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Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial)

INTRODUCTION: Adolescence is a period of major transition in physical, cognitive, social and emotional development, and the peak time for the onset of mental health conditions, substance use disorders and sexual and reproductive health risks. Prevention and treatment during this time can improve hea...

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Autores principales: Hocking, Jane S, Watson, Cathy, Chondros, Patty, Sawyer, Susan M, Ride, Jemimah, Temple-Smith, Meredith, Boyle, Douglas, Skinner, Rachel, Patton, George C, Lim, Megan S C, Pirkis, Jane, Johnson, Caroline, Newton, Sara, Wardley, Amelia, Blashki, Grant, Guy, Rebecca, Dalziel, Kim, Sanci, Lena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432627/
https://www.ncbi.nlm.nih.gov/pubmed/37586870
http://dx.doi.org/10.1136/bmjopen-2023-074154
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author Hocking, Jane S
Watson, Cathy
Chondros, Patty
Sawyer, Susan M
Ride, Jemimah
Temple-Smith, Meredith
Boyle, Douglas
Skinner, Rachel
Patton, George C
Lim, Megan S C
Pirkis, Jane
Johnson, Caroline
Newton, Sara
Wardley, Amelia
Blashki, Grant
Guy, Rebecca
Dalziel, Kim
Sanci, Lena
author_facet Hocking, Jane S
Watson, Cathy
Chondros, Patty
Sawyer, Susan M
Ride, Jemimah
Temple-Smith, Meredith
Boyle, Douglas
Skinner, Rachel
Patton, George C
Lim, Megan S C
Pirkis, Jane
Johnson, Caroline
Newton, Sara
Wardley, Amelia
Blashki, Grant
Guy, Rebecca
Dalziel, Kim
Sanci, Lena
author_sort Hocking, Jane S
collection PubMed
description INTRODUCTION: Adolescence is a period of major transition in physical, cognitive, social and emotional development, and the peak time for the onset of mental health conditions, substance use disorders and sexual and reproductive health risks. Prevention and treatment during this time can improve health and well-being now and into the future. However, despite clinical guidelines recommending annual preventive health assessments for young people, health professionals cite lack of consultation time and adequate funding as key barriers. This trial aims to determine whether a specific fee-for-service (‘rebate payment’) for a young person’s health assessment, is effective and cost-effective at increasing the detection and management of health risk behaviours and conditions among young people. METHODS AND ANALYSIS: This cluster randomised controlled trial will be conducted in Australian general practice. 42 general practices (clusters) will be randomly allocated 1:1 to either an intervention arm where general practitioners receive a rebate payment for each annual health assessment undertaken for 14–24-year-olds during a 2 year study period, or a control arm (no rebate). The rebate amount will be based on the Medical Benefits Schedule (Australia’s list of health professional services subsidised by the Australian Government) currently available for similar age-based assessments. Our primary outcome will be the annual rate of risk behaviours and health conditions recorded in the patient electronic health record (eg, alcohol/drug use, sexual activity and mental health issues). Secondary outcomes include the annual rate of patient management activities related to health risks and conditions identified (eg, contraception prescribed, sexually transmitted infection tests ordered). A process evaluation will assess acceptability, adoption, fidelity and sustainability of the rebate; an economic evaluation will assess its cost-effectiveness. Analyses will be intention-to-treat. ETHICS AND DISSEMINATION: Ethics approval has been obtained from University of Melbourne Human and Research Ethics Committee (2022-23435-29990-3). Findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12622000114741
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spelling pubmed-104326272023-08-18 Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial) Hocking, Jane S Watson, Cathy Chondros, Patty Sawyer, Susan M Ride, Jemimah Temple-Smith, Meredith Boyle, Douglas Skinner, Rachel Patton, George C Lim, Megan S C Pirkis, Jane Johnson, Caroline Newton, Sara Wardley, Amelia Blashki, Grant Guy, Rebecca Dalziel, Kim Sanci, Lena BMJ Open General practice / Family practice INTRODUCTION: Adolescence is a period of major transition in physical, cognitive, social and emotional development, and the peak time for the onset of mental health conditions, substance use disorders and sexual and reproductive health risks. Prevention and treatment during this time can improve health and well-being now and into the future. However, despite clinical guidelines recommending annual preventive health assessments for young people, health professionals cite lack of consultation time and adequate funding as key barriers. This trial aims to determine whether a specific fee-for-service (‘rebate payment’) for a young person’s health assessment, is effective and cost-effective at increasing the detection and management of health risk behaviours and conditions among young people. METHODS AND ANALYSIS: This cluster randomised controlled trial will be conducted in Australian general practice. 42 general practices (clusters) will be randomly allocated 1:1 to either an intervention arm where general practitioners receive a rebate payment for each annual health assessment undertaken for 14–24-year-olds during a 2 year study period, or a control arm (no rebate). The rebate amount will be based on the Medical Benefits Schedule (Australia’s list of health professional services subsidised by the Australian Government) currently available for similar age-based assessments. Our primary outcome will be the annual rate of risk behaviours and health conditions recorded in the patient electronic health record (eg, alcohol/drug use, sexual activity and mental health issues). Secondary outcomes include the annual rate of patient management activities related to health risks and conditions identified (eg, contraception prescribed, sexually transmitted infection tests ordered). A process evaluation will assess acceptability, adoption, fidelity and sustainability of the rebate; an economic evaluation will assess its cost-effectiveness. Analyses will be intention-to-treat. ETHICS AND DISSEMINATION: Ethics approval has been obtained from University of Melbourne Human and Research Ethics Committee (2022-23435-29990-3). Findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12622000114741 BMJ Publishing Group 2023-08-16 /pmc/articles/PMC10432627/ /pubmed/37586870 http://dx.doi.org/10.1136/bmjopen-2023-074154 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle General practice / Family practice
Hocking, Jane S
Watson, Cathy
Chondros, Patty
Sawyer, Susan M
Ride, Jemimah
Temple-Smith, Meredith
Boyle, Douglas
Skinner, Rachel
Patton, George C
Lim, Megan S C
Pirkis, Jane
Johnson, Caroline
Newton, Sara
Wardley, Amelia
Blashki, Grant
Guy, Rebecca
Dalziel, Kim
Sanci, Lena
Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial)
title Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial)
title_full Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial)
title_fullStr Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial)
title_full_unstemmed Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial)
title_short Will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? Protocol for a cluster randomised controlled trial (RAd Health Trial)
title_sort will a fee-for-service payment for a young people’s health assessment in general practice increase the detection of health risk behaviours and health conditions? protocol for a cluster randomised controlled trial (rad health trial)
topic General practice / Family practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432627/
https://www.ncbi.nlm.nih.gov/pubmed/37586870
http://dx.doi.org/10.1136/bmjopen-2023-074154
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