Abstract 12940: The Power of Engagement: How Stakeholder Engagement Influenced the Design and Conduct of a Clinical Trial With Home Health Aides and Their Heart Failure Patients
Circulation(2023)
Abstract
Background: Although home health aides and attendants (HHAs) frequently provide care to community-dwelling adults with heart failure (HF), they have rarely been the focus of interventions aimed at improving patient outcomes. Engaging HHAs and other key home health care stakeholders in the research process is essential to designing user-friendly interventions and feasible clinical trials that can leverage their role in delivering care, as well as identifying effective implementation strategies that improve service delivery and patient outcomes. Aim: Herein, we aimed to demonstrate how stakeholder engagement influenced all aspects of HF clinical trial design with this marginalized workforce. Methods: This study involved an academic community partnership between Weill Cornell Medicine and two non-profit organizations, VNS Health, a large, non-profit organization that provides home care, population and care management, community health services, and hospice care in New York, NY; and the 1199SEIU Training and Employment Fund, the largest union of healthcare workers in the US that provides training to HHAs. A stakeholder-engaged research approach was used to a) develop a novel intervention that trains HHAs on HF and integrates them into the care team through an mHealth application, and b) design a pilot randomized clinical trial (RCT) testing this intervention among HHAs caring for adults with HF who receive home care from VNS Health. Results: Over the course of four years, stakeholders in home health were engaged in every aspect of the research process, from the motivation and rationale for the study, to intervention development and refinement, selection of outcomes, and planning and conduct of an ongoing pilot study for a future pragmatic RCT [Table 1]. Conclusion: This study offers an example and methods for how stakeholders can be engaged in the design, conduct and dissemination of a trial aimed at improving HF care.
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