Improving Participation in Pulmonary Rehabilitation Through Peer Support and Storytelling

Status: Recruiting
Location: See location...
Intervention Type: Behavioral
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Chronic Obstructive Pulmonary Disease (COPD) affects approximately 16 million Americans and is characterized by recurrent exacerbations that lead to 1.5 million Emergency Department visits and 700,000 hospitalizations annually. Pulmonary rehabilitation (PR) is a structured program of exercise and self-management support that has been proven to relieve shortness of breath and increase quality of life when initiated after an exacerbation, but unfortunately, few eligible patients participate. This project will compare the effectiveness of two novel strategies - one involving video narratives of other patients telling their story of how they overcame challenges and completed PR, the other involving telephonic peer coaching with an individual with lived experience - to enhanced usual care, and to each other, at increasing patient participation in PR after an exacerbation.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 40
Healthy Volunteers: f
View:

• 40 years or older

• Received treatment for COPD exacerbation in either inpatient or outpatient setting

• Referred for pulmonary rehabilitation

• Ability to understand and communicate in English

• Willingness to participate in calls with peer coach and to view storytelling videos

• Working phone

Locations
United States
Massachusetts
Baystate Health
RECRUITING
Springfield
Contact Information
Primary
Rajashree Kotejoshyer, ScD
Rajashree.Kotejoshyer@baystatehealth.org
978-761-8709
Backup
Jennifer Hazelton
jennifer.hazelton@umassmed.edu
978-337-0340
Time Frame
Start Date: 2023-02-24
Estimated Completion Date: 2026-08-31
Participants
Target number of participants: 305
Treatments
No_intervention: Enhanced usual care
Enhanced usual care describes a process in which automated surveillance is used to identify individuals experiencing a COPD exacerbation. This is followed by direct outreach - either through in-person visits while a patient is hospitalized, or by mail and telephone in the outpatient setting, to facilitate referral to PR. Subjects randomized to this arm will be given a pamphlet describing the benefits of PR.
Active_comparator: Enhanced usual care + Storytelling
Subjects randomized to the eUC + Storytelling intervention will view the video narrative(s) of one or more individuals with COPD who has overcome similar barriers and has attended a program of PR. Subjects will be shown the first chapter of the story immediately after randomization and will receive email and/or text messages to prompt viewing of subsequent chapters at 2 weeks, 1 month, 2 months, 3 months and 5 months. Emails and text messages will include a link to a REDCap document that contains a set of embedded video clips representing the next chapter in each storyteller's narrative.
Active_comparator: Enhanced usual care + Peer support
Subjects randomized to the eUC + Peer support intervention will be matched with a peer coach of the same gender, race, and approximate age. For those enrolled during a hospitalization, coaches will be instructed to attempt the initial phone contact prior to the patient's discharge; for patients enrolled after an ED visit or outpatient exacerbation, coaches will be instructed to contact the patients within 72 hours of randomization. Peer coaches will be asked to complete at least one call each week during months 1-2, biweekly calls during months 3-4, and monthly calls during months 5-6. Coaches will be asked to follow a conversation guide, provided during the initial training, to structure phone conversations with their paired patient.
Sponsors
Collaborators: University of Michigan, COPD Foundation, University of Massachusetts, Worcester, National Heart, Lung, and Blood Institute (NHLBI)
Leads: Baystate Medical Center

This content was sourced from clinicaltrials.gov