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Attitude to ComputersNCT03063268

An Interactive Patient-Centered Consent for Research Using Medical Records

A study testing Trust-Enhanced Messaging on E-Consent, Interactive features on E-Consent and Standard E-Consent in people with Attitude to Computers and Attitude of Health Personnel, run by University of Florida at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this project is to develop and evaluate a novel, electronic informed consent application for research involving electronic health record (EHR) data. In response to NIH RFA-OD-15-002, this study addresses research using clinical records and data, including the issues of the appropriate content and duration… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Trust-Enhanced Messaging on E-Consent, Interactive features on E-Consent and Standard E-Consent
Could I receive a placebo?
No, everyone receives an active treatment
How many people
734 participants
Where
1 siteUnited States
Study dates
6 Nov 2017to 9 Aug 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Patients with a scheduled medical visit at a UF Family Medicine clinic
  • Capacitated, english-speaking patients
  • Ages 18 and over
  • Patients who meets the above criteria and is willing to consent to participate in the trial.

Who cannot join

  • Patients who do not complete the UF IRB approved informed consent form
  • Patients under the age of 18 years of age

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Florida

    Gainesville, Florida, 32611

Other trials in United States

About this study

The goal of this project is to develop and evaluate a novel, electronic informed consent application for research involving electronic health record (EHR) data. In response to NIH RFA-OD-15-002, this study addresses research using clinical records and data, including the issues of the appropriate content and duration of informed consent and patient preferences about research use of clinical information. This study will design an electronic consent application intended to improve patients' satisfaction with and understanding of consent for research using their EHR data. The electronic application will provide interactive functionality that creates a virtual, patient-centered discussion with patients about research that uses EHR data. Also, to correct potential misconceptions and increase informedness, the application will present trust-enhancing messages that highlight facts about research regulations, researcher training, and data protections. This study (Specific Aim 2 of the linked study protocol) will compare the effectiveness of the interactive, trust-enhanced consent application to an interactive consent and standard consent (no interactivity, no trust- enhancement) using a randomized trial of the three consents with 750 adults in a network of family medicine practices. Primary outcomes will be satisfaction with the consent decision and understanding of the consent content. This application will allow patients to learn more about clinical research and make informed choices about whether or not they want their health records and data to be used for research. This first phase of this project (IRB#:201500678) was innovative because it created a virtual, patient-centered discussion about research using EHR data. Moreover, this project produced a consent application that clinicians and researchers will use in this phase (Phase two) of the trial as an ethically sound and practical tool for consenting patients, in a clinical setting, for research involving EHRs. Overall, this study will improve understanding of how to best give patients information about research that uses their health records and data. With this understanding, this study will develop a new computer application that patients can use in their doctors' offices. This application will allow patients to learn more about clinical research and make informed choices about whether or not they want their health records and data to be used for research.

Read the detailed description

This study (Specific Aim 2 of the linked study protocol) will compare the effectiveness of the interactive, trust-enhanced consent application to an interactive consent and standard consent (no interactivity, no trust- enhancement) using a randomized trial of the three consents with 750 adults in a network of family medicine practices. Primary outcomes will be satisfaction with the consent decision and understanding of the consent content.

Conceptually, the hypothesized effectiveness of this study's new consent application relies on two constructs, interactivity and trust. Many studies have identified the importance of trust in researchers when it comes to people's willingness to participate in research. Moreover, trust in the source of information is critical to participants' evaluations of risk information. And, risk information is an important element of the research consent process. Thus, highlighted relevant messages to participants at the outset of a research consent process. It is expected that these messages will not coerce participants nor will they dramatically alter participants' general trust in researchers. More importantly, empirically assessments of both of these expectations to ensure the application delivers an ethically appropriate consenting experience. However, it is expected that presenting key facts about research data protections, researcher training, and research regulations will increase the likelihood that participants will be willing to learn about research using medical records. In turn, this will increase participants' understanding and help them make a more informed decision. In the absence of these trust-related messages, it is expected that many participants will simply disengage from the details of the consent information and thus make a less informed decision about participating. Next, the investigators' use of interactivity is supported by research on the effectiveness of communications that interactively deliver detail, empower audiences, and allow a self - discovery process. Indeed, an interactive, person-to-person consent process is the standard approach in clinical trials. Therefore, in the new consent application, the interface will allow participants to interactively explore the details that are most important for their personal understanding of research using EHRs and most relevant to their personal information needs and satisfaction with the consent decision. Without this interactive information exploration, which is essentially dynamically tailored to their personal information needs, participants are more likely to be overwhelmed by the volume of information presented and unable to obtain the information they want most. Under these circumstances, participants' overall understanding of the consent information is likely to decrease, and they are likely to make less satisfactory decisions. There are two specific hypotheses: (1) compared to the standard consent, the interactive consent will lead to increased decisional satisfaction and understanding of the consent; and (2) compared to the interactive consent, the interactive, trust-enhanced consent will lead to increased decisional satisfaction and understanding of the consent.

