Behavioural Interventions to Improve Equity in Outpatient Access

Summary

The goal of this clinical trial is to improve health equity within outpatient service access. This is through design and behavioural science-informed interventions that aim to improve rates of first outpatient appointment attendance. Health equity refers to the avoidable and unfair differences in health access, outcomes and experience between groups or populations. Outpatient services are those appointments where advice from a specialised medical professional is provided to a patient in a clinic setting.

This clinical trial aims to test different ways of supporting people to attend their first outpatient appointments at five clinical specialties (ophthalmology, gastroenterology, colorectal surgery, cardiology and plastic surgery) at Imperial College Healthcare NHS Trust (ICHT). It is specifically focused on improving attendance for people who are most likely to miss their appointment based on ICHT data, which includes people from minority ethnic backgrounds and people living in the most deprived postcodes.

The main question this clinical trial aims to answer is:

• Do behavioural science-informed message interventions improve rates of first outpatient appointment attendance in patients facing inequity of access based on ethnicity and deprivation?

The secondary questions this clinical trial aims to answer include:

* Do behavioural science-informed message interventions improve rates of first outpatient appointment attendance across all patient groups?
* Do behavioural science-informed message interventions increase the number of patients who "self-cancel" their appointment if they need to?
* In which patient groups did the message interventions have most impact, e.g., a certain age range?
* Which factors were associated with improved outpatient attendance rates specifically in participants from minority ethnic groups or living in area with highest level of deprivation?
* What was the overall outcome of all first outpatient appointments included in the clinical trial?
* What was the overall successful message delivery rate for the messages sent as part of the study? Were there particular participant groups that were more likely to have an undelivered message?
* What was the overall outcome of appointment attendance for people who received a text message intervention compared with receiving a text message and/or email intervention?
* How well did participants engage with the message interventions e.g. did they click the link provided in the message?

Conditions

• Behavioural Science Interventions to Improve Health Equity

Interventions

BEHAVIORAL

Additional message with behavioural science-informed content and associated web pages

Behavioural science-informed messages sent 14-days prior to outpatient appointment which include links to re-designed web pages

OTHER

Usual communication strategy

Usual communications sent from outpatient services to remind participants about their appointments

Sponsors & Collaborators

• Imperial College Healthcare NHS Trust

  collaborator OTHER

• Imperial College London

  lead OTHER

Principal Investigators

• Sarah Huf · Imperial College London

Study Design

Allocation

NON_RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-01-08

Primary Completion

2024-11-20

Completion

2024-11-20

Countries

• United Kingdom

Study Locations