Educational videos to reduce racial disparities in ICD therapy via innovative designs (VIVID): a randomized clinical trial.
Educational videos to reduce racial disparities in ICD therapy via innovative designs (VIVID): a randomized clinical trial.
复制标题
通过创新设计减少 ICD 治疗种族差异的教育视频 (VIVID)：一项随机临床试验。
DOI：
10.1016/j.ahj.2013.03.031
复制
发表时间：
2013
影响因子：
4.8
通讯作者：
Peterson,EricD
中科院分区：
文献类型：
--
作者：
Thomas,KevinL;Zimmer,LouiseO;Dai,David;Al-Khatib,SanaM;AllenLaPointe,NancyM;Peterson,EricD
背景符合植入性心律转复/除颤器(ICD)条件的人比白人接受ICD的可能性要小得多。这种差异可能部分是由于患者偏好的种族差异造成的。我们假设，一个有针对性的以患者为中心的教育视频可以提高对心脏骤停(SCA)和ICD的知识，并减少ICD偏好的种族差异。我们进行了一项试点研究，以评估在随机试验中检验这一假说的可行性。方法：我们制作了一段视频，其中包括关于SCA和ICD的动画、医生评论和患者证词。主要结果是决定植入ICD作为种族和干预的功能。在2011年1月1日至2011年12月31日期间，59名患者(37名白人和22名黑人)被随机分配到视频或医疗保健提供者咨询/日常护理中。结果与白人患者相比，黑人患者更年轻(中位年龄55岁对68岁)，更有可能上过大学或技校。基线SCA和ICD知识在两个种族群体中相似，干预后显著提高。观看视频的黑人患者与白人患者想要ICD的可能性一样高(60.0%比79.2%，P=.20)；在那些接受常规护理的患者中，黑人患者比白人患者想要ICD的可能性更低(42.9%比84.6%，P=0.05)。结论在符合ICD条件的个人中，视频决策辅助增加了患者对ICD的了解，并减少了患者对ICD偏好的种族差异。
BACKGROUNDBlack individuals eligible for an implantable cardioverter/defibrillator (ICD) are considerably less likely than white individuals to receive one. This disparity may, in part, be explained by racial differences in patient preferences. We hypothesized that a targeted patient-centered educational video could improve knowledge of sudden cardiac arrest (SCA) and ICDs and reduce racial differences in ICD preferences. We conducted a pilot study to assess the feasibility of testing this hypothesis in a randomized trial.METHODSWe created a video that included animation, physician commentary, and patient testimonials on SCA and ICDs. The primary outcome was the decision to have an ICD implanted as a function of race and intervention. Between January 1, 2011, and December 31, 2011, 59 patients (37 white and 22 black) were randomized to the video or health care provider counseling/usual care.RESULTSRelative to white patients, black patients were younger (median age, 55 vs 68 years) and more likely to have attended college or technical school. Baseline SCA and ICD knowledge was similar and improved significantly in both racial groups after the intervention. Black patients viewing the video were as likely as white patients to want an ICD (60.0% vs 79.2%, P = .20); and among those in the usual care arm, black patients were less likely than white patients to want an ICD (42.9% vs 84.6% P = .05).CONCLUSIONAmong individuals eligible for an ICD, a video decision aid increased patient knowledge and reduced racial differences in patient preference for an ICD.