Evaluating a Physician Opinion Leader Intervention to Increase Utilization of Coaching/Therapy During Residency

NCT ID: NCT05499468

Last Updated: 2022-11-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

493 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-30

Study Completion Date

2022-10-11

Brief Summary

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Investigators will assess the efficacy of a physician popular opinion leader-led intervention to increase awareness and utilization of existing evidence-based coaching or therapy among post-graduate clinical trainees at Stanford.

Detailed Description

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All Stanford residents are provided access to evidence-based coaching and/or therapy, such as cognitive and behavioral targeting of drivers of burnout.

The present project evaluates the ability of a popular opinion leader approach to normalize use of these resources with the hope of increasing utilization. Over the ark of 31 months, all training programs will receive the intervention.

A flexible, minimally intrusive, residency-randomized cluster design will be used to determine the sequence of which programs receive the intervention immediately verses delayed. Investigators delivered an intervention adapted from the CDC Popular Opinion Leader framework for encouraging physicians to utilize existing resources for individual support during residency through Stanford WellConnect (a confidential mental health promotion program for medical residents, fellows, and all benefits-eligible faculty in the School of Medicine at Stanford during their training). Support resources include evidence-based coaching and/or therapy, such as cognitive and behavioral targeting of drivers of burnout for which physicians are at higher-than-average risk. All health promotion efforts were delivered as part of clinical training, outside the scope of this distinct research evaluation. No data has been collected from individual POLs or workshop participants to date.

Investigators will utilize administratively collected data from postgraduate physician trainee populations across 20 Stanford paired residency programs with 5 or more house-staff (residents or fellows) each. 10 programs were randomly assigned to be the first to receive the intervention, and 10 to a delayed intervention group (10 programs). The immediate intervention arm (vs. delayed) received a POL-led health promotion intervention delivered as part of their regular postgraduate medical training educational activities (e.g., during didactic sessions), designed to encourage them to consider participating in existing, evidence-based one-on-one support resources (coaching and therapy with trained professionals) available through WellConnect. The POL intervention includes two formal workshop discussions and informal conversations with trained physician POL colleagues. The delayed intervention arm continued to receive their regular postgraduate medical training educational activities as well as access to the same coaching and therapy resources through WellConnect, and any other wellness resources involved in the curriculum at each program as the immediate intervention arm. The delayed intervention arm will also receive the POL program from November 1st 2022 through May 2023.

The investigators will evaluate multiple outcomes between the immediate and delayed intervention arms using administratively collected WellConnect usage data (% of each program who participate in coaching or therapy from each enrolled residency program population during the trial). In addition, investigators will analyze administratively collected institutional wellness survey data to determine population level differences in perceptions of stigma against mental health support, self-valuation, burnout, and professional fulfillment.

Conditions

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Workplace Culture Help-Seeking Behavior Social Stigma Education, Medical, Continuing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Popular-Opinion Leader-led workshops & conversations to encourage utilization of support resources

Physicians identified by programwide Qualtrics survey item asking housestaff who in their program they respect and trust most, personally and professionally. Identified POLs were invited to join this health promotion effort as a POL to improve the culture of wellness and psychological safety among housestaff and encourage them to utilize resources at a time when they may benefit significantly. POLs were trained to endorse the benefits of mental health promotion coaching or therapy for residents training at Stanford.

Group Type OTHER

Popular-Opinion Leader-led encouragement during training meetings and informal conversation

Intervention Type OTHER

Investigators adapted evidence-based principles from the Popular Opinion Leader framework to increase utilizations of existing one-on-one emotional support resources for physicians-in-training at Stanford (an effective HIV prevention intervention developed by the CDC for changing social norms and reducing behavioral risk factors led by influential members of a community, trained to promote behavior change). All intervention activities designed to encourage utilization were delivered as part of health promotion during pre-existing clinical training meetings and no data was collected during these workshops. Identified POLs were recruited and trained to encourage their colleagues to use existing support resources and engage in two 30-60 minute workshops scheduled to occur during training meetings.

