Trial Outcomes & Findings for Pilot Testing of an Equity Focused and Trauma-informed Communication Intervention During Family-centered Rounds (NCT NCT05618652)

NCT ID: NCT05618652

Last Updated: 2026-06-05

Results Overview

The AIM has 4 items, each with a response on 5 point Likert scale (1=completely disagree to 5=completely agree). The score will be averaged for all items for a total score range of 1 to 5, where a higher score indicates great acceptability. Reported for all hospital clinicians after receiving the intervention (i.e., both clinicians assigned to immediately receive the intervention and the waitlist group).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

51 participants

Primary outcome timeframe

Up to 12 months following the coaching intervention for each arm

Results posted on

2026-06-05

Participant Flow

Aim 1 participants were not considered enrolled.

Participant milestones

Participant milestones
Measure
Clinician Coaching Intervention Arm-- Caregivers
Clinicians who receive the intervention will participate for up to 12 months, which includes completion of didactics, 8 audio-recorded clinical encounters, 4 feedback sessions, and completion of a post-intervention brief interview and survey. After completing didactic training elements, clinicians will receive coaching and professional feedback on their communication with caregivers of children in the hospital. The investigators will provide clinicians with illustrative examples from their encounters to prompt discussion and self-reflection. Caregivers of hospitalized children will not know if their clinician has received the communication intervention. The investigators will recruit 40 caregivers in this arm. Equity Focused and Trauma-Informed Communication Intervention: Clinician communication intervention that includes didactic training and real-time feedback on communication behaviors during clinical encounters.
Clinician Coaching Control Arm-- Caregivers
Caregivers of hospitalized children will not know if their clinician has yet received the communication intervention. The investigators will recruit 40 caregivers in this arm prior to clinicians receiving the intervention. Equity Focused and Trauma-Informed Communication Intervention: Clinician communication intervention that includes didactic training and real-time feedback on communication behaviors during clinical encounters.
Immediate Intervention Hospitalists
Hospital clinicians who received the intervention immediately.
Waitlist Control Hospitalists
Hospital clinicians who received the intervention later.
Overall Study
STARTED
20
23
4
4
Overall Study
COMPLETED
20
23
4
4
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Data not collected on Hospitalists.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Clinician Coaching Control Arm-- Caregivers
n=23 Participants
Caregivers of hospitalized children will not know if their clinician has yet received the communication intervention. The investigators will recruit 40 caregivers in this arm prior to clinicians receiving the intervention. Equity Focused and Trauma-Informed Communication Intervention: Clinician communication intervention that includes didactic training and real-time feedback on communication behaviors during clinical encounters.
Clinician Coaching Intervention Arm-- Caregivers
n=20 Participants
Clinicians who receive the intervention will participate for up to 12 months, which includes completion of didactics, 8 audio-recorded clinical encounters, 4 feedback sessions, and completion of a post-intervention brief interview and survey. After completing didactic training elements, clinicians will receive coaching and professional feedback on their communication with caregivers of children in the hospital. The investigators will provide clinicians with illustrative examples from their encounters to prompt discussion and self-reflection. Caregivers of hospitalized children will not know if their clinician has received the communication intervention. The investigators will recruit 40 caregivers in this arm. Equity Focused and Trauma-Informed Communication Intervention: Clinician communication intervention that includes didactic training and real-time feedback on communication behaviors during clinical encounters.
Immediate Intervention Hospitalists
n=4 Participants
Hospital clinicians who received the intervention immediately.
Waitlist Control Hospitalists
n=4 Participants
Hospital clinicians who received the intervention later.
Total
n=51 Participants
Total of all reporting groups
Age, Customized
≤ 24 years
3 Participants
n=23 Participants • Data not collected on Hospitalists.
6 Participants
n=20 Participants • Data not collected on Hospitalists.
9 Participants
n=43 Participants • Data not collected on Hospitalists.
Age, Customized
25-44 years
15 Participants
n=23 Participants • Data not collected on Hospitalists.
13 Participants
n=20 Participants • Data not collected on Hospitalists.
28 Participants
n=43 Participants • Data not collected on Hospitalists.
Age, Customized
≥ 45 years
5 Participants
n=23 Participants • Data not collected on Hospitalists.
1 Participants
n=20 Participants • Data not collected on Hospitalists.
6 Participants
n=43 Participants • Data not collected on Hospitalists.
Sex/Gender, Customized
Gender · Female
17 Participants
n=23 Participants
19 Participants
n=20 Participants
3 Participants
n=4 Participants
4 Participants
n=4 Participants
43 Participants
n=51 Participants
Sex/Gender, Customized
Gender · Male
4 Participants
n=23 Participants
1 Participants
n=20 Participants
1 Participants
n=4 Participants
0 Participants
n=4 Participants
6 Participants
n=51 Participants
Sex/Gender, Customized
Gender · Prefer not to answer
2 Participants
n=23 Participants
0 Participants
n=20 Participants
0 Participants
n=4 Participants
0 Participants
n=4 Participants
2 Participants
n=51 Participants
Race/Ethnicity, Customized
Race/Ethnicity · Non-Hispanic Black or African-American
12 Participants
n=23 Participants
12 Participants
n=20 Participants
1 Participants
n=4 Participants
1 Participants
n=4 Participants
26 Participants
n=51 Participants
Race/Ethnicity, Customized
Race/Ethnicity · Hispanic or Latino(a/e)
11 Participants
n=23 Participants
8 Participants
n=20 Participants
0 Participants
n=4 Participants
0 Participants
n=4 Participants
19 Participants
n=51 Participants
Race/Ethnicity, Customized
Race/Ethnicity · Asian
0 Participants
n=23 Participants
0 Participants
n=20 Participants
1 Participants
n=4 Participants
0 Participants
n=4 Participants
1 Participants
n=51 Participants
Race/Ethnicity, Customized
Race/Ethnicity · White
0 Participants
n=23 Participants
0 Participants
n=20 Participants
2 Participants
n=4 Participants
3 Participants
n=4 Participants
5 Participants
n=51 Participants
Region of Enrollment
United States
23 Participants
n=23 Participants
20 Participants
n=20 Participants
4 Participants
n=4 Participants
4 Participants
n=4 Participants
51 Participants
n=51 Participants

