A Digital Serious Illness Conversation Coach

数字重病对话教练

基本信息

批准号：
10759161
负责人：
Y. Xian Ho
金额：
$ 27.49万
依托单位：
DIMAGI, INC.
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-30 至 2024-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10759161
关键词：
Address Adoption Adult Anxiety Benchmarking Caring Cessation of life Chronic Disease Communication Decision Making Development Diagnosis Educational Intervention Effectiveness Enrollment Feedback Frequencies Future Goals Health Professional Heart Diseases Industry Standard Intervention Interview Knowledge Learning Learning Skill Life Logic Logistics Lung diseases Malignant Neoplasms Managed Care Modeling Nurses Oncology Outcome Measure Palliative Care Patient Care Patients Phase Physicians Pilot Projects Primary Care Process Quality of life Randomized, Controlled Trials Recommendation Role Sampling Small Business Innovation Research Grant Social Workers Structure Surveys System Technology Testing Training United States United States National Institutes of Health Ventilator Work acceptability and feasibility career chatbot cost effective cost effectiveness design digital disability effectiveness evaluation end of life end of life care experience follow-up health training human centered design implementation study improved medical specialties novel preference programs promoter prototype psychological distress satisfaction skills usability

Address Adoption Adult Anxiety Benchmarking Caring Cessation of life Chronic Disease Communication Decision Making Development Diagnosis Educational Intervention Effectiveness Enrollment Feedback Frequencies Future Goals Health Professional Heart Diseases Industry Standard Intervention Interview Knowledge Learning Learning Skill Life Logic Logistics Lung diseases Malignant Neoplasms Managed Care Modeling Nurses Oncology Outcome Measure Palliative Care Patient Care Patients Phase Physicians Pilot Projects Primary Care Process Quality of life Randomized, Controlled Trials Recommendation Role Sampling Small Business Innovation Research Grant Social Workers Structure Surveys System Technology Testing Training United States United States National Institutes of Health Ventilator Work acceptability and feasibility career chatbot cost effective cost effectiveness design digital disability effectiveness evaluation end of life end of life care experience follow-up health training human centered design implementation study improved medical specialties novel preference programs promoter prototype psychological distress satisfaction skills usability

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项目摘要

PROJECT SUMMARY It has been shown that conversations on end-of-life care focused on a patient’s goals of care can reduce psychological distress and anxiety and lead to improved quality of life, and potentially prolonged life, for patients living with serious illness. The Serious Illness Conversation Guide (SICG) is a validated and widely used framework for training the critical communication skills needed to effectively conduct these conversations; however, there currently exists no mechanism to easily support and continue to build these skills in a scalable way. Evidence suggests that conversational agents, i.e., chatbots, can be used for training and reinforcing communication skills. In this Phase I SBIR project, we propose to optimize and assess the feasibility and acceptability of a chatbot designed to augment SICG training for healthcare professionals (HCPs) on initiating and conducting sensitive conversations with patients diagnosed with serious illness. We will develop and test a chatbot directly with HCPs who are navigating serious illness conversations and/or may be expected to in the future. We will demonstrate feasibility and acceptability of an enhanced chatbot prototype through the following two specific aims: In Aim 1, we will create and adapt chatbot content and build an enhanced, fully functional prototype of the chatbot with expert inputs. The chatbot will feature 3 different patient scenarios ranging in case complexity. In Aim 2, we will conduct a pilot usability study of the prototype with 50 target end users—a diverse sample of HCPs varying in role, specialty, and career phase who have received at least one training session in the SICG. Following enrollment, HCPs will independently test the chatbot-led training and complete surveys at 3 timepoints—baseline, endline, and 1-month after enrollment—to assess the following outcome measures: pre-/post-training confidence in having serious illness conversations, usability, and user satisfaction. Semi-structured endline interviews will be conducted with a purposive sample of 15-20 HCPs to collect additional qualitative feedback on user experience and recommendations for improvement. Results of this Phase I SBIR project will inform a larger scale implementation study in potential Phase II work to evaluate the effectiveness and cost-effectiveness of the proposed intervention to reinforce and augment critical communication skills essential to the care of seriously ill patients.

项目摘要已经表明，有关临终护理的对话集中在患者的护理目标上可以减少心理困扰和动画，并导致生活质量的改善，并且对于患有严重疾病的患者，可能会延长寿命。严重疾病对话指南（SICG）是一个经过验证的广泛使用的框架，用于培训关键有效地进行这些对话所需的沟通技巧；但是，那里目前没有任何机制可以轻松支持并继续以可扩展的方式建立这些技能方式。证据表明，会话代理，即聊天机器人，可用于培训和增强沟通技巧。在此阶段I SBIR项目中，我们建议优化和评估旨在增加SICG培训的聊天机器人的可行性和可接受性医疗保健专业人员（HCPS）在与诊断出严重疾病的患者。我们将直接与HCP开发和测试聊天机器人他们正在进行严重疾病的对话和/或可能会在将来进行。我们通过以下两个具体目标：在AIM 1中，我们将创建和调整聊天机器人内容并构建一个使用专家输入的聊天机器人增强，功能齐全的原型。聊天机器人将配备3 如果复杂性，不同的患者场景范围范围。在AIM 2中，我们将执行飞行员可用性研究原型具有50个目标最终用户的原型 - HCP的潜水员样本的作用不同，专业和职业阶段，他们在SICG中至少接受了一次培训课程。入学后，HCP将独立测试由聊天机器人主导的培训并完成在3个时间点进行调查（登记后的基线，终点和1个月），以评估以下结果指标：患有严重疾病的训练前/训练后信心对话，可用性和用户满意度。半结构化终点采访将是用15-20 HCP的实际样本进行的，以收集有关的其他定性反馈用户经验和改进建议。这个阶段I SBIR项目的结果将在潜在的第二阶段工作中告知大规模实施研究，以评估提议的干预措施的有效性和成本效益，以加强和增强关键的沟通技巧对重病患者的照顾至关重要。