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It is widely accepted that prevention is far more impactful than curative medicine and must be included in primary care. In a previous pilot study, we evaluated passive video preventive lifestyle education in the emergency department. The current study is a randomized prospective trial assessing the practicality and impact of a brief interactive educational video intervention to patients during primary care clinic visits.
Background and Summary of Objectives: It is widely accepted that prevention is far more impactful than curative medicine concerning overall health efficacy. The primary care setting faces the challenges of increasingly important time constraints and conflicting priorities. However, prevention is a priority regarding the improvement in health outcomes. In a previous pilot study, we investigated the impact of a simple instructional video on patients' willingness to change in the emergency department setting. The initial intervention was passive, requiring subjects to watch a video without interaction. The current study evaluates the practicality and impact of bringing a brief interactive educational video intervention to patients at the primary care clinic visit.
Summary of Study Design This randomized, non-blinded prospective study of "just in time" education for adult patients presenting to the primary care clinic immediately following their primary care appointment.
Patients will be randomized to receive the interactive intervention video during this encounter with the practitioner in the clinic. The intervention is an interactive video with a duration of approximately 10-15 minutes. The video is interactive because it asks the patients to answer simple questions about the content in the video to keep them engaged with the content. For instance, if the participant indicates that they do not smoke, the video will "skip" the smoking cessation education and move directly to the other prevention domains. Before leaving the clinic, all patients will be presented with a questionnaire about their readiness and confidence to initiate lifestyle changes (transtheoretical stage of change measured on a "readiness ruler") and additional survey instruments. Most of these questions will come from existing validated scales, including the Gillespie & Lenz behavior modification tool, the Pittsburgh Sleep Quality Index, and select questions from the US HCAHPS Patient Satisfaction Survey. They will be asked for access to their medical record and their willingness to be contacted for a follow-up survey.
Outcome measures:
The study's primary outcome will be the results of the Lifestyle Readiness to Change and Confidence to Change questionnaires. Secondary outcomes will include satisfaction with the primary care clinic visit using select questions from HCAHPS, and whether they intend to change any specific lifestyle behavior (dichotomous, yes/no) and, if yes, to specific which one(s), seeking medical care outside of the clinic visit as determined by a review of the patient's medical record at intervals of 30 days and six months. HIV will not be evaluated outside of its inclusion in the Charlson Comorbidity Index (CCI). A follow-up survey at approximately 3-12 months will evaluate new diagnoses related to chest pain and ask about the individual's lifestyle changes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Video intervention group | Experimental | The intervention is an interactive preventive education video lasting approximately 10 minutes. The video is interactive because it asks the patients to answer simple questions about the content in the video to keep them engaged. For instance, if the participant indicates that they do not smoke, the video will "skip" the smoking cessation education and move directly to the other prevention domains. |
|
| Control | No Intervention | This arm consists of those randomized to receive no video |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Video preventive education | Other | Interactive video that teaches the subject about the overall importance of prevention, smoking cessation, proper diet, exercise, and sleep. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Lifestyle Readiness to Change and Confidence to Change questionnaires | The study's primary outcome will be the results of the Lifestyle Readiness to Change and Confidence to Change questionnaires. | Immediately following exposure to the intervention or not (both arms receive the questionnaires) |
| Measure | Description | Time Frame |
|---|---|---|
| Satisfaction, intent to changve lifestyle behavior, follow up clinic visit | satisfaction with the primary care clinic visit using select questions from HCAHPS, and whether they intend to change any specific lifestyle behavior (dichotomous, yes/no) and, if yes, to specific which one(s), seeking medical care outside of the clinic visit as determined by a review of the patient's medical record within approximately six months. A follow-up survey at approximately 3-12 months will evaluate new diagnoses related to chest pain and ask about the individual's lifestyle changes. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Daniel Keyes, MD, MPH | Contact | 734-931-0734 | dankeyes@msu.edu |
| Name | Affiliation | Role |
|---|---|---|
| Daniel Keyes, MD, MPH | Trinity Health-Livonia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Trinity Health-Livonia Hospital and Affiliated Clinics | Livonia | Michigan | 48154 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28359707 | Background | Wood EB, Harrison G, Trickey A, Friesen MA, Stinson S, Rovelli E, McReynolds S, Presgrave K. Evidence-Based Practice: Video-Discharge Instructions in the Pediatric Emergency Department. J Emerg Nurs. 2017 Jul;43(4):316-321. doi: 10.1016/j.jen.2016.11.003. Epub 2017 Mar 28. | |
| 10938218 | Background | Stange KC, Flocke SA, Goodwin MA, Kelly RB, Zyzanski SJ. Direct observation of rates of preventive service delivery in community family practice. Prev Med. 2000 Aug;31(2 Pt 1):167-76. doi: 10.1006/pmed.2000.0700. |
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The data contains patient health information (PHI), and currently, there is no plan for public disclosure of the data.
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| ID | Term |
|---|---|
| D005247 | Feeding Behavior |
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D001522 | Behavior, Animal |
| D001519 | Behavior |
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
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Randomized Clinical Trial of Interactive Preventive Video Education
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| 18 months |
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| 41886477 | Derived | Arroyo DL, Keyes D, Abdulshafi GW, Jafri A, Hasan H, Steinberger D, Dabajeh B, Nassar A, Karn A, Nkrumah R, Dhanoa P, Shedden K. Brief interactive lifestyle preventive medicine video education in the primary care clinic: Protocol for a randomized clinical trial. PLoS One. 2026 Mar 26;21(3):e0322244. doi: 10.1371/journal.pone.0322244. eCollection 2026. |
| D006331 |
| Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |