ElderTree Smart System for Older Adults

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

268 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-29

Study Completion Date

2023-09-26

Brief Summary

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Multiple chronic conditions (MCCs) are costly and pervasive among older adults. MCCs account for 90% of Medicare spending, and 65% of Medicare beneficiaries have 3 or more chronic conditions; 23% have 5 or more. MCCs are often addressed in primary care, where time pressures force a focus on medication and lab results rather than self-management skills.

The primary purpose of this study is to investigate whether voice-activated "smart" technology increases adoption and sustains use of an evidence-based electronic health intervention (Elder Tree, or ET) for older adults with multiple chronic conditions, and thereby improves its potential to widely enhance quality of life and health outcomes. ET is an existing intervention providing tools, motivation, and support on a computer platform to help older adults manage their health.

An Agency for Health Care Research and Quality (AHRQ)-funded randomized controlled trial (RCT) found that ET improved quality of life and other factors among high users of primary care with multiple chronic conditions such as diabetes and hypertension. However, many people did not use it extensively, which is a common problem with all web apps.

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Detailed Description

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Conditions

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Chronic Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Control group

Participants will receive treatment as usual (TAU).

Group Type PLACEBO_COMPARATOR

Treatment as usual (TAU)

Intervention Type BEHAVIORAL

Treatment as usual (TAU)

ElderTree on laptop (ET- LT)

Participants will receive ElderTree on a laptop.

Group Type EXPERIMENTAL

ElderTree on laptop (ET- LT)

Intervention Type BEHAVIORAL

ElderTree (ET) is an existing intervention providing tools, motivation, and support on a computer platform to help older adults manage their health.

ET is based on the extensively tested Comprehensive Health Enhancement Support System (CHESS). ET is a "walled garden" free of ads, with design features based on older users' feedback as well as best-practice principles such as uncluttered screens and large type. ET uses computers to deliver key elements of successful interventions: long duration, ongoing outreach, prompts, monitoring, cognitive reframing, action planning, problem solving, self-tailoring, and peer support. ET-LT arm will access ET on Laptop (ET- LT)

ElderTree on smart system (ET- SS)

Participants will receive ElderTree on a smart system.

Group Type EXPERIMENTAL

ElderTree on smart system (ET- SS)

Intervention Type BEHAVIORAL

ElderTree (ET) is an existing intervention providing tools, motivation, and support on a computer platform to help older adults manage their health.

ET is based on the extensively tested Comprehensive Health Enhancement Support System (CHESS). ET is a "walled garden" free of ads, with design features based on older users' feedback as well as best-practice principles such as uncluttered screens and large type. ET uses computers to deliver key elements of successful interventions: long duration, ongoing outreach, prompts, monitoring, cognitive reframing, action planning, problem solving, self-tailoring, and peer support.

ElderTree on smart system (ET- SS) will use voice-activated "smart" speakers connected to the Internet. Because they are used by talking and listening rather than typing and reading, many barriers associated with laptop use can be avoided.

Interventions

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ElderTree on laptop (ET- LT)

ElderTree (ET) is an existing intervention providing tools, motivation, and support on a computer platform to help older adults manage their health.

ET is based on the extensively tested Comprehensive Health Enhancement Support System (CHESS). ET is a "walled garden" free of ads, with design features based on older users' feedback as well as best-practice principles such as uncluttered screens and large type. ET uses computers to deliver key elements of successful interventions: long duration, ongoing outreach, prompts, monitoring, cognitive reframing, action planning, problem solving, self-tailoring, and peer support. ET-LT arm will access ET on Laptop (ET- LT)

Intervention Type BEHAVIORAL

ElderTree on smart system (ET- SS)

ElderTree (ET) is an existing intervention providing tools, motivation, and support on a computer platform to help older adults manage their health.

ET is based on the extensively tested Comprehensive Health Enhancement Support System (CHESS). ET is a "walled garden" free of ads, with design features based on older users' feedback as well as best-practice principles such as uncluttered screens and large type. ET uses computers to deliver key elements of successful interventions: long duration, ongoing outreach, prompts, monitoring, cognitive reframing, action planning, problem solving, self-tailoring, and peer support.

ElderTree on smart system (ET- SS) will use voice-activated "smart" speakers connected to the Internet. Because they are used by talking and listening rather than typing and reading, many barriers associated with laptop use can be avoided.

Intervention Type BEHAVIORAL

Treatment as usual (TAU)

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Be ≥60 years old;
* Have been treated in University of Wisconsin (UW) Health clinics, with no plans to leave during the study period (only relevant for UW Health patients, not patients recruited from the community);
* Have a chronic pain diagnosis AND a medical diagnoses of three or more of the following common chronic conditions: Chronic obstructive pulmonary disease (COPD), asthma, diabetes, hyperlipidemia, hypertension, ischemic heart disease, atrial fibrillation, heart failure, stroke, BMI 30+, cancer, chronic kidney disease, depression, osteoporosis, arthritis, or dizziness/falls/loss of vestibular function;
* Be willing to share healthcare use (e.g. 30-day readmissions) in electronic health records (only relevant for UW Health patients, not patients recruited from the community); and
* Allow researchers to share information about a patient's health status with their primary care physician (PCP).

Exclusion Criteria

* Require an interpreter
* Have a medical diagnosis of any of the following:

* Alzheimer's
* Schizophrenia/other psychotic disorders
* Dementia
* Autism spectrum disorder
* Known terminal illness with less than 6 months to live
* Acute medical problem requiring immediate hospitalization

Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes