Improving Transportation Assets and the Effects on Wellness Metrics

Social Determinants of Health Clinical Trial

— ACTiN  

Official title:

ACTiN and Health Metrics: Improving Transportation Assets as a Critical Social Determinant of Health and the Effects on Wellness and Chronic Disease Metrics.

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05510765
• Other study ID #: 4212.081022
• Status: Not yet recruiting
• Phase: N/A
• Start date: October 2022
• Est. completion date: January 2024

Study information

• Verified date: August 2022
• Source: Unified Potential, Inc.
• Contact: John Salmon, MD
• Phone: 434-847-5050
• Email: john[@]unifiedpotential.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

1. Implementation of an Advanced Connected Transportation Network (ACTiN), a novel, collaborative multinetwork transportation model for small cities and rural areas.

2. Evaluation of effectiveness in improving transportation assets for clients of a community-based nonprofit specializing in addressing social determinants of health (Lighthouse Community Health Services in Lynchburg, VA).

3. Simultaneous evaluation of wellness metrics based on the standards of the CMS Annual Wellness Visit and metrics associated with common chronic diseases.

Description:

1. Implementation of a community transportation solution The project will be managed by Unified Potential, Inc., a 501c3 tax-exempt organization for transportation.

• The solution requires implementation of four separate transportation "networks"

• Public / Contracted / For-Hire Transportation

• Workforce Transportation Network

• Community Rideshare Network

• Volunteer Transportation Network

2. Assessment of Personal Transportation Assets

• Subjects asked to complete a survey upon intake, at six months, and at one year

• Digital survey:

• Can be completed by individual using provided smartphone app or at onsite desktop kiosk

• Can be facilitated by a caregiver or other provider not involved in data analysis

3. Assessment of health and wellness metrics and chronic disease metrics if applicable

• Dataset based on metrics assessed in the Center for Medicare and Medicaid Services (CMS) Annual Wellness Visit

• All metrics quantified via either binary (yes/no) or through use of a validated scale (see below)

• Data collected electronically at onsite or in-home provider visits at intake, six months, and one year

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 50
• Est. completion date: January 2024
• Est. primary completion date: October 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult resident of the City of Lynchburg, Virginia

• Under-resourced at trial entry as defined by meeting eligibility for welfare, food stamps/SNAP, Medicaid, Housing Choice Voucher program, or income at or below 200% of the Federal Poverty Threshold.

Exclusion Criteria:

• None

Related Conditions & MeSH terms

• Social Determinants of Health

Intervention

Behavioral:
• Transportation service
Improved transportation assets applied to all aspects of subjects life

Locations

Country	Name	City	State
United States	Lighthouse Community Health Center	Lynchburg	Virginia

Sponsors (1)

Lead Sponsor	Collaborator
John M. Salmon IV, MD

Country where clinical trial is conducted

United States, 

References & Publications (3)

Bradley EH, Elkins BR, Herrin J, Elbel B. Health and social services expenditures: associations with health outcomes. BMJ Qual Saf. 2011 Oct;20(10):826-31. doi: 10.1136/bmjqs.2010.048363. Epub 2011 Mar 29. — View Citation

Hood CM, Gennuso KP, Swain GR, Catlin BB. County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. Am J Prev Med. 2016 Feb;50(2):129-35. doi: 10.1016/j.amepre.2015.08.024. Epub 2015 Oct 31. — View Citation

Solberg LI. Theory vs Practice: Should Primary Care Practice Take on Social Determinants of Health Now? No. Ann Fam Med. 2016 Mar;14(2):102-3. doi: 10.1370/afm.1918. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Rides completed	Total number of rides for test subject per week, averaged over previous 6 months, measured at intake, 6 months, and 1 year.	1 year
Primary	Cost of transportation	Total cost per mile of transportation, averaged over previous 6 months, measured at intake, 6 months, and 1 year.	1 year
Primary	Untreated disease(s)	Total number of attributed disease diagnoses that are not being treated, measured at intake, 6 months, and 1 year.	1 year
Primary	Cancer screening success	Number of eligible cancer screening exams not performed (lung, colon, breast), measured at intake, 6 months, and 1 year.	1 year
Secondary	Unmet transportation needs	Total number of rides per week that test subject is unable to complete, averaged over 6 previous 6 months, measured at intake, 6 months, and 1 year.	1 year
Secondary	Unmet medical transportation needs	Total number of medical (including mental health) appointments missed due to transportation, averaged over previous 6 months, measured at intake, 6 months, and 1 year.	1 year
Secondary	Prescribed medications	Total number of prescribed medications, measured at intake, 6 months, and 1 year.	1 year
Secondary	Prescribed medications not utilized	Total number of prescribed medications that are not being utilized (all cause), averaged over previous 6 months, measured at intake, 6 months, and 1 year.	1 year
Secondary	Weight	Weight in pounds, measured at intake, 6 months, and 1 year.	1 year
Secondary	BMI	Body mass index, measured at intake, 6 months, and 1 year.	1 year
Secondary	Blood Pressure	Blood Pressure (mmHg), measured at intake, 6 months, and 1 year.	1 year
Secondary	Hgb A1c	Hemoglobin A1c, measured at intake, 6 months, and 1 year.	1 year
Secondary	ADL	Activities of daily living (Barthel index), measured at intake, 6 months, and 1 year.	1 year
Secondary	IADL	Instrumental activities of daily living (Lawton scale), measured at intake, 6 months, and 1 year.	1 year
Secondary	Physical activity	Physical activity / exercise assessment (Modified Kaiser physical activity survey), measured at intake, 6 months, and 1 year.	1 year
Secondary	Psychosocial assessment	Psychosocial assessment (PAT, Briggs Health), measured at intake, 6 months, and 1 year.	1 year
Secondary	Cognitive function	Cognitive function test (CPCOG), measured at intake, 6 months, and 1 year.	1 year
Secondary	Depression screening	Depression screening and/or assessment (MHA depression screening tool), measured at intake, 6 months, and 1 year.	1 year
Secondary	Other mental health conditions	Other mental health conditions (MHA screening and assessment tools), measured at intake, 6 months, and 1 year.	1 year
Secondary	Smoking assessment	Smoking / tobacco / nicotine use (No/Yes, with yes triggering LDCT assessment), measured at intake, 6 months, and 1 year.	1 year
Secondary	Substance use	Substance use or abuse (CAGE), measured at intake, 6 months, and 1 year.	1 year

External Links

•   2017-2019 Community Health Needs Assessment