Clinical Research Directory

One-Page Truth-Telling Aid for Cancer Disclosure

The goal of this clinical trial is to learn whether a one-page communication aid can improve communication between physicians and patients with cancer during cancer-related truth-telling consultations. The one-page aid is designed to help physicians quickly understand patients' preferences and needs before the consultation. The main questions it aims to answer are: * Does the one-page communication aid improve patients' satisfaction with how cancer-related information is explained? * Does the one-page communication aid reduce patients' emotional distress after the consultation? * Does the one-page communication aid improve physicians' confidence in communicating cancer-related information? Researchers will compare patients whose physicians receive the one-page communication aid with patients whose physicians provide usual care with a blank sheet for patients to write down questions. This comparison will help determine whether the one-page aid improves communication, emotional outcomes, and physician confidence. Participants will: * Complete questionnaires before and after the consultation * Receive either the one-page communication aid or a blank sheet, depending on their physician's group * Complete follow-up questionnaires at 3 months and 6 months after the consultation Physicians will also complete brief questionnaires about their communication confidence at baseline, 1 week after recruitment of their first enrolled patient, 3 months, and 6 months.

Improving Communication About Pain and Opioids

The overall goal of this protocol is to pilot test a clinician training intervention that uses standardized patients (trained actors playing patient roles) as instructors who impart communication skills to primary care clinicians. This project will conduct a pilot clinical trial of the intervention developed by the primary investigator in order to evaluate intervention feasibility and generate data to plan a subsequent fully-powered, multisite trial. Primary care clinicians will be randomized to receive either the intervention or control; 48 patients (2 per clinician) will then be recorded during clinic visits with study clinicians and will provide data on post-visit perceptions and health outcomes. Study hypotheses are that visits with clinicians who receive the intervention (versus control) will be associated with more frequent use of targeted communication skills, lower probability of high-risk opioid prescribing, higher patient-reported agreement with treatment plan, and lower pain interference 2 months later.

Mastery Learning in Communication Skills

The goal of this study is to determine whether mastery learning in communication skills can improve skills in a simulated environment and have translational improvements in outcomes. The main questions it aims to answer are: 1. Does mastery learning improve skills in the simulation laboratory? 2. Does mastery learning improve clinical skills as seen by milestone performance? and 3 Does mastery learning improve burnout levels? The study is a multi-institutional randomized controlled trial of anesthesiology residents from five different residency programs. Participants will be randomized to mastery training in communication skills and standard of care, which is vicarious learning. Researchers will compare these two groups to see if mastery learning improves skills and translational outcomes.

Evaluating AI for the Translation of KM Resources

Knowledge mobilization resources for parents provide information to help make health decisions for their children. These resources can include videos, infographics, and plain language summaries. They are often created in English. This can make them hard to understand for people whose first language is not English. Translating these resources into other languages may be helpful. However, professional translation can take time and be expensive. The study will compare a resource that is in English with the same resource translated into another language. The investigators will use both high and low resource languages commonly spoken in Alberta: Mandarin, Punjabi, Tagalog, Urdu. Parents who speak these languages will be asked to answer questions about how easy it is to understand and use the information. The investigators will also see if artificial intelligence can be used to translate the resource. To do this, parents will be asked to look at a resource that was translated by a professional and the same resource that was translated using artificial intelligence. Then, parents will answer questions about how clear the translations are. Parents will be asked to participate in the study using the internet. They will answer questions using an online questionnaire. Parents will also be asked if they are interested in taking part in an online interview. This will help us understand their thoughts about the resources in more detail. The plan is to involve 576 parents with 144 parents per language group. This project will help to better understand whether parents prefer a resource in their own language compared to an English version. It will also help to understand whether artificial intelligence can be used to translate resources so that they are easier for parents to access. This work is very important so that all parents and their children have access to high quality health information. This can help all families make the best decisions for their children's health.

Baby Steps III: Testing a Clinician and Patient Intervention to Promote Smoking Cessation Among Pregnant Women

The investigators propose to conduct a combined intervention that pairs SMS smoking cessation messages for patients with individualized training for OB clinicians to improve quit rates among pregnant smoking. The aim is to determine the effect of the intervention versus control on smoking cessation outcomes on patient smoking cessation. The investigators will recruit patients at their first OB visit who report smoking at Duke and Pitt. Patients in both the control and intervention arm will receive smoking cessation support messages throughout their pregnancy. OB clinicians in the intervention arm will receive tailored smoking cessation counseling training. Clinicians in both arms will receive a one-time 5 A lecture. The investigators will analyze smoking cessation outcomes and audio recordings. This is a minimal risk study.

