient empowerment and chronic disease management approaches highlight the importance of creating service delivery models and treatment tools that include the patient and are tailored to his/her social context. Given this climate, and the unmet clinical need, the time is ripe for innovative d...

show abstract

Feasibility of automated pre-screening for lifestyle and behavioral health risk factors in primary care

Cited by 67 publications

References 45 publications

A Practical Do-It-Yourself Recruitment Framework for Concurrent eHealth Clinical Trials: Simple Architecture (Part 1) (Preprint)

A Practical Do-It-Yourself Recruitment Framework for Concurrent eHealth Clinical Trials: Simple Architecture (Part 1) (Preprint)

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient–Provider Communication in Primary Care

Thinking Outside the Visit: Digitally Extending the Reach of Behavioral Health

Contact Info

Product

Resources

About