Evaluation of a patient communication resource (Check-Backv2) in rural chronic disease settings

INTERVENTION: The intervention is the Check‐BackV2 package which has been developed to help rural patients with chronic diseases or carers of someone with a chronic disease build their skills and confidence to engage in active, two‐way discussions with clinicians. The Check‐BackV2 package comprises a 6‐page pamphlet, a wallet card and postcard with reminders to use check‐back and a link to the revised check‐back website (the latter for optional viewing). The pamphlet, wallet card and postcard include a brief description of what Check‐back is and how to use it in health appointments. The resources have been designed specifically for this study. Participants in the intervention group will also be sent two SMS reminders (at weeks 4 and 5 after the intervention pack is sent) to use check‐back during their next planned health appointment. These resources and revisions to the check‐back website have been co‐designed with consumers and clinicians as part of The Check‐Back study (ACTRN12623000378628). The Check‐BackV2 website will be a modified version of the current check‐back website (https://checkback.org/). This website is self‐administered, includes videos, animations and a personal action plan, and takes approximately 15 minutes to complete. The Check‐BackV2 package will be mailed to participants in the intervention group at once recruitment is finalised. Participants will be able to read the pamphlet and view the website as often as they wish. We will collect survey data at weeks 2 and 12 following their health appointment, and 10 participants will be interviewed. Clinicians who work within chronic disease services at a participating health service will also be invited to be interviewed. These clinicians may or may not have provided care to participants during the study period. Th CONDITION: Arthritis;Asthma;Back pain;Cancer ;Cardiovascular disease;Chronic obstructive pulmonary disease;Diabetes;Chronic kidney disease;Osteoporosis; ; Arthritis ; Asthma ; Back pain ; Cancer ; Cardiovascular disease ; Chronic obstructive pulmonary disease ; Diabetes ; Chronic kidney disease ; Osteoporosis Cancer ‐ Any cancer Cardiovascular ‐ Coronary heart disease Metabolic and Endocrine ‐ Diabetes Musculoskeletal ‐ Osteoarthritis Musculoskeletal ‐ Osteoporosis Musculoskeletal ‐ Other muscular and skeletal disorders Renal and Urogenital ‐ Kidney disease Respiratory ‐ Asthma Respiratory ‐ Chronic obstructive pulmonary disease PRIMARY OUTCOME: Patient activation[Patient Activation Measure (PAM‐13) Baseline (6‐10 weeks prior to planned health appointment) and 12‐weeks after planned health appointment] SECONDARY OUTCOME: Clinician perspectives about the intervention.[An investigator will telephone the clinicians who work in rural chronic disease settings to discuss their perspectives on the intervention. Semi structured interviews will be conducted and will be recorded and transcribed verbatim by the investigator. At the conclusion of the study] ED presentation[Episode dates, reason for admission (participants will provide both data points in the self‐report survey questions designed specifically for this study) 2‐weeks & 12‐weeks after planned health appointment] Engage with providers[HLQ Scale 6 Baseline (6‐10 weeks prior to planned health appointment), 2‐weeks & 12‐weeks after planned health appointment] Feeling understood by healthcare providers[Health Literacy Questionnaire (HLQ) Scale 1 Baseline (6‐10 weeks prior to planned health appointment), 2‐weeks & 12‐weeks after planned health appointment] Have sufficient information[HLQ Scale 2 Baseline (6‐10 weeks prior to planned health appointment), 2‐weeks & 12‐weeks after planned health appointment] Health appointments[Health appointments attended (self‐report survey questions designed specifically for this study) 2‐weeks & 12‐weeks after planned health appointment] Hospital admission[Episode dates, reason for admission (participants will provide both data points in the self‐report survey questions designed specifically for this study) 2‐weeks & 12‐weeks after planned health appointment] Medication adherence[Medication Adherence Rating scale (MARS‐10) Baseline (6‐10 weeks prior to planned health appointment) and 12‐weeks after planned health appointment] Navigating the healthcare system[HLQ Scale 7 Baseline (6‐10 weeks prior to planned health appointment), 2‐weeks & 12‐weeks after planned health appointment] Patient perspectives about the intervention.[An investigator will telephone the participants in the intervention arm to investigate their perspectives on using the intervention. Semi‐structured interviews will be conducted and will be recorded and transcribed verbatim by the investigator. 12‐weeks after their planned health appointment] INCLUSION CRITERIA: For patients/carers, inclusion criteria are: ‐ Adults (18 years and over); ‐ Living with one or more chronic diseases (arthritis, asthma, back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, and osteoporosis); ‐ A patient/carer of outpatient services at a participating health service; ‐ Has an upcoming health appointment within the next 6‐10 weeks (can be telehealth or in‐person). This time‐frame allows sufficient time for recruitment and consent processes, and (for the intervention group), time to become familiar with the Check‐BackV2 package. ‐ Lives in a Modified Monash Model 3‐5 area (designated as rural/remote). They can be attending a health appointment at a larger regional or metropolitan centre as long as they live in a rural/remote area. ‐ Able to understand and speak English as the Check‐BackV2 package is only available in English at this stage; ‐ Able to prov