Language Translation of Knowledge Mobilization Resources

Knowledge mobilization (KM) resources are tools designed to facilitate the use of research evidence in healthcare decision-making. These resources are created in various formats - including plain language summaries, infographics, and videos - to meet the needs of diverse end-users, such as healthcare professionals, policymakers, patients, and caregivers. They are intended to be easily accessible; however, individuals whose first language is not English may have difficulty understanding them. Thus, translating KM resources into other languages is essential to support health equity and accessibility, but it is often costly and time intensive. This study aims to explore whether artificial intelligence (AI) tools, specifically ChatGPT - an AI-based large language model developed by OpenAI - can effectively translate KM resources for members of the public whose first language is not English. The resource being evaluated offers guidance on preventing post-COVID-19 condition and has already been translated by a professional (human) translator into seven languages commonly spoken in Canada: French, Spanish, Ukrainian, Tagalog, Arabic, Chinese, and Punjabi. Using ChatGPT, AI-generated translations will be created in those same seven languages. For this study, participants - adults living in Canada whose first language is one of the selected languages and able to read English - will be randomly assigned to review either an AI-generated or a professionally translated version of a KM resource. They will then complete a questionnaire evaluating their understanding of the resource, as well as the readability and acceptability of the translation. This study will contribute to the Investigators' understanding of the potential use of AI for translating health information. The goal is to support equitable access to health information and promote citizen-centered care by reducing language barriers using innovative solutions.

Writing Intervention With Adolescents and Young Adults With Cancer

Young people with cancer have difficult experiences and writing exercises may help improve their well-being. However, very few studies have examined how a creative writing activity might be useful for young people with cancer. In this pilot study, researchers at St. Jude Children's Research Hospital hope to explore whether teenagers and young adults with cancer want to participate in a writing exercise and whether they find it to be valuable. Primary Objective To assess the feasibility and acceptability of a writing-based narrative medicine intervention for adolescent and young adult patients with cancer.

Dime La VerDAD: Verify, Debunk, and Disseminate

Dime la Verdad (Tell me the truth) will evaluate the use of storytelling by community health workers as a communication strategy to disseminate reliable health information on social media and encourage informed decision-making in favor of recommended immunizations in communities with high morbidity and mortality due to respiratory virus infections. Dime La Verdad is an innovative social media capacity-building program based on theoretical frameworks related to health communication that empowers community health workers to disseminate reliable information about respiratory virus protection strategies through the use of personal narratives on social media. The proposed work will use a rigorous stepped wedge design to 1) deliver a scalable program of science communicators using an adapted curriculum grounded in principles of health communication, 2) evaluate how diffusion of health messaging is perceived on social media, and 3) discern how use of personal narratives to enhance science communication can encourage informed decision-making to promote evidence-based immunization practices and improve health outcomes.

Communication for Early Mobilisation of People Living With Dementia Following Surgery for Hip Fracture

This goal of this study is to identify ways that healthcare professionals communicate that are effective in helping a person living with dementia to stand or walk after surgery for a broken hip (hip fracture). We aim to identify 'what works' in successfully helping people with dementia to mobilise early, and share this in practice. The main question the research aims to answer is: What healthcare professional communication practices are effective in achieving early and continued mobilisation among people living with dementia following hip fracture surgery? We will use a research method called 'Conversation Analysis', to look at the fine detail of the language healthcare professionals use and responses to it. We will make video recordings of real-life ward care, when healthcare staff are trying to help a person with dementia get up early after hip fracture surgery. We will involve people with dementia in decisions to take part and get agreement from their families before we record anything. We have done this successfully in two previous studies. We will record up to 50 episodes of care on three trauma orthopaedic wards. We will identify specific, practical recommendations and 'teachable' approaches: ways of speaking, or sequences of requests or instructions. We will work with people with dementia, family carers, educators and clinicians to do this. We will use clips of videos in future communication training.

Adapted Hospital Discharge Intervention: the CONNECT Pilot

Hospital discharge is a dangerous time for patients: one in five will suffer an adverse event, such as a medication error, and nearly 25% will be readmitted within 30 days. This time is even more dangerous for patients with who face communication barriers, including those with non-English language preference (NELP), low health literacy, and the elderly. The investigators will pilot a post-discharge educational intervention to reinforce written discharge instructions (known as the After Visit Summary or AVS) using a randomized controlled trial design (2:1 intervention: control). The control group will receive current standard of care discharge education which includes a nurse reviewing their AVS and an automated call in English that allows patients to numerically select types of problems/questions that are then escalated to a nurse who should return their call within a few days. The intervention group will receive the standard of care discharge education with the AVS and an additional post-discharge educational call delivered by a registered nurse or other qualified health professional with the option to have written instructions professionally translated and sent via MyChart message--if available in their preferred language.

STOP? II: Testing of a Toolbox for Structured Communication in the Operating Room

The purpose of the study is to test the impact of the StOP?-protocol - an intra-operative communication briefing, on post-operative mortality and important patient outcomes.

The Fundamentals of Communication in Surgery

The goal of this observational study is to evaluate the impact of the FCS curriculum on achieving the learning objectives and resident reported self-efficacy with communication skills and determine the scalability of the training across a range of general surgery training programs

Breaking Bad News Skills of Doctors and Residents in the Surgical Setting

Breaking bad news is a very stressful and difficult situation for health care professionals, especially clinical doctors and surgeons. Acquiring skills for this sort of communication is very important due to the large volume of times that these professionals will have to deal with it and because it can affect the doctor-patient relationship forever. The objective of this study is to evaluate the skill of surgeons and residents in surgical specialties in breaking bad news to patients and families across Spanish hospitals. This will be done by analyzing the subjects in terms of their knowledge and experience using a specialized questionnaire based on breaking bad news protocol, designed in the "Hospital Sant Joan de Déu" Children's hospital in Barcelona.