Evaluating a Physician Opinion Leader Intervention to Increase Utilization of Coaching/Therapy During Residency (POL)

Stanford University

Status: Completed

Conditions: Help-Seeking Behavior; Social Stigma; Workplace Culture; Education, Medical, Continuing

Treatments: Other: Popular-Opinion Leader-led encouragement during training meetings and informal conversation

Study type: Interventional

Funder types: Other

Identifiers

NCT05499468

60993

Details and patient eligibility

About

Investigators will assess the efficacy of a physician popular opinion leader-led intervention to increase awareness and utilization of existing evidence-based coaching or therapy among post-graduate clinical trainees at Stanford.

Full description

All Stanford residents are provided access to evidence-based coaching and/or therapy, such as cognitive and behavioral targeting of drivers of burnout.

The present project evaluates the ability of a popular opinion leader approach to normalize use of these resources with the hope of increasing utilization. Over the ark of 31 months, all training programs will receive the intervention.

A flexible, minimally intrusive, residency-randomized cluster design will be used to determine the sequence of which programs receive the intervention immediately verses delayed. Investigators delivered an intervention adapted from the CDC Popular Opinion Leader framework for encouraging physicians to utilize existing resources for individual support during residency through Stanford WellConnect (a confidential mental health promotion program for medical residents, fellows, and all benefits-eligible faculty in the School of Medicine at Stanford during their training). Support resources include evidence-based coaching and/or therapy, such as cognitive and behavioral targeting of drivers of burnout for which physicians are at higher-than-average risk. All health promotion efforts were delivered as part of clinical training, outside the scope of this distinct research evaluation. No data has been collected from individual POLs or workshop participants to date.

Investigators will utilize administratively collected data from postgraduate physician trainee populations across 20 Stanford paired residency programs with 5 or more house-staff (residents or fellows) each. 10 programs were randomly assigned to be the first to receive the intervention, and 10 to a delayed intervention group (10 programs). The immediate intervention arm (vs. delayed) received a POL-led health promotion intervention delivered as part of their regular postgraduate medical training educational activities (e.g., during didactic sessions), designed to encourage them to consider participating in existing, evidence-based one-on-one support resources (coaching and therapy with trained professionals) available through WellConnect. The POL intervention includes two formal workshop discussions and informal conversations with trained physician POL colleagues. The delayed intervention arm continued to receive their regular postgraduate medical training educational activities as well as access to the same coaching and therapy resources through WellConnect, and any other wellness resources involved in the curriculum at each program as the immediate intervention arm. The delayed intervention arm will also receive the POL program from November 1st 2022 through May 2023.

The investigators will evaluate multiple outcomes between the immediate and delayed intervention arms using administratively collected WellConnect usage data (% of each program who participate in coaching or therapy from each enrolled residency program population during the trial). In addition, investigators will analyze administratively collected institutional wellness survey data to determine population level differences in perceptions of stigma against mental health support, self-valuation, burnout, and professional fulfillment.

Enrollment: 493 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• This post-test only evaluation study will use de-identified data that investigators will request after administrative survey data is collected by the organization
• The primary aim dataset will include WellConnect program level usage data, indicating the total aggregate number of service requests from the cohorts of physicians in the 20 postgraduate training programs at Stanford whose program directors opted to allow their trainees to participate in the Popular Opinion Leader-led population health promotion intervention
• The data set for secondary aims will include completely de-identified data from all house-staff who are enrolled in programs participating in the POL program, and who completed the regularly scheduled institutional wellness survey

Exclusion criteria

• Nonphysicians
• Those outside 20 training programs cohorts participating in the POL intervention at Stanford

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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493 participants in 2 patient groups

Popular-Opinion Leader-led workshops & conversations to encourage utilization of support resources

Other group

Description:

Physicians identified by programwide Qualtrics survey item asking housestaff who in their program they respect and trust most, personally and professionally. Identified POLs were invited to join this health promotion effort as a POL to improve the culture of wellness and psychological safety among housestaff and encourage them to utilize resources at a time when they may benefit significantly. POLs were trained to endorse the benefits of mental health promotion coaching or therapy for residents training at Stanford.

Treatment:

Other: Popular-Opinion Leader-led encouragement during training meetings and informal conversation

Standard Training Program Curriculum and Access to Existing Support Resources

No Intervention group

Description:

All residents and fellows continued to have the same access to coaching and psychotherapy resources available through Stanford WellConnect, along with other educational activities in their usual training.