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AzTrials

Covid19 VaccinationNCT05099497

Supporting Audit and Feedback to Encourage Vaccine Uptake

A study testing Using Practice Facilitators to Support Physicians in people with Covid19 Vaccination and Vaccine Uptake, run by Women's College Hospital at 1 site in Canada.

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

In Ontario, approximately 6,000 family physicians can access a secure online system that provides a report that lists the COVID-19 vaccination status for each patient in their roster. Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Covid19 Vaccination, Vaccine Uptake
What is being tested?
Using Practice Facilitators to Support Physicians
Type of treatment
Vaccines
Could I receive a placebo?
No, everyone receives an active treatment
How many people
600 participants
Where
1 siteCanada
Study dates
15 Nov 2021to 15 Nov 2022
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 Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • 6,690 family physicians across Ontario who have active (up-to-date passwords) ONE ID accounts

Who cannot join

  • family physicians across Ontario who do not have an active ONE ID account
  • family physicians with less than 300 rostered patients
  • family physicians with more than 3000 rostered patients

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Women's College Hospital

    Toronto, Ontario, M5S1B2

Other trials in Canada

About this study

Official title: Big Data and Little Behaviours: Feedback and Quality Improvement Supports to Primary Care to Facilitate COVID-19 Vaccine Uptake

In Ontario, approximately 6,000 family physicians can access a secure online system that provides a report that lists the COVID-19 vaccination status for each patient in their roster.

This implementation trial tests a practice facilitation intervention that aims to support family physicians to access their vaccination reports and effectively communicate with their unvaccinated patients. The facilitator will help develop action plans and offer a range of options, including co-hosted online town-halls, support for medical office assistants to coordinate patient outreach, and/or connection to trained, volunteer medical students that can help with patient outreach.

Read the detailed description

Our goal is to provide additional resources for family physicians who most need support to effectively engage with unvaccinated patients. Specifically, practice facilitators will use participatory methods incorporating lessons from change management and quality improvement methodology.

Our practice facilitators will help physicians by:

  1. Providing technical support to access their vaccination report (or activating a delegate to do so), and to prepare a complete list of their patients that still need to be vaccinated with available contact information.
  2. Helping develop an outreach plan with their administrative staff. Outreach can include bulk emails, text messages, phone call, or an invitation to a townhall. They will provide advice and resources for family physicians and their staff in responding to vaccine-related questions. Every eligible physician (i.e., those with access to a vaccine list) in a given practice location will be able to benefit from the support of the practice facilitator.
  3. The physicians will also be offered the help of a medical student volunteer to assist with patient engagement. Under the Health Insurance Portability and Accountability Act (HIPAA), Physicians, as the acting health information custodian, can legally assign a custodian to do something on their behalf. The medical student volunteer will enter into a non-disclosure agreement (NDA) to ensure the patient's privacy and confidentiality of vaccination status. The medical student volunteer can help with patient engagement and offer support to family physicians who might not have the time to personally contact those patients who have yet to receive both doses of the COVID-19 vaccine. The medical student volunteers will be provided with a script for making telephone calls and training in Private Health Information, refraining from providing medical advice and the importance of confidentiality. They will also be provided with a list of common questions to address when contacting patients regarding COVID-19 vaccination and resources on how to engage in conversation with individuals who are vaccine hesitant.. A few topics provided to the medical student volunteer prior to contacting patients will include making the case for vaccination, finding out patient concerns, how to counter common vaccine concerns (speed of vaccine development, safety, side effects, misinformation, distrust of science, government and medical community, underlying conditions that can increase vulnerability to vaccine side effects) and why vaccination matters. According to the Canadian Medical Protective Association (CMPA), the medical student will be covered under the insurance of the physician as long as the physician provides permission to contact the patient. The medical student must also record the interaction using the call log datasheet provided by the research team and send this information back to the Family Physicians to be included in their EMR. A call log form will be provided for every volunteer to track their calls and the patients who were contacted.
  4. Physicians will also be invited to co-host in a townhall with their unvaccinated patients. Each physician will have the opportunity to organize one town hall for their patients. The facilitator and our research staff will support these town halls, including a template slide deck, and customizable promotional material, all developed in partnership with the Health Commons Solutions Lab. Family physicians will take part in the session so they can address any clinical questions. The family physician will be offered a stipend for their time involved in inviting unvaccinated patients to the sessions and participation. Following the webinar, family physicians will be supported to send targeted letters to each of their as-yet-unvaccinated patients with action plans and supportive materials. Physicians working in communities with community ambassadors (i.e. a lay health advisor) will also have opportunity to include a community ambassador in their town hall. Community ambassadors can co-host the townhall and play an integral piece as they have connections with the community and understand the context and their struggles.
Being tested
Using Practice Facilitators to Support Physicians
Keywords
Covid19, Vaccine Uptake, Vaccine Hesitancy, Vaccine Confidence, Community Outreach, Audit and Feedback
Medical subject headings
COVID-19, Vaccination Hesitancy

