Trial Outcomes & Findings for Virtual cOaching in Making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) (NCT NCT03834870)

NCT ID: NCT03834870

Last Updated: 2023-04-20

Results Overview

Participation will be determined by the ratio of participants who are successfully enrolled to the total number of eligible patients. The numerator, denominator, frequencies and 95% confidence intervals will be reported.

Recruitment status

COMPLETED

Study phase

EARLY_PHASE1

Target enrollment

1012 participants

Primary outcome timeframe

up to 16 months

Results posted on

2023-04-20

Participant Flow

Participant milestones

Participant milestones
Measure
Elder Adults in Emergency Department Setting
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Overall Study
STARTED
1012
Overall Study
COMPLETED
1002
Overall Study
NOT COMPLETED
10

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Virtual cOaching in Making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Elder Adults in Emergency Department Setting
n=1002 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Age, Continuous
73.5 years
STANDARD_DEVIATION 9.04 • n=5 Participants
Age, Customized
60-69
392 Participants
n=5 Participants
Age, Customized
70-79
370 Participants
n=5 Participants
Age, Customized
80-89
177 Participants
n=5 Participants
Age, Customized
90+
63 Participants
n=5 Participants
Sex: Female, Male
Female
594 Participants
n=5 Participants
Sex: Female, Male
Male
408 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
49 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
938 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
15 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
3 Participants
n=5 Participants
Race (NIH/OMB)
Asian
10 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
298 Participants
n=5 Participants
Race (NIH/OMB)
White
673 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
16 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=5 Participants
Region of Enrollment
United States
1002 participants
n=5 Participants
Education
Associate's Degree
46 Participants
n=5 Participants
Education
Undergraduate Degree (Bachelor's program or equivalent)
192 Participants
n=5 Participants
Education
Professional Degree (Master's program or equivalent)
138 Participants
n=5 Participants
Education
High School Graduate or GED
290 Participants
n=5 Participants
Education
High School Not Completed
92 Participants
n=5 Participants
Education
Refused/Unknown
4 Participants
n=5 Participants
Education
Some college
240 Participants
n=5 Participants
Household Income
Less than 25k
291 Participants
n=5 Participants
Household Income
Between 25k to 34k
122 Participants
n=5 Participants
Household Income
Between 35k to 49k
111 Participants
n=5 Participants
Household Income
Between 50k to 74k
116 Participants
n=5 Participants
Household Income
Between 75k to 99k
63 Participants
n=5 Participants
Household Income
Between 100k to 149k
53 Participants
n=5 Participants
Household Income
More than 150k
42 Participants
n=5 Participants
Household Income
Refused/Unknown
204 Participants
n=5 Participants
Marital Status
Single or Never Married
233 Participants
n=5 Participants
Marital Status
Widowed
221 Participants
n=5 Participants
Marital Status
Married or Co-habituating
360 Participants
n=5 Participants
Marital Status
Divorced
157 Participants
n=5 Participants
Marital Status
Separated
19 Participants
n=5 Participants
Marital Status
Other
7 Participants
n=5 Participants
Marital Status
Refused/Unknown
5 Participants
n=5 Participants
Employment Status
Full Time
103 Participants
n=5 Participants
Employment Status
Not Employed/Retired
840 Participants
n=5 Participants
Employment Status
Part Time
56 Participants
n=5 Participants
Employment Status
Refused/Unknown
3 Participants
n=5 Participants
Living Arrangement
In Their Own Home
936 Participants
n=5 Participants
Living Arrangement
In Someone Else's Home
42 Participants
n=5 Participants
Living Arrangement
Assisted Living
24 Participants
n=5 Participants
Number of Household Members
2 persons
STANDARD_DEVIATION 1.1 • n=5 Participants
Internet Usage
Every Day
530 Participants
n=5 Participants
Internet Usage
1-2 Times a Week
157 Participants
n=5 Participants
Internet Usage
1-2 Times a Month
32 Participants
n=5 Participants
Internet Usage
Rarely
280 Participants
n=5 Participants
Internet Usage
Refused/Unknown
3 Participants
n=5 Participants
Confidence in Using Technology
6.9 units on a scale
STANDARD_DEVIATION 2.91 • n=5 Participants

PRIMARY outcome

Timeframe: up to 16 months

Population: The total number of eligible participants.

Participation will be determined by the ratio of participants who are successfully enrolled to the total number of eligible patients. The numerator, denominator, frequencies and 95% confidence intervals will be reported.

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=1204 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Implementation in Terms of Participation
1012 Participants

PRIMARY outcome

Timeframe: up to 16 months

Population: The number of participants who were enrolled in the study (n=1,012)/

Usage will be determined by the number of consented participants enrolled in the study who used VOICES to completion.

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=1012 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Implementation in Terms of Usage
1002 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 16 months

Population: The number of participants who successfully used VOICES to completion.

