Behavioral interventions to improve population health outreach for hepatitis C screening: randomized clinical trial.
Behavioral interventions to improve population health outreach for hepatitis C screening: randomized clinical trial.
复制标题
DOI：
10.1136/bmj.n1022
复制
发表时间：
2021-05-18
期刊：
影响因子：
--
通讯作者：
Asch DA
中科院分区：
文献类型：
--
作者：
Mehta SJ;Day SC;Norris AH;Sung J;Reitz C;Wollack C;Snider CK;Shaw PA;Asch DA
为了评估是否选择不使用框架、结合行为科学概念的消息传递或电子通信，可以增加1945至1965年间出生的患者接受丙型肝炎病毒(HCV)筛查的机会。实用型随机对照试验。2019年4月至2020年5月期间，来自一个学术卫生系统(美国宾夕法尼亚州费城)的43家初级保健诊所。1945年至1965年之间出生的患者，在登记前两年内没有筛查史和至少两次初级保健访问。这项多水平试验分为两项研究。亚研究A包括17名初级保健临床医生的1656名符合条件的患者，他们按1：1的比例随机分配到关于丙型肝炎病毒筛查的邮寄信件(仅限信件)或类似的带有丙型肝炎病毒筛查实验室订单的信件(信件+次序)。子研究B包括其余19名符合 标准的837名患者，随后是417名临床医生。活跃的电子患者门户用户被随机分为1：5，分别收到关于丙型肝炎病毒筛查的邮寄信件(Letter)或内容类似的电子患者门户消息(患者门户)；不活跃的患者门户用户被邮寄一封信件。在析因设计中，子研究B中的患者也被随机分成1：1接受标准内容(通常护理)，或基于社会规范、预期后悔、互惠和承诺原则的内容(行为内容)。在四个月内完成丙型肝炎病毒检测的患者比例。21例 患者进入意向处理分析。在亚研究A的1,642名患者中，19.2%(95%可信区间16.5%至21.9%)完成了仅字母ARM的筛查，43.1%(39.7%至46.4%)完成了字母+订单ARM(P<；0.001)的筛查。在B亚研究的19例 患者中，14.6%(13.9%~15.3%)完成了常规护理内容的筛查，13.6%(13.0%~14.3%)完成了行为科学内容的筛查(P=0.06)。在活跃的患者门户用户中，17.8%(16.0%至19.5%)在收到信件后完成筛查，13.8%(13.1%至14.5%)在收到患者门户消息(P<；0.001)后完成筛查。选择退出框架和减少工作量，包括签署的实验室订单，扩大对丙型肝炎病毒的筛查。行为科学信息传递内容不会增加接受度，邮寄信件的响应率高于患者门户信息。临床试验.gov NCT03712553。
To evaluate whether opt out framing, messaging incorporating behavioral science concepts, or electronic communication increases the uptake of hepatitis C virus (HCV) screening in patients born between 1945 and 1965. Pragmatic randomized controlled trial. 43 primary care practices from one academic health system (Philadelphia, PA, USA) between April 2019 and May 2020. Patients born between 1945 and 1965 with no history of screening and at least two primary care visits in the two years before the enrollment period. This multilevel trial was divided into two studies. Substudy A included 1656 eligible patients of 17 primary care clinicians who were randomized in a 1:1 ratio to a mailed letter about HCV screening (letter only), or a similar letter with a laboratory order for HCV screening (letter+order). Substudy B included the remaining 19 837 eligible patients followed by 417 clinicians. Active electronic patient portal users were randomized 1:5 to receive a mailed letter about HCV screening (letter), or an electronic patient portal message with similar content (patient portal); inactive patient portal users were mailed a letter. In a factorial design, patients in substudy B were also randomized 1:1 to receive standard content (usual care), or content based on principles of social norming, anticipated regret, reciprocity, and commitment (behavioral content). Proportion of patients who completed HCV testing within four months. 21 303 patients were included in the intention-to-treat analysis. Among the 1642 patients in substudy A, 19.2% (95% confidence interval 16.5% to 21.9%) completed screening in the letter only arm and 43.1% (39.7% to 46.4%) in the letter+order arm (P<0.001). Among the 19 661 patients in substudy B, 14.6% (13.9% to 15.3%) completed screening with usual care content and 13.6% (13.0% to 14.3%) with behavioral science content (P=0.06). Among active patient portal users, 17.8% (16.0% to 19.5%) completed screening after receiving a letter and 13.8% (13.1% to 14.5%) after receiving a patient portal message (P<0.001). Opt out framing and effort reduction by including a signed laboratory order with outreach increased screening for HCV. Behavioral science messaging content did not increase uptake, and mailed letters achieved a greater response rate than patient portal messages. ClinicalTrials.gov NCT03712553.
登录
查看更多内容
DOI：
10.1073/pnas.1103170108
发表时间：
2011-06-28
影响因子：
11.1
作者：
Milkman, Katherine L.;Beshears, John;Madrian, Brigitte C.
通讯作者：
Madrian, Brigitte C.
2001-2013 年美国退伍军人肝硬化和肝细胞癌负担趋势（按肝脏疾病分类
影响因子：
29.4
作者：
Beste, Lauren A.;Leipertz, Steven L.;Ioannou, George N.
通讯作者：
Ioannou, George N.
影响因子：
3.4
作者：
Fowler, Floyd J., Jr.;Cosenza, Carol;Cleary, Paul D.
通讯作者：
Cleary, Paul D.
影响因子：
105.7
作者：
Montoy, Juan Carlos C.;Dow, William H.;Kaplan, Beth C.
通讯作者：
Kaplan, Beth C.
DOI：
10.15585/mmwr.mm6638a3
发表时间：
2017-09-29
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Flanigan CA;Leung SJ;Rowe KA;Levey WK;King A;Sommer JN;Morne JE;Zucker HA
通讯作者：
Zucker HA