What participants receive

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

  • Using Practice Facilitators to Support PhysiciansOther

    Utilize practice facilitators to empower family physicians to contact those who remain unvaccinated have better access to the COVID-19 vaccine.

Study groups in NCT05099497
Study groupRoleWhat they receive
Intervention group: Practice facilitation and additional supportExperimentalOntario Health will send out letters to physicians in the intervention group that will explain to them that they have a large group of eligible and unvaccinated patients and that an initiative is planned to support them in reaching out to those patients, with an embedded evaluation. It will ask them to reach out to the research team to plan a time to access the supports to gather more information, or to opt-out from the evaluation. Specifically, physicians will receive invitations to receive practice facilitation via mail letter and fax, followed by up to five weekly phone calls from a team member at Ontario Health.
Receives: Other: Using Practice Facilitators to Support Physicians
Control group- No interventionNo interventionWe choose to include a control group as we do not have the resources to deliver the intervention to the entire physician group. Cluster randomization by primary practice address will limit contamination.

What is being measured

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

  1. Any vaccine dose during follow-up interval

    Count of vaccine doses among rostered patients 12+/100 patients

    Measured: approximately 4 months (from time of randomization until follow-up completed end of fiscal year, March 31, 2022)

Secondary outcomes (4)
  1. 1st vaccine dose during follow-up interval

    patients 12+ eligible not yet vaccinated and received first dose during follow-up interval

    Measured: 4 months

  2. 2nd vaccine dose during follow-up interval

    Second vaccine doses among rostered patients 12+ during follow-up interval

    Measured: 4 months

  3. 3rd vaccine dose during follow-up interval

    Third (booster) doses among rostered patients 12+ during follow-up interval

    Measured: 4 months

  4. Pediatric dose during follow-up interval

    Vaccine doses among rostered patients aged 5-11 during follow-up interval

    Measured: 4 months

Timeline

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

  1. First posted29 Oct 2021
  2. Study start15 Nov 2021
  3. Primary completion15 Mar 2022
  4. Study completion15 Nov 2022

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
Model description
Cluster randomized-control trial
Masking
Single blind
Who is masked
Investigator
Enrolment
600 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05099497
Sponsor's protocol ID
2021-0082-E
Status last verified
Apr 2024
First submitted
5 Oct 2021
Last updated
24 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Data analysis will take place at the Institute for Clinical Evaluative Sciences (ICES). Ontario Health will provide ICES with a list of physicians that were in either the control or intervention group. This list will be transferred to ICES using a secure portal process (axway). Data will be captured from administrative databases (including COVaxON registry data) held at ICES. Data will be linked at the physician level using their encrypted CPSO (College of Physicians and Surgeons of Ontario) number.

Publications

  • Jarrett C, Wilson R, O'Leary M, Eckersberger E, Larson HJ; SAGE Working Group on Vaccine Hesitancy. Strategies for addressing vaccine hesitancy - A systematic review. Vaccine. 2015 Aug 14;33(34):4180-90. doi: 10.1016/j.vaccine.2015.04.040. Epub 2015 Apr 18.

