Testing the Feasibility, User Experiences, and Preliminary Effect of Conversation Cards for Adolescents