Being tested
Trust-Enhanced Messaging on E-Consent, Interactive features on E-Consent, Standard E-Consent
Keywords
Electronic Consent, Human Behavior, Bioethics, Research Ethics, Electronic Medical Records (EMR), Electronic Health Records (EHR), Informed Consent Form, Interactive Consent, Health Record Data

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Trust-Enhanced Messaging on E-ConsentBehavioural

    Also called Trust-Enhanced E-Consent

    Messaging with trust-enhanced modification to the language that the research team has identified as beneficial additional knowledge to provide to participants. This messaging was reviewed by participants from Phase I and edited as suggested.

  • Interactive features on E-ConsentBehavioural

    Also called Interactive E-Consent

    Interactive hyperlinks to open up to further information for key words that participants from Phase I and prototype design and testing have identified as gaps in subject knowledge and provision of information to subjects.

  • Standard E-ConsentBehavioural

    Standard consent currently used by the University of Florida (UF) IRB with no trust-enhanced messaging or interactive hyperlinks that provide further information for subjects.

Study groups in NCT03063268
Study groupRoleWhat they receive
Trust-Enhanced Messaged with Interactive Features on E-ConsentExperimentalMessaging with trust-enhanced modification to the language that the research team has identified as beneficial additional knowledge to provide to participants. This messaging was reviewed by participants from Phase I and edited as suggested.
Receives: Behavioral: Trust-Enhanced Messaging on E-Consent; Behavioral: Interactive features on E-Consent; Behavioral: Standard E-Consent
Interactive Features on E-ConsentExperimentalInteractive hyperlinks to open up to further information for key words that participants from Phase I and prototype design and testing have identified as gaps in subject knowledge and provision of information to subjects.
Receives: Behavioral: Interactive features on E-Consent; Behavioral: Standard E-Consent
Standard E-ConsentActive comparatorStandardized text currently used by the University of Florida (UF) IRB with no trust-enhanced messaging or interactive hyperlinks that provide further information for subjects.
Receives: Behavioral: Standard E-Consent

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Baseline Satisfaction with consent decision

    Satisfaction With Decisions scale (Holmes-Rovner et al. 1996); 6-items, 5-point Likert scale (strongly disagree-strongly agree)

    Measured: Immediate at baseline

  2. Change from Baseline Satisfaction with consent decision

    Satisfaction With Decisions scale (Holmes-Rovner et al. 1996); 6-items, 5-point Likert scale (strongly disagree-strongly agree)

    Measured: 1-week follow-up from Baseline

  3. Baseline Understanding of consent content

    Modified version of the Quality of Informed Consent scale, Part B (Joffe et al. 2001); 14-items, 5-point Likert scale (I didn't understand this at all - I understood this very well)*

    Measured: Immediate at Baseline

  4. Change from Baseline Understanding of consent content

    Modified version of the Quality of Informed Consent scale, Part B (Joffe et al. 2001); 14-items, 5-point Likert scale (I didn't understand this at all - I understood this very well)*

    Measured: 1-week follow-up from Baseline

  5. Change from Baseline Understanding of consent content

    Modified version of the Quality of Informed Consent scale, Part B (Joffe et al. 2001); 14-items, 5-point Likert scale (I didn't understand this at all - I understood this very well)*

    Measured: 6-month follow-up from Baseline

Secondary outcomes (22)
  1. Baseline Perceived Voluntariness

    Decision Making Control instrument to assess voluntary consent (Miller et. al.,2011); 9-items, 5-point Likert Scale (Strongly disagree-Strongly Agree)

    Measured: Immediate at Baseline

  2. Change from Baseline Perceived Voluntariness

    Decision Making Control instrument to assess voluntary consent (Miller et. al.,2011); 9-items, 5-point Likert Scale (Strongly disagree-Strongly Agree)

    Measured: 1-week follow-up from Baseline

  3. Baseline Trust in medical researchers

    Trust In Medical Researchers Scale (Mainous et al. 2006); 12 items, 5-point Likert scale (strongly disagree-strongly agree); Aggregate scores range from 0-48 Sub-analysis of the two Trust in Medical Researchers subscales (or TIMRS)- Participant Deception; Researcher Honesty.

    Measured: Prior to consent

  4. Change from Baseline Trust in medical researchers

    Trust In Medical Researchers Scale (Mainous et al. 2006); 12 items, 5-point Likert scale (strongly disagree-strongly agree); Aggregate scores range from 0-48 Sub-analysis of the two Trust in Medical Researchers subscales (or TIMRS)- Participant Deception; Researcher Honesty.

    Measured: Immediate at Baseline

  5. Change from Baseline Trust in medical researchers

    Trust In Medical Researchers Scale (Mainous et al. 2006); 12 items, 5-point Likert scale (strongly disagree-strongly agree); Aggregate scores range from 0-48 Sub-analysis of the two Trust in Medical Researchers subscales (or TIMRS)- Participant Deception; Researcher Honesty.