    PubMed 25896377
  • COVID19Tracker.ca: Ontario Vaccination Data, 2021

  • Semeniuk I: How many COVID-19 vaccine doses could make the difference between a fourth wave in Canada and no wave at all? New models offer four scenarios, The Globe and Mail, 2021

  • Gilkey MB, Calo WA, Moss JL, Shah PD, Marciniak MW, Brewer NT. Provider communication and HPV vaccination: The impact of recommendation quality. Vaccine. 2016 Feb 24;34(9):1187-92. doi: 10.1016/j.vaccine.2016.01.023. Epub 2016 Jan 24.

    PubMed 26812078
  • Lu PJ, Yankey D, Fredua B, O'Halloran AC, Williams C, Markowitz LE, Elam-Evans LD. Association of Provider Recommendation and Human Papillomavirus Vaccination Initiation among Male Adolescents Aged 13-17 Years-United States. J Pediatr. 2019 Mar;206:33-41.e1. doi: 10.1016/j.jpeds.2018.10.034. Epub 2018 Nov 15.

    PubMed 30448270
  • Cataldi JR, Kerns ME, O'Leary ST. Evidence-based strategies to increase vaccination uptake: a review. Curr Opin Pediatr. 2020 Feb;32(1):151-159. doi: 10.1097/MOP.0000000000000843.

    PubMed 31790027
  • Dahrouge S, Glazier R, Hogg W: Defining measures of panel size. Primary health care system (PHCS) Program, 2010

  • Ontario College of Family Physicians: With Vaccines Coming, Family Doctors Could Jab Millions More If Fully Involved, 2021

  • Anderson EL. Recommended solutions to the barriers to immunization in children and adults. Mo Med. 2014 Jul-Aug;111(4):344-8.

    PubMed 25211867
  • SAGE Working Group: Report of the SAGE working group on vaccine hesitancy. Geneva: World Health Organization, 2014

  • Briss PA, Rodewald LE, Hinman AR, Shefer AM, Strikas RA, Bernier RR, Carande-Kulis VG, Yusuf HR, Ndiaye SM, Williams SM. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. The Task Force on Community Preventive Services. Am J Prev Med. 2000 Jan;18(1 Suppl):97-140. doi: 10.1016/s0749-3797(99)00118-x.

    PubMed 10806982
  • Fu LY, Zimet GD, Latkin CA, Joseph JG. Associations of trust and healthcare provider advice with HPV vaccine acceptance among African American parents. Vaccine. 2017 Feb 1;35(5):802-807. doi: 10.1016/j.vaccine.2016.12.045. Epub 2017 Jan 4.

    PubMed 28063706
  • BeWORKS Research Group: COVID-19 Vaccine Hesitancy: A Behavioural Lens on a Critical Problem, 2021

  • Dube E, Gagnon D, MacDonald NE; SAGE Working Group on Vaccine Hesitancy. Strategies intended to address vaccine hesitancy: Review of published reviews. Vaccine. 2015 Aug 14;33(34):4191-203. doi: 10.1016/j.vaccine.2015.04.041. Epub 2015 Apr 18.

    PubMed 25896385
  • Lau R, Stevenson F, Ong BN, Dziedzic K, Treweek S, Eldridge S, Everitt H, Kennedy A, Qureshi N, Rogers A, Peacock R, Murray E. Achieving change in primary care--effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews. BMJ Open. 2015 Dec 23;5(12):e009993. doi: 10.1136/bmjopen-2015-009993.

    PubMed 26700290

Questions about this trial

What is this clinical trial studying?

A study testing Using Practice Facilitators to Support Physicians in people with Covid19 Vaccination and Vaccine Uptake, run by Women's College Hospital at 1 site in Canada.

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 1 inclusion and 3 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 24 Apr 2024. 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 Canada. 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?

Any vaccine dose during follow-up interval (time frame: approximately 4 months (from time of randomization until follow-up completed end of fiscal year, March 31, 2022)). 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 NCT05099497, which also lists 56 linked publications.

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 24 Apr 2024.

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