PRIMARY outcome

Timeframe: Up to 12 months

Population: Potential participants who were approached for the study.

Outcome measures

Outcome measures
Measure
All Caregivers
n=64 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=11 Participants
Hospital clinicians
Feasibility Measured by Enrollment Rate of Clinicians and Caregivers
43 Participants
8 Participants

PRIMARY outcome

Timeframe: Up to 12 months

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Feasibility Measured by the Rate of Complete Data Collection by Caregivers
22 Participants
20 Participants

PRIMARY outcome

Timeframe: Up to 12 months

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Fidelity Measured by the Rate of Intervention Elements Completed Per Encounter by Clinicians
4.6 Intervention Elements Per Encounter
Standard Deviation 2.6
9.2 Intervention Elements Per Encounter
Standard Deviation 3.9

PRIMARY outcome

Timeframe: Up to 12 months following the coaching intervention for each arm

The AIM has 4 items, each with a response on 5 point Likert scale (1=completely disagree to 5=completely agree). The score will be averaged for all items for a total score range of 1 to 5, where a higher score indicates great acceptability. Reported for all hospital clinicians after receiving the intervention (i.e., both clinicians assigned to immediately receive the intervention and the waitlist group).

Outcome measures

Outcome measures
Measure
All Caregivers
n=8 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
Hospital clinicians
Acceptability of the Intervention as Measured by the Acceptability of Intervention Measure (AIM)
4.6 score on a scale
Standard Deviation 0.35

PRIMARY outcome

Timeframe: Up to 12 months following the coaching intervention for each arm

The FIM has 4 items, each with a response on 5 point Likert scale (1=completely disagree to 5=completely agree). The score will be averaged for all items for a total score range of 1 to 5, where a higher score indicates great feasibility. Reported for all hospital clinicians after receiving the intervention (i.e., both clinicians assigned to immediately receive the intervention and the waitlist group).

