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Trial registered on ANZCTR
Registration number
ACTRN12619000512123
Ethics application status
Approved
Date submitted
25/03/2019
Date registered
29/03/2019
Date last updated
29/03/2019
Date data sharing statement initially provided
29/03/2019
Date results provided
29/03/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effect of 'Teach-back', a simple communication tool, on disease knowledge in people with chronic hepatitis B
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Scientific title
Health Literacy and Chronic Hepatitis B: Using teach-back to improve patient understanding.
– a randomized controlled study
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Secondary ID [1]
297767
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Nil known
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Universal Trial Number (UTN)
U1111-1230-4054
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic hepatitis B
312106
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Condition category
Condition code
Oral and Gastrointestinal
310665
310665
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Infection
310739
310739
0
0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants in the intervention group received a once-off education session prior to their routine liver clinic outpatient appointment, run by a trained investigator, using the teach-back strategy. This session involved a discussion between the investigator and participant on the four domains of CHB – transmission, natural history, epidemiology and prevention and clinical management; supported by simple explanations and images using an educational resource specifically developed for people with low health literacy. This session continued until the participant had adequate understanding of each aspect covered, which ranged from 15-45 minutes. Information was explained using plain language and medical jargon avoided. After covering each concept, the investigator would use teach-back to confirm patient understanding, for example: ‘To check that I have explained the information clearly, could you please tell me how hepatitis B is spread?’. If the answers were wrong or incomplete, the investigator would re-explain the concept and reassess until the participant understood the information.
The trained investigator was a final year medical student, who had received training to facilitate the 'teach-back' intervention from the viral hepatitis nurse.
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Intervention code [1]
313999
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Other interventions
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Comparator / control treatment
All participants in both study arms would first complete a questionnaire to assess their baseline knowledge of hepatitis B. Participants in the control group did not have a teach-back education session and would attend their routine liver clinic outpatient appointment as scheduled.
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Control group
Active
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Outcomes
Primary outcome [1]
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Participant’s score on a questionnaire consisting of 23 true or false questions covering four domains of HBV – transmission, natural history, epidemiology and prevention and clinical management. This was a modified, validated questionnaire from a previous study assessing understanding in patients living with chronic hepatitis B.
Source of validated questionnaire:
Hajarizadeh B, Wallace J, Richmond J, Ngo N, Enright C. Hepatitis B knowledge and associated factors among people with chronic hepatitis B. Aust NZJ Public Health. 2015;39(6):563-568.
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Assessment method [1]
319507
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Timepoint [1]
319507
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Baseline, immediately after intervention and 1-month post-intervention
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Secondary outcome [1]
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Nil
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Assessment method [1]
368511
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
English-speaking patients aged 18 years or greater and diagnosed with chronic hepatitis B were eligible for the study
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Subjects will be excluded from the study for the following criteria:
1. Decompensated liver disease
2. Unwilling / unable to participate in a questionnaire
3. Non-English speaking patients
4. Withdraws from study
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated allocation sequence
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive statistics were reported as mean ± standard deviation (SD) or median (interquartile range) for continuous data, and statistical summaries were reported as counts and percentages of participants with a positive response for categorical data. Group equivalence was assessed by the Chi-square test and Fisher exact test on categorical variables and independent sample t-test on continuous variables. The intervention and control group knowledge scores were compared by paired t-test and analysis of variance (ANOVA) for normally distributed data and by Wilcoxon signed rank test for non-normally distributed data. Linear regression was conducted to detect associations between knowledge scores and sociodemographic characteristics. Variables that reached statistical significance (p=0.05) and those that showed a trend towards association with knowledge score (p=0.1 was accepted), were included in the multivariate model. All analyses were performed on an intent-to-treat basis and included all enrolled participants. In all cases, comparisons were two-tailed and a p-value of =0.05 was considered statistically significant. Data was analysed using SPSS software version 23 (IBM, New York, 2015).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/02/2017
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Date of last participant enrolment
Anticipated
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Actual
12/05/2017
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Date of last data collection
Anticipated
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Actual
12/06/2017
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Sample size
Target
100
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Accrual to date
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Final
70
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
13457
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St Vincent's Hospital (Melbourne) Ltd - Fitzroy
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Recruitment postcode(s) [1]
26064
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3065 - Fitzroy
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Funding & Sponsors
Funding source category [1]
302288
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Hospital
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Name [1]
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St Vincent's Hospital Melbourne
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Address [1]
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41 Victoria Parade, Fitzroy, Victoria, 3065
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Country [1]
302288
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Australia
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Funding source category [2]
302291
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University
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Name [2]
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The University of Melbourne
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Address [2]
302291
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Grattan Street, Parkville, Victoria, 3010
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Country [2]
302291
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Australia
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Primary sponsor type
Individual
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Name
Alexander Thompson
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Address
St Vincent's Hospital Melbourne
41 Victoria Parade, Fitzroy, Victoria 3065
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Country
Australia
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Secondary sponsor category [1]
302167
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None
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Name [1]
302167
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Nil
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Address [1]
302167
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Nil
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Country [1]
302167
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302965
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St Vincent's Hospital Melbourne - Human Ethics Research Committee
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Ethics committee address [1]
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Research Governance Unit Level 5, Building E (Aikenhead Building) 27 Victoria Parade Fitzroy VIC 3065
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Ethics committee country [1]
302965
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Australia
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Date submitted for ethics approval [1]
302965
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22/11/2016
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Approval date [1]
302965
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21/12/2016
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Ethics approval number [1]
302965
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LRR 203/16
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Summary
Brief summary
Limited health literacy has great impact on patient health outcomes; poorer knowledge of disease is linked with suboptimal self-care, reduced treatment adherence and increased use of emergency services. Studies conducted to assess health literacy and patient understanding amongst patients living with chronic hepatitis B (CHB) have revealed gaps in disease-specific knowledge. Despite this, there are few studies evaluating strategies to improve patient knowledge of hepatitis B. The 'teach-back' strategy is a communication tool that has been shown to be successful in improving disease-specific knowledge in other areas of health. 'Teach-back' ensures the health provider checks for understanding with patients and then allowing opportunity for clarification. This study hypothesises that there is a poor baseline understanding amongst patients living with CHB and that the teach-back method will improve disease-specific knowledge. This would form the foundation for future studies to evaluate how improved understanding translates into greater health outcomes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
92002
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Prof Alexander Thompson
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Address
92002
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St. Vincent's Hospital Melbourne
41 Victoria Parade
Fitzroy
Victoria
3065
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Country
92002
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Australia
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Phone
92002
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+61 03 92312211
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Fax
92002
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Email
92002
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[email protected]
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Contact person for public queries
Name
92003
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Sophie Tran
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Address
92003
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St. Vincent's Hospital Melbourne
41 Victoria Parade
Fitzroy
Victoria
3065
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Country
92003
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Australia
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Phone
92003
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+61 03 9231 2211
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Fax
92003
0
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Email
92003
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[email protected]
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Contact person for scientific queries
Name
92004
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Sophie Tran
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Address
92004
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St. Vincent's Hospital Melbourne
41 Victoria Parade
Fitzroy
Victoria
3065
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Country
92004
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Australia
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Phone
92004
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+61 03 9231 2211
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Fax
92004
0
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Email
92004
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
1711
Informed consent form
377236-(Uploaded-25-03-2019-09-03-12)-Study-related document.docx
1712
Study protocol
377236-(Uploaded-25-03-2019-09-03-46)-Study-related document.docx
1713
Ethical approval
377236-(Uploaded-25-03-2019-09-05-09)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF