Empowering Monterey Bay Residents for Activated, Collaborative, and Equitable Care

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorStanford University

About this trial

The purpose of the EMBRACE Study is to evaluate whether a facilitated intervention improves shared decision-making (SDM) and patient activation among low-income and minority individuals more than usual care only. The ultimate goal is to enhance SDM and patient activation in care.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Participants must be receiving clinical care by a primary care physician in the Monterey area

Participants must be 18 years or older.

Participants must speak either English or Spanish.

Participants must be able to consent verbally in English or Spanish to all study procedures.

Disqualifiers

None

Trial design

Design model

Parallel

Treatments tested in this trial

  • Research Assistant Support

    Behavioral

    For those in the experimental group, a Research Assistant will provide health education and support as described in the Intervention arm.

Treatment groups

138 Participants
are divided into 2 treatment groups
Group A: Usual CareNo intervention 0 interventions
Group B: EMBRACE plus usual careExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Patient activation using the "Patient Activation Measure" survey

Each patient will receive a validated patient activation survey using the "Patient Activation Measure" at enrollment and 3 months after study enrollment. This is a validated measure from Insignia Health. Responses are: disagree strongly, disagree, agree, agree strongly with higher activation correlated with responses of agree and agree strongly. Each item is rated on 4-point scale (1 strongly disagree to 4 strongly agree, with additional "not applicable" option). Higher scores indicate greater patient activation. For the PAM-10, minimum score is 0 (if all not-applicable) and maximum is 40. Raw scores are converted into activation levels per the scoring guidelines by Insignia Health for: level 1 Disengaged and Overwhelmed, level 2 Becoming Aware but Still Struggling, level 3 Taking Action and Gaining Control, level 4 Maintaining "Behaviors and Pushing Further. Scores for each group will be averaged at 3 months after study enrollment.

Time frame
3-months post-enrollment
2

Patient activation using the "Patient Activation Measure" survey

Each patient will receive a validated patient activation survey using the "Patient Activation Measure" at enrollment and 6 months after study enrollment. This is a validated measure from Insignia Health. Responses are: disagree strongly, disagree, agree, agree strongly with higher activation correlated with responses of agree and agree strongly. Each item is rated on 4-point scale (1 strongly disagree to 4 strongly agree, with additional "not applicable" option). Higher scores indicate greater patient activation. For the PAM-10, minimum score is 0 (if all not-applicable) and maximum is 40. Raw scores are converted into activation levels per the scoring guidelines by Insignia Health for: level 1 Disengaged and Overwhelmed, level 2 Becoming Aware but Still Struggling, level 3 Taking Action and Gaining Control, level 4 Maintaining "Behaviors and Pushing Further. Scores for each group will be averaged at 6 months after study enrollment.

Time frame
6-months post-enrollment

Secondary outcomes

1

Quality of shared decision-making using the "Shared Decision Making" questionnaire

The SDM-Q-9, a questionnaire assessing patient involvement in shared decision-making (SDM), is scored by summing the responses to its nine items, each on a 6-point Likert scale (0 completely disagree to 5 completely agree). The raw scores range from 0 to 45, with higher scores indicating greater perceived SDM. The change in shared-decision making from baseline to 3 months will be measured.

Time frame
3-months post-enrollment
2

Quality of shared decision-making using the "Shared Decision Making" questionnaire

The SDM-Q-9, a questionnaire assessing patient involvement in shared decision-making (SDM), is scored by summing the responses to its nine items, each on a 6-point Likert scale (0 completely disagree to 5 completely agree). The raw scores range from 0 to 45, with higher scores indicating greater perceived SDM. The change in shared-decision making at baseline to 6 months will be measured.

Time frame
6-months post-enrollment
3

Patient Quality of Life Using the "Functional Assessment of Cancer Therapy - General Survey"

Each patient will the validated "Functional Assessment of Cancer Therapy - General Survey (FACT-G)," which is a 27-item survey with response options including: not at all, a little bit, somewhat, quite a bit, or very much. Five items also allow for a response of 'prefer not to answer.' Scoring for the FACT-G will be done in accordance with the FACT-G Scoring Guidelines (Version 4), available here: https://www.facit.org/measures-scoring-downloads/fact-g-scoring-downloads. In summary, scoring is for four subscales included within the survey, including (1) Physical Well-Being (score range: 0-28), (2) Social Family Well-Being (score range: 0-28), (3) Emotional Well-Being (score range: 0-24), and (4) Functional Well-Being (score range: 0-28). A total score is created from the sum of the subscale scores and has a minimum of zero and maximum of 108, where a higher score indicates greater quality of life. The change in quality of life at baseline to 3 months will be measured.

Time frame
3-months post-enrollment
4

Patient Quality of Life Using the "Functional Assessment of Cancer Therapy - General Survey"

Each patient will the validated "Functional Assessment of Cancer Therapy - General Survey (FACT-G)," which is a 27-item survey with response options including: not at all, a little bit, somewhat, quite a bit, or very much. Five items also allow for a response of 'prefer not to answer.' Scoring for the FACT-G will be done in accordance with the FACT-G Scoring Guidelines (Version 4), available here: https://www.facit.org/measures-scoring-downloads/fact-g-scoring-downloads. In summary, scoring is for four subscales included within the survey, including (1) Physical Well-Being (score range: 0-28), (2) Social Family Well-Being (score range: 0-28), (3) Emotional Well-Being (score range: 0-24), and (4) Functional Well-Being (score range: 0-28). A total score is created from the sum of the subscale scores and has a minimum of zero and maximum of 108, where a higher score indicates greater quality of life. The change in quality of life at baseline to 6 months will be measured.

Time frame
6-months post-enrollment

Other outcomes

Sponsors and contacts

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Stanford University

Lead sponsor

Gilead Sciences

Collaborator