Increasing the feasibility, impact, and equity of the Medicare Annual Wellness Visit (AWV) with a practice tailored AWV intervention: A stepped wedge clinical trial protocol.
<h4>Background</h4>Older adults vastly underutilize evidence-based preventive health services and screenings that reduce illness, morbidity and mortality. The free-to-patient Medicare Annual Wellness Visit (AWV) is an opportunity to enhance preventive healthcare use, but also is underuse...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0329004 |
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| Summary: | <h4>Background</h4>Older adults vastly underutilize evidence-based preventive health services and screenings that reduce illness, morbidity and mortality. The free-to-patient Medicare Annual Wellness Visit (AWV) is an opportunity to enhance preventive healthcare use, but also is underused.<h4>Objectives</h4>To evaluate the effect of a practice-tailored intervention on the sustained use of Medicare AWVs and on guideline-recommended preventive services and racial/ethnic disparities in 3 types of practice settings.<h4>Methods</h4>This is a stepped wedge cluster randomized controlled trial. The intervention will be implemented at the practice level in 24 primary care practices across the country (8 community-based, 8 academic, and 8 serving medically underserved populations). Electronic health record data will be used to assess changes in AWV and preventive service delivery rates and racial, ethnic, and gender disparities. Semi-structured interviews will be conducted with clinicians/staff and patients, and clinicians will be surveyed to assess the process and acceptability of the intervention. The protocol is registered on clinicaltrials.gov (NCT05910736).<h4>Results</h4>Analyses will determine the effect of the intervention on AWV visit and preventive health services use at 12- and 24-months post-intervention implementation. Additional analyses will evaluate the effect of the intervention on reducing racial/ethnic disparities.<h4>Conclusions</h4>A practice-tailored intervention has the potential to increase use of AWVs and preventive health services, and reduce racial/ethnic disparities, in diverse practice settings. |
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| ISSN: | 1932-6203 |