Fidelity evaluation of the dialogue around respiratory illness treatment (DART) program communication training.


Journal

Patient education and counseling
ISSN: 1873-5134
Titre abrégé: Patient Educ Couns
Pays: Ireland
ID NLM: 8406280

Informations de publication

Date de publication:
07 2022
Historique:
received: 29 09 2021
revised: 04 03 2022
accepted: 10 03 2022
pubmed: 29 3 2022
medline: 18 6 2022
entrez: 28 3 2022
Statut: ppublish

Résumé

To evaluate receipt fidelity of communication training content included in a multifaceted intervention known to reduce antibiotic over-prescribing for pediatric acute respiratory tract infections (ARTIs), by examining the degree to which clinicians implemented the intended communication behavior changes. Parents were surveyed regarding clinician communication behaviors immediately after attending 1026 visits by children 6 months to < 11 years old diagnosed with ARTIs by 53 clinicians in 18 pediatric practices. Communication outcomes analyzed were whether clinicians: (A) provided both a combined (negative + positive) treatment recommendation and a contingency plan (full implementation); (B) provided either a combined treatment recommendation or a contingency plan (partial implementation); or (C) provided neither (no implementation). We used mixed effects multinomial logistic regression to determine whether these 3 communication outcomes changed between baseline and the time periods following each of 3 training modules. After completing the communication training, the adjusted probability of clinicians fully implementing the intended communication behavior changes increased by an absolute 8.1% compared to baseline (95% Confidence Interval [CI]: 2.4%, 13.8%, p = .005). Our findings support the receipt fidelity of the intervention's communication training content. Clinicians can be trained to implement communication behaviors that may aid in reducing antibiotic over-prescribing for ARTIs.

Identifiants

pubmed: 35341612
pii: S0738-3991(22)00104-5
doi: 10.1016/j.pec.2022.03.011
pmc: PMC9203931
mid: NIHMS1790133
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0

Banques de données

ClinicalTrials.gov
['NCT02943551']

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S. Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Pagination

2611-2616

Subventions

Organisme : NICHD NIH HHS
ID : R01 HD084547
Pays : United States

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

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Auteurs

Rita Mangione-Smith (R)

Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA. Electronic address: Rita.M.Mangione-Smith@kp.org.

Jeffrey D Robinson (JD)

Department of Communication, Portland State University, Portland, OR, USA. Electronic address: jeffreyr@pdx.edu.

Chuan Zhou (C)

Department of Pediatrics, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA. Electronic address: Chuan.Zhou@seattlechildrens.org.

James W Stout (JW)

Department of Pediatrics, University of Washington, Seattle, WA, USA. Electronic address: jstout@u.washington.edu.

Alexander G Fiks (AG)

Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Primary Care Research, American Academy of Pediatrics, IL, USA. Electronic address: fiks@email.chop.edu.

Madeleine Shalowitz (M)

Department of Psychiatry and Behavioral Medicine, Rush University School of Medicine, Chicago, IL, USA. Electronic address: Madeleine_Shalowitz@rush.edu.

Jeffrey S Gerber (JS)

Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: GERBERJ@email.chop.edu.

Dennis Burges (D)

Department of Pediatrics, University of Washington, Seattle, WA, USA. Electronic address: dburges@uw.edu.

Benjamin Hedrick (B)

Department of Pediatrics, University of Washington, Seattle, WA, USA. Electronic address: bhedrick@uw.edu.

Louise Warren (L)

Department of Pediatrics, University of Washington, Seattle, WA, USA. Electronic address: lcnovak@uw.edu.

Robert W Grundmeier (RW)

Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: grundmeier@email.chop.edu.

Matthew P Kronman (MP)

Department of Pediatrics, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA. Electronic address: matthew.kronman@seattlechildrens.org.

Laura P Shone (LP)

Primary Care Research, American Academy of Pediatrics, IL, USA. Electronic address: lshone@aap.org.

Jennifer Steffes (J)

Primary Care Research, American Academy of Pediatrics, IL, USA. Electronic address: jsteffes@aap.org.

Margaret Wright (M)

Primary Care Research, American Academy of Pediatrics, IL, USA. Electronic address: mewright@uic.edu.

John Heritage (J)

Department of Sociology, University of California Los Angeles, Los Angeles, CA, USA. Electronic address: heritage@ucla.edu.

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Classifications MeSH