Health Literacy and Weight Change in a Digital Health Intervention for Women: A Randomized Controlled Trial in Primary Care Practice

Abstract The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.

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Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients

Contemporary Clinical Trials ◽

10.1016/j.cct.2016.03.006 ◽

2016 ◽

Vol 48 ◽

pp. 12-20 ◽

Cited By ~ 27

Author(s):

Perry Foley ◽

Dori Steinberg ◽

Erica Levine ◽

Sandy Askew ◽

Bryan C. Batch ◽

...

Keyword(s):

Primary Care ◽

Randomized Controlled Trial ◽

Digital Health ◽

Controlled Trial ◽

Obesity Treatment ◽

Treatment Intervention ◽

Randomized Controlled ◽

Primary Care Patients

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The physical activity counselling (PAC) randomized controlled trial: rationale, methods, and interventions

Applied Physiology Nutrition and Metabolism ◽

10.1139/h07-075 ◽

2007 ◽

Vol 32 (6) ◽

pp. 1170-1185 ◽

Cited By ~ 32

Author(s):

Michelle S. Fortier ◽

William Hogg ◽

Tracey L. O’Sullivan ◽

Christopher Blanchard ◽

Robert D. Reid ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Care Practice ◽

Randomized Controlled ◽

Physical Activity Counselling ◽

Metabolic Outcomes ◽

Motivation And Confidence ◽

The Impact

Primary care is a promising venue to build patient motivation and confidence to increase physical activity (PA). Physician PA counselling has demonstrated some success; however, maintenance of behaviour change appears to require more intensive interventions. In reality, most physicians do not have the necessary training nor the time for this type of counselling. The purpose of this paper is to outline the rationale, methods, and interventions for the ongoing physical activity counselling (PAC) randomized controlled trial (RCT), which aims to assess the impact of integrating a PA counsellor into a primary care practice. This RCT has 2 arms: (i) brief PA counselling (2–4 min) from a health care provider and (ii) brief PA counselling + intensive PA counselling from a PA counsellor (3 months). The impact of this intervention is being evaluated using the comprehensive RE-AIM framework. One hundred twenty insufficiently active adult patients, aged 18 to 69 y and recruited during regular primary care visits have been randomized. Dependent measures include psychological mediators, PA participation, quality of life, and physical and metabolic outcomes. The PAC project represents an innovative, theoretically-based approach to promoting PA in primary care, focusing on psychological mediators of change. We anticipate that key lessons from this study will be useful for shaping future public health interventions, theories, and research.

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Digital health intervention during cardiac rehabilitation: A randomized controlled trial

American Heart Journal ◽

10.1016/j.ahj.2017.02.016 ◽

2017 ◽

Vol 188 ◽

pp. 65-72 ◽

Cited By ~ 37

Author(s):

R. Jay Widmer ◽

Thomas G. Allison ◽

Ryan Lennon ◽

Francisco Lopez-Jimenez ◽

Lilach O. Lerman ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Cardiac Rehabilitation ◽

Digital Health ◽

Controlled Trial ◽

Health Intervention ◽

Randomized Controlled

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A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial

npj Digital Medicine ◽

10.1038/s41746-020-00325-z ◽

2020 ◽

Vol 3 (1) ◽

Cited By ~ 1

Author(s):

Julie Redfern ◽

Genevieve Coorey ◽

John Mulley ◽

Anish Scaria ◽

Lis Neubeck ◽

...

Keyword(s):

Cardiovascular Disease ◽

Primary Care ◽

Health Care ◽

Randomized Controlled Trial ◽

Risk Factor ◽

Digital Health ◽

Controlled Trial ◽

Control Group ◽

Randomized Controlled ◽

Multicenter Randomized Controlled Trial

Abstract Digital health applications (apps) have the potential to improve health behaviors and outcomes. We aimed to examine the effectiveness of a consumer web-based app linked to primary care electronic health records (EHRs). CONNECT was a multicenter randomized controlled trial involving patients with or at risk of cardiovascular disease (CVD) recruited from primary care (Clinical Trial registration ACTRN12613000715774). Intervention participants received an interactive app which was pre-populated and refreshed with EHR risk factor data, diagnoses and, medications. Interactive risk calculators, motivational messages and lifestyle goal tracking were also included. Control group received usual health care. Primary outcome was adherence to guideline-recommended medications (≥80% of days covered for blood pressure (BP) and statin medications). Secondary outcomes included attainment of risk factor targets and eHealth literacy. In total, 934 patients were recruited; mean age 67.6 (±8.1) years. At 12 months, the proportion with >80% days covered with recommended medicines was low overall and there was no difference between the groups (32.8% vs. 29.9%; relative risk [RR] 1.07 [95% CI, 0.88–1.20] p = 0.49). There was borderline improvement in the proportion meeting BP and LDL targets in intervention vs. control (17.1% vs. 12.1% RR 1.40 [95% CI, 0.97–2.03] p = 0.07). The intervention was associated with increased attainment of physical activity targets (87.0% intervention vs. 79.7% control, p = 0.02) and e-health literacy scores (72.6% intervention vs. 64.0% control, p = 0.02). In conclusion, a consumer app integrated with primary health care EHRs was not effective in increasing medication adherence. Borderline improvements in risk factors and modest behavior changes were observed.

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