Participant satisfaction will be measured along multiple dimensions using post-use satisfaction survey with two 5-point Likert response set scales, developed by the research team. Scale 1: Likert scale 1-5, where 1= Very Dissatisfied, and 5= Very Satisfied Scale 2: Likert scale 1-5, where 1= Strongly Disagree, and 5= Strongly Agree

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=1002 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Acceptability
Level of confidentiality and privacy provided while using this tool (Scale 1)
4.57 units on a scale
Standard Deviation 0.76
Acceptability
The time it took to complete using the VOICES tool (Scale 1)
4.44 units on a scale
Standard Deviation 0.81
Acceptability
Your ability to complete the VOICES tool on your own on the iPad, without any staff (Scale 1)
4.5 units on a scale
Standard Deviation 0.81
Acceptability
Time to complete the tool on the iPad was short (Scale 2)
4.11 units on a scale
Standard Deviation 0.98
Acceptability
I felt engaged in the tool throughout the process (Scale 2)
4.29 units on a scale
Standard Deviation 0.81
Acceptability
Audio and visual aids of the tool were helpful (Scale 2)
4.41 units on a scale
Standard Deviation 0.75
Acceptability
I felt the fonts, size and the colors of the text in the tool were appropriate and readable (Scale2)
4.53 units on a scale
Standard Deviation 0.68
Acceptability
Using this tool on the iPad was very easy (Scale 2)
4.53 units on a scale
Standard Deviation 0.67
Acceptability
I was comfortable answering questions on the iPad (Scale 2)
4.56 units on a scale
Standard Deviation 0.65
Acceptability
Using the iPad and the headphones provided more privacy (Scale 2)
4.5 units on a scale
Standard Deviation 0.70
Acceptability
I feel comfortable discussing mistreatment with a doctor or medical professional (Scale 2)
4.4 units on a scale
Standard Deviation 0.80
Acceptability
This tool is appropriate for learning about mistreatment (Scale 2)
4.54 units on a scale
Standard Deviation 0.66
Acceptability
This tool is appropriate to be used in the emergency department (Scale 2)
4.41 units on a scale
Standard Deviation 0.73
Acceptability
I was able to complete VOICES on the iPad on my own (Scale 2)
4.40 units on a scale
Standard Deviation 0.80
Acceptability
Using VOICES on the iPad was a frustrating experience (Scale 2)
1.87 units on a scale
Standard Deviation 1.30
Acceptability
The instructions provided by Vicky were clear and easy to follow (Scale 2)
4.59 units on a scale
Standard Deviation 0.61
Acceptability
I feel more confident about understanding EM/resources in case I/someone else I know is mistreated
4.50 units on a scale
Standard Deviation 0.67
Acceptability
I feel safer after using VOICES on the iPad (Scale 2)
4.21 units on a scale
Standard Deviation 0.89
Acceptability
I learned new, useful things about elder mistreatment (Scale 2)
4.34 units on a scale
Standard Deviation 0.68
Acceptability
I would like to see this used by other older adults in the community such as the doctor's office (2)
4.52 units on a scale
Standard Deviation 0.68

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 16 months

Population: The number of participants who successfully used VOICES to completion.

Demand will be assessed through examining how likely will VOICES be used by patients. To do this, the size of target population of EM victims in the ED will be measured by the % of the patients who self-identified with elder mistreatment and the % who receive the Brief Negotiation Interview (BNI) portion of VOICES.

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=1002 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Demand
Participants who received the BNI
71 Participants
Demand
Participants who self-identified with elder mistreatment
67 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 16 months

Population: The number of participants who successfully used VOICES to completion.

Practicality will be assessed by observing the ease of VOICES use by patients. To do this, a series of steps will be watched to determine the efficiency of implementation measured by the average time (1) to consent \& orient participants to the tool and (2) needed to complete VOICES documented by the Research Assistant; and (3) patients perceived time of VOICES as measured on post-survey. Each of these will be reported as part of the overall outcome.

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=1002 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Practicality
Actual Consent Duration
14.9 minutes
Standard Deviation 5.9
Practicality
Participant Estimated Time to Completion
12.2 minutes
Standard Deviation 9.1
Practicality
Actual VOICES Duration
8.8 minutes
Standard Deviation 5.4

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 16 months

Population: The number of participants who successfully used VOICES to completion.

To understand the efficacy of VOICES in this pilot, we will look at how many participants changed their self-identification response after completing the educational component.

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=1002 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Efficacy of the Educational Material
Overall participants who changed their self-identification response
40 Participants
Efficacy of the Educational Material
"Yes" (does self-identify) response changed to "No" (does not self-identify) response
21 Participants
Efficacy of the Educational Material
"No" (does not self-identify) response changed to "Yes" (does self-identify) response
19 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 16 months

Population: The number of participants who successfully used VOICES to completion and accessed the self-disclosure Brief Negotiation Interview (N=18).

We will look at how many patients changed their readiness to disclose after completing the Brief Negotiation Interview (BNI).

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=18 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Efficacy of the Brief Negotiation Interview
3 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 16 months

Population: The number of participants who self-identified with elder mistreatment.

We will explore whether self-identification impacts likelihood of self-disclosure. Effect-size estimation measured by change in the % of patients who disclose among those who self-identified.

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=67 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Efficacy of Self-Identification on Self-Disclosure
49 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: up to 16 months

Population: The number of participants who used VOICES to completion and screened positive for suspicion of elder mistreatment (n=112).

To understand the accuracy of the VOICES tool, a preliminary evaluation of the accuracy of VOICES as a screening tool in correctly classifying EM cases that were positive based on social worker assessment, and those referred to Adult Protective Services (APS). The percent correct classification will be reported.

Outcome measures

Outcome measures
Measure
Elder Adults in Emergency Department Setting
n=112 Participants
Elder mistreatment in an Emergency Department setting. Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES): Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) screening tool.
Accuracy
Participants substantiated for elder mistreatment
49 Participants
Accuracy
Of the substantiated participants, participants referred to Adult Protective Services (APS)
11 Participants
Accuracy
Referred APS cases accepted and opened by APS
11 Participants

Adverse Events

Elder Adults in Emergency Department Setting

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Fuad Abujarad

Yale University

Phone: +1 (203) 737-5088

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place