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Social Risk Score and Closed Loop Referral for Chronic Disease

Johns Hopkins Community Physicians - EBMC, Baltimore, MD
Chronic Disease+3 More ConditionsSocial Risk Score and CDS Tool - Other
Eligibility
18+
All Sexes
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Study Summary

This trial aims to improve care for racial/ethnic minorities and socially disadvantaged populations with chronic diseases by leveraging HIT to integrate digital info on social needs.

Eligible Conditions
  • Chronic Disease
  • Diabetes
  • High Blood Pressure
  • Congestive Heart Failure

Treatment Effectiveness

Phase-Based Effectiveness

1 of 3
N/A

Similar Trials

1
Hybrid Closed Loop System
1
Financial coaching and services
1
Immediate Chronic Disease Prevention Program (CDPP)

Study Objectives

1 Primary · 3 Secondary · Reporting Duration: Baseline and at 3 month follow-up

Month 3
Change in the number of hospitalization events and emergency department (ED) visits between intervention and control arms
Change in the number of social needs identified during the visit
Difference in the number of patients with social needs identified in the intervention and control groups
Difference in the number of patients with social needs who receive services at a CBO in intervention and control groups

Trial Safety

Phase-Based Safety

1 of 3

Similar Trials

1
Hybrid Closed Loop System
1
Financial coaching and services
1
Immediate Chronic Disease Prevention Program (CDPP)

Awards & Highlights

No Placebo Group
All patients enrolled in this trial will receive the new treatment.

Trial Design

2 Treatment Groups

Social Risk Score and Closed Loop Referral
1 of 2
Control
1 of 2

Active Control

600 Total Participants · 2 Treatment Groups

Primary Treatment: Social Risk Score and Closed Loop Referral · No Placebo Group · N/A

Social Risk Score and Closed Loop Referral
Other
ActiveComparator Group · 1 Intervention: Social Risk Score and CDS Tool · Intervention Types: Other
Control
Other
ActiveComparator Group · 1 Intervention: Standard of Care · Intervention Types: Other

Trial Logistics

Trial Timeline

Screening: ~3 weeks
Treatment: Varies
Reporting: baseline and at 3 month follow-up

Who is running the clinical trial?

Johns Hopkins UniversityLead Sponsor
2,115 Previous Clinical Trials
32,578,169 Total Patients Enrolled
5 Trials studying Chronic Disease
2,711 Patients Enrolled for Chronic Disease
National Institute on Minority Health and Health Disparities (NIMHD)NIH
316 Previous Clinical Trials
1,322,393 Total Patients Enrolled
5 Trials studying Chronic Disease
2,906 Patients Enrolled for Chronic Disease
Elham Hatef, MD, MPHPrincipal InvestigatorJohns Hopkins University

Eligibility Criteria

Age 18+ · All Participants · 1 Total Inclusion Criteria

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References

Frequently Asked Questions

Are there any available openings for participants in this research?

"As per the clinicaltrials.gov database, this study is actively seeking participants; it was initially registered on May 1st of 2023 and its details were recently revised on May 10th of that same year." - Anonymous Online Contributor

Unverified Answer

What is the projected scope of participants for this experiment?

"Affirmative. According to the entry on clinicaltrials.gov, this research project is actively seeking participants and was first listed on May 1st 2023 with its most recent update being made 10 days later. 600 individuals need to be recruited from 3 different healthcare facilities." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

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