Outcome measures

Outcome measures
Measure
All Caregivers
n=8 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
Hospital clinicians
Feasibility Measured by the Feasibility of Intervention Measure (FIM)
4.9 score on a scale
Standard Deviation 0.38

PRIMARY outcome

Timeframe: Up to 12 months

Clinician communication behaviors measured via audio-recorded hospital encounters.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Number of Clinician Rapport-building Statements
0.0 statements
Interval 0.0 to 1.0
1.0 statements
Interval 0.0 to 1.0

PRIMARY outcome

Timeframe: Up to 12 months

Clinician communication behaviors measured via audio-recorded hospital encounters.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Number of Clinician Partnership-building Statements
2.0 statements
Interval 1.0 to 3.0
4.0 statements
Interval 2.5 to 5.0

PRIMARY outcome

Timeframe: Up to 12 months

Clinician communication behaviors measured via audio-recorded hospital encounters.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Number of Times Team Interrupted the Caregiver
2.0 times
Interval 1.0 to 3.0
0.5 times
Interval 0.0 to 2.0

PRIMARY outcome

Timeframe: Up to 12 months

Clinician communication behaviors measured via audio-recorded hospital encounters.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Number of Times the Team Praised the Caregiver
0.5 times
Interval 0.0 to 1.0
2.0 times
Interval 1.0 to 3.0

PRIMARY outcome

Timeframe: Up to 12 months

Clinician communication behaviors measured via audio-recorded hospital encounters.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Number of Times the Team Asked Permission
1.0 times
Interval 0.0 to 1.0
1.0 times
Interval 1.0 to 2.0

PRIMARY outcome

Timeframe: Up to 12 months

Satisfaction was measured with a single item. Response options: 1=Not at all satisfied, 2= A little satisfied, 3= Satisfied, 4=Extremely Satisfied.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Caregiver Satisfaction Measured by Survey
4.0 score on a scale
Interval 3.0 to 4.0
4.0 score on a scale
Interval 3.0 to 4.0

PRIMARY outcome

Timeframe: Up to 12 months

Trust was measured using a validated 5-item measure, the Wake Forest Physician Trust Scale. Responses to each item were a 5-point Likert scale, which was averaged together for these analyses for a total score range of 1 to 5, where a higher score indicates greater trust.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Caregiver Trust in Their Childs Doctors Measured by the Wake Forest Physician Trust Scale
4.4 score on a scale
Interval 4.0 to 5.0
4.8 score on a scale
Interval 4.8 to 5.0

PRIMARY outcome

Timeframe: Up to 12 months

All IPC items use an identical set of response options: 1='never'; 2='rarely'; 3='sometimes'; 4='usually'; 5='always.' Scale scores are calculated as the mean of non-missing responses to the corresponding items (i.e., item responses are averaged, not summed). Domains of hurried and discrimination were reverse coded so that higher scores represented better communication.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Caregiver Reported Communication Quality Measured by the Interpersonal Processes of Care Short Form (IPC-18)
Hurried
4.6 score on a scale
Interval 3.8 to 5.0
4.9 score on a scale
Interval 4.3 to 5.0
Caregiver Reported Communication Quality Measured by the Interpersonal Processes of Care Short Form (IPC-18)
Discrimination
5.0 score on a scale
Interval 5.0 to 5.0
5.0 score on a scale
Interval 5.0 to 5.0

