Program Project – Improving Provider Announcement Communication Training (IMPACT)

Provider recommendations are uniquely powerful in improving health care use. However, primary care teams and healthcare systems experience challenges with clinical communication, and many questions remain unanswered about how to increase the potency of provider recommendations. We propose the P01 Program Project, “Improving Provider Announcement Communication Training (IMPACT).” The goal of IMPACT is to improve clinical communication and health care use among children ages 9-12 years. IMPACT's specific aims are to 1) Identify opportunities to improve clinical communication; 2) Evaluate the impact and cost of clinical communication interventions in cluster randomized clinical trials; and 3) Support implementation of clinical communication interventions in healthcare systems. The IMPACT Program Project's shared theme is amplifying the impact of a Cancer Control Program to improve clinical communication in healthcare systems. The projects will work together to enhance the impact of the Announcement Approach Training (AAT), a clinical communication training for primary care professionals, which received designation as a Cancer Control Program from the National Cancer Institute. Project 1 will establish how to involve the whole primary care team in recommendations for primary care. The project will examine whether optimizing the use of standing orders support increases health care use in clinics receiving the AAT. Project 2 will examine what motivates providers to make clinical recommendations for primary care. The project will establish whether clinic-level financial incentives increase heath care use in clinics receiving the AAT. Project 3 will examine who should facilitate the trainings. The project will establish whether engaging clinical champions in healthcare systems to implement the AAT within their own systems increases health care use. Project 4 will examine which interventions fit systems' resources. The project will examine the budget impact, cost-effectiveness, and population health impact of these interventions in rural and nonrural areas and aid decision makers with a decision support tool to facilitate the adoption of promising interventions. The research projects will receive support from 3 cores: Administrative, Data, and Intervention. IMPACT's activities will culminate with the creation of the Implementation Guide to support improving health care use in healthcare systems. Throughout the proposed Program Project, the shared theme and AAT focus will create synergies among the projects and cores that generate significant and novel insights into how to improve clinical communication and health care use. Our approach will also accelerate the evolution of communication trainings for primary care professionals, accomplishing in 5 years what might otherwise take two decades.