Standard Training Program Curriculum and Access to Existing Support Resources

All residents and fellows continued to have the same access to coaching and psychotherapy resources available through Stanford WellConnect, along with other educational activities in their usual training.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Popular-Opinion Leader-led encouragement during training meetings and informal conversation

Investigators adapted evidence-based principles from the Popular Opinion Leader framework to increase utilizations of existing one-on-one emotional support resources for physicians-in-training at Stanford (an effective HIV prevention intervention developed by the CDC for changing social norms and reducing behavioral risk factors led by influential members of a community, trained to promote behavior change). All intervention activities designed to encourage utilization were delivered as part of health promotion during pre-existing clinical training meetings and no data was collected during these workshops. Identified POLs were recruited and trained to encourage their colleagues to use existing support resources and engage in two 30-60 minute workshops scheduled to occur during training meetings.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* This post-test only evaluation study will use de-identified data that investigators will request after administrative survey data is collected by the organization
* The primary aim dataset will include WellConnect program level usage data, indicating the total aggregate number of service requests from the cohorts of physicians in the 20 postgraduate training programs at Stanford whose program directors opted to allow their trainees to participate in the Popular Opinion Leader-led population health promotion intervention
* The data set for secondary aims will include completely de-identified data from all house-staff who are enrolled in programs participating in the POL program, and who completed the regularly scheduled institutional wellness survey

Exclusion Criteria

* Nonphysicians
* Those outside 20 training programs cohorts participating in the POL intervention at Stanford
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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The Physicians Foundation

UNKNOWN

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Mickey Trockel

Professor of Psychiatry and Behavioral Sciences

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mickey T Trockel, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Stanford Medicine

Palo Alto, California, United States

Site Status

Countries

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United States

References

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Kassam A, Papish A, Modgill G, Patten S. The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: the Opening Minds Scale for Health Care Providers (OMS-HC). BMC Psychiatry. 2012 Jun 13;12:62. doi: 10.1186/1471-244X-12-62.

Reference Type BACKGROUND
PMID: 22694771 (View on PubMed)

Trockel M, Bohman B, Lesure E, Hamidi MS, Welle D, Roberts L, Shanafelt T. A Brief Instrument to Assess Both Burnout and Professional Fulfillment in Physicians: Reliability and Validity, Including Correlation with Self-Reported Medical Errors, in a Sample of Resident and Practicing Physicians. Acad Psychiatry. 2018 Feb;42(1):11-24. doi: 10.1007/s40596-017-0849-3. Epub 2017 Dec 1.

Reference Type BACKGROUND
PMID: 29196982 (View on PubMed)

Trockel MT, Hamidi MS, Menon NK, Rowe SG, Dudley JC, Stewart MT, Geisler CZ, Bohman BD, Shanafelt TD. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019 Oct;94(10):2022-2031. doi: 10.1016/j.mayocp.2019.04.040. Epub 2019 Sep 19.

Reference Type BACKGROUND
PMID: 31543254 (View on PubMed)

NIMH Collaborative HIV/STD Prevention Trial Group. The community popular opinion leader HIV prevention programme: conceptual basis and intervention procedures. AIDS. 2007 Apr;21 Suppl 2:S59-68. doi: 10.1097/01.aids.0000266458.49138.fa.

Reference Type BACKGROUND
PMID: 17413265 (View on PubMed)

Shanafelt TD, Dyrbye LN, West CP, Sinsky C, Tutty M, Carlasare LE, Wang H, Trockel M. Suicidal Ideation and Attitudes Regarding Help Seeking in US Physicians Relative to the US Working Population. Mayo Clin Proc. 2021 Aug;96(8):2067-2080. doi: 10.1016/j.mayocp.2021.01.033. Epub 2021 Jul 20.

Reference Type BACKGROUND
PMID: 34301399 (View on PubMed)

Mojtabai R, Evans-Lacko S, Schomerus G, Thornicroft G. Attitudes Toward Mental Health Help Seeking as Predictors of Future Help-Seeking Behavior and Use of Mental Health Treatments. Psychiatr Serv. 2016 Jun 1;67(6):650-7. doi: 10.1176/appi.ps.201500164. Epub 2016 Feb 14.

Reference Type BACKGROUND
PMID: 26876662 (View on PubMed)

Other Identifiers

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60993

Identifier Type: -

Identifier Source: org_study_id

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