    Measured: 1-week follow-up from Baseline

  6. Change from Baseline Trust in medical researchers

    Trust In Medical Researchers Scale (Mainous et al. 2006); 12 items, 5-point Likert scale (strongly disagree-strongly agree); Aggregate scores range from 0-48 Sub-analysis of the two Trust in Medical Researchers subscales (or TIMRS)- Participant Deception; Researcher Honesty.

    Measured: 6-month follow-up from Baseline

  7. Baseline Willingness to participate in research (i.e., allow EHR to be used in research);

    Consent for past and future EHR data to be shared with researchers for IRB-approved studies (yes/no); Consent for EHR to be linked with biospecimen data and released to researchers (yes/no)

    Measured: Immediate at Baseline

  8. Change from Baseline Willingness to participate in research (i.e., allow EHR to be used in research);

    Consent for past and future EHR data to be shared with researchers for IRB-approved studies (yes/no); Consent for EHR to be linked with biospecimen data and released to researchers (yes/no)

    Measured: 1-week follow-up from Baseline

  9. Change from Baseline Willingness to participate in research (i.e., allow EHR to be used in research);

    Consent for past and future EHR data to be shared with researchers for IRB-approved studies (yes/no); Consent for EHR to be linked with biospecimen data and released to researchers (yes/no)

    Measured: 6-month follow-up from Baseline

  10. Engagement with consent information

    Time spent using consent application and click activity; Focused immersion in information (Agarwal \& Karahanna 2000); 5 items, 5-point Likert scale (strongly disagree-strongly agree)

    Measured: Immediate at Baseline (only)

  11. Baseline Numeracy Abilities

    Level of comfort, understanding, and preferences regarding commonly used mathematical skills (percentages, ratios, and probability)

    Measured: Immediate at Baseline

  12. Change from Baseline Numeracy Abilities

    Level of comfort, understanding, and preferences regarding commonly used mathematical skills (percentages, ratios, and probability)

    Measured: 1-week follow-up from Baseline

  13. Change from Baseline Numeracy Abilities

    Level of comfort, understanding, and preferences regarding commonly used mathematical skills (percentages, ratios, and probability)

    Measured: 6-month follow-up from Baseline

  14. Baseline Possibility of using a Computer Application

    Ease of use, comfort with, and improvements associated with Computer application use

    Measured: Immediate at Baseline

  15. Change from Baseline Possibility of using a Computer Application

    Ease of use, comfort with, and improvements associated with Computer application use

    Measured: 1-week follow-up from Baseline

  16. Change from Baseline Possibility of using a Computer Application

    Ease of use, comfort with, and improvements associated with Computer application use

    Measured: 6-month follow-up from Baseline

  17. Baseline Using new Computer Applications

    Experiences with computer applications that the participant has never used before

    Measured: Immediate at Baseline

  18. Change from Baseline Using new Computer Applications

    Experiences with computer applications that the participant has never used before

    Measured: 1-week follow-up from Baseline

  19. Change from Baseline Using new Computer Applications

    Experiences with computer applications that the participant has never used before

    Measured: 6-month follow-up from Baseline

  20. Baseline Dissemination & Access of Personal Health Records and Health Information

    Sharing of personal health record information with trusted scientists, healthcare providers, and past experiences of accessing personal health records

    Measured: Immediate at Baseline

  21. Change from Baseline Dissemination & Access of Personal Health Records and Health Information

    Sharing of personal health record information with trusted scientists, healthcare providers, and past experiences of accessing personal health records

    Measured: 1-week follow-up from Baseline

  22. Change from Baseline Dissemination & Access of Personal Health Records and Health Information

    Sharing of personal health record information with trusted scientists, healthcare providers, and past experiences of accessing personal health records

    Measured: 6-month follow-up from Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Feb 2017
  2. Study start6 Nov 2017
  3. Primary completion9 Aug 2019
  4. Study completion9 Aug 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
734 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03063268
Sponsor's protocol ID
IRB201602061 - N
Other IDs
R01HD086700
Status last verified
Aug 2019
First submitted
16 Feb 2017
Last updated
12 Aug 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Harle CA, Golembiewski EH, Rahmanian KP, Brumback B, Krieger JL, Goodman KW, Mainous AG, Moseley RE. Does an interactive trust-enhanced electronic consent improve patient experiences when asked to share their health records for research? A randomized trial. J Am Med Inform Assoc. 2019 Jul 1;26(7):620-629. doi: 10.1093/jamia/ocz015.

    PubMed 30938751

Questions about this trial

What is this clinical trial studying?

A study testing Trust-Enhanced Messaging on E-Consent, Interactive features on E-Consent and Standard E-Consent in people with Attitude to Computers and Attitude of Health Personnel, run by University of Florida at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Baseline Satisfaction with consent decision (time frame: Immediate at baseline). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03063268, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2019.

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