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Reducing racial disparities in health outcomes is a major policy concern in the United States. Although there has been recent progress to close the gap, black men continue to experience earlier morbidity and mortality from preventable and manageable medical conditions, and live on average 4.2 years less than their white male peers. An oft-prescribed solution to close this stubborn gap is to increase the diversity of the healthcare workforce. Another common policy tool to increase take-up of preventative healthcare services is financial incentives. In this randomized evaluation, we will estimate the effects of financial incentives and a racially concordant physician on the uptake of preventive health services in Oakland, California.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Discordant | Placebo Comparator | Does not receive the concordant provider. |
|
| Concordant | Experimental | The intervention is that the subject receives the concordant provider. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Concordant | Behavioral | We will be randomizing across providers - we are particularly interested in racial concordance. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Average Take-up of Preventive Services (Post-consultation) | Take-up of preventative services was scored as either zero (did not utilize any post-consultation services) or 1 (utilized at least 1 post-consultation service). Four non-incentivized post-consultation preventive services were offered (for BMI, blood pressure, cholesterol, and/or diabetes); the subject had the opportunity to select service(s) after meeting with their assigned doctor. | 1 day |
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Inclusion Criteria:
Exclusion Criteria:
-
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Barbershops / Fleamarkets | Oakland | California | 94577 | United States |
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1374 participants were recruited and completed the baseline survey prior to coming to the clinic. 667 filled out the baseline survey but did not come to the clinic and were not randomized. 70 additional participants were excluded from participation and were not randomized.
We recruited 1374 black men in barbershops and flea markets to take the baseline survey. The subjects were given a coupon which allowed them entrance to the clinic.
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| ID | Title | Description |
|---|---|---|
| FG000 | Discordant | Subject is not randomized to a concordant provider. Concordant: The black male subject is seen by a non-black male doctor. |
| FG001 | Concordant | Subject is randomized to a concordant provider. Concordant: The black male subject is seen by a black male doctor. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Numbers are those who presented to the clinic and who met study criteria (African-American, age 18+, male)
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| ID | Title | Description |
|---|---|---|
| BG000 | Discordant | Does not receive the concordant provider. Concordant: We will be randomizing across providers - we are particularly interested in racial concordance. |
| BG001 | Concordant |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Average Take-up of Preventive Services (Post-consultation) | Take-up of preventative services was scored as either zero (did not utilize any post-consultation services) or 1 (utilized at least 1 post-consultation service). Four non-incentivized post-consultation preventive services were offered (for BMI, blood pressure, cholesterol, and/or diabetes); the subject had the opportunity to select service(s) after meeting with their assigned doctor. | Posted | Mean | Standard Deviation | score on a scale | 1 day |
|
1 day
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Discordant | Subject is not randomized to a concordant provider. Concordant: The black male subject is seen by a non-black male doctor. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Marcella Alsan, Associate Professor of Medicine | Stanford University | (650) 721-1352 | malsan@stanford.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 21, 2018 | May 7, 2019 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D001519 | Behavior |
| D007251 | Influenza, Human |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D009976 | Orthomyxoviridae Infections |
| D012327 | RNA Virus Infections |
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RCT
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The intervention is that the subject receives the concordant provider.
Concordant: We will be randomizing across providers - we are particularly interested in racial concordance.
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Average education level | Education level was scored as either zero (less than high school education) or 1 (completed high school education). | Mean | Standard Deviation | score on a scale |
|
|
|
| 0 |
| 324 |
| 0 |
| 324 |
| 0 |
| 324 |
| EG001 | Concordant | Subject is randomized to a concordant provider. Concordant: The black male subject is seen by a black male doctor. | 0 | 313 | 0 | 313 | 0 | 313 |
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| D014777 | Virus Diseases |
| D012140 | Respiratory Tract Diseases |