PRIMARY outcome

Timeframe: Up to 12 months

All IPC items use an identical set of response options: 1='never'; 2='rarely'; 3='sometimes'; 4='usually'; 5='always.' Scale scores are calculated as the mean of non-missing responses to the corresponding items (i.e., item responses are averaged, not summed). Lower scores represent better communication.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Caregiver Reported Communication Quality Measured by the Interpersonal Processes of Care Short Form (IPC-18)
Elicit concern
5.0 score on a scale
Interval 4.0 to 5.0
5.0 score on a scale
Interval 4.8 to 5.0
Caregiver Reported Communication Quality Measured by the Interpersonal Processes of Care Short Form (IPC-18)
Results
5.0 score on a scale
Interval 4.0 to 5.0
5.0 score on a scale
Interval 4.5 to 5.0
Caregiver Reported Communication Quality Measured by the Interpersonal Processes of Care Short Form (IPC-18)
Shared decision-making
4.3 score on a scale
Interval 3.3 to 5.0
4.9 score on a scale
Interval 4.3 to 5.0
Caregiver Reported Communication Quality Measured by the Interpersonal Processes of Care Short Form (IPC-18)
Respect
5.0 score on a scale
Interval 4.7 to 5.0
5.0 score on a scale
Interval 4.8 to 5.0

SECONDARY outcome

Timeframe: 30-60 minutes before and 20-30 minutes after FCR

Population: Participants with salivary cortisol data collected.

The investigators will assess for reductions in caregiver salivary cortisol following interactions with clinical teams. The investigators will collect saliva samples from caregivers at two time points: 30-60 minutes before and 20-30 minutes after family-centered rounds (FCR). The investigators anticipate lower salivary cortisol levels in the intervention compared to control arm at 20-30 minutes following FCR. The investigators will also compare differences in the change in cortisol from before and after FCR for each caregiver; the investigators hypothesize caregivers in the intervention arm will have a smaller change from baseline following FCR.

Outcome measures

Outcome measures
Measure
All Caregivers
n=5 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=7 Participants
Hospital clinicians
Change in Caregiver Salivary Cortisol
-18 ng/dL
Interval -41.0 to -11.0
-16 ng/dL
Interval -75.0 to 69.0

SECONDARY outcome

Timeframe: Up to 12 months

The investigators will measure caregiver participation during clinical encounters by counting the number of times caregivers (1) ask a question, (2) state a preference and (3) express an emotion per clinician encounter. These three behaviors will be summed together and analyzed in aggregate as a count of caregiver participatory behaviors.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Number of Caregiver Participatory Behaviors
4.5 participatory behaviors
Interval 1.5 to 9.0
5.0 participatory behaviors
Interval 1.0 to 7.0

SECONDARY outcome

Timeframe: Up to 12 months

Using validated approach described by Lion et al. the caregiver description of "the main condition child was admitted for" will be compared to the diagnoses listed by the child's doctors in the electronic health record.

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Percentage of Caregivers Who Correctly Identify Child's Diagnosis
60.9 percentage of caregivers
70.0 percentage of caregivers

SECONDARY outcome

Timeframe: Up to 30 days after discharge

Child unplanned hospital readmission

Outcome measures

Outcome measures
Measure
All Caregivers
n=23 Participants
Caregivers of hospitalized children approached for the study
Hospitalists
n=20 Participants
Hospital clinicians
Percentage of Participants With Hospital Readmission at 30 Days
8.7 percentage of participants
10.0 percentage of participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 90 days after discharge

Child unplanned hospital readmission

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 12 months following the coaching intervention for each arm

The IAM has 4 items, each with a response on 5 point Likert scale (1=completely disagree to 5=completely agree). The score will be averaged for all items for a total score range of 1 to 5, where a higher score indicates great appropriateness. Reported for all hospital clinicians after receiving the intervention (i.e., both clinicians assigned to immediately receive the intervention and the waitlist group).

Outcome measures

Outcome data not reported

Adverse Events

Clinician Coaching Control Arm-- Caregivers

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Clinician Coaching Intervention Arm-- Caregivers

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Immediate Intervention Hospitalists

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Waitlist Control Hospitalists

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Victoria M. Parente, MD, MPH

Duke University

Phone: 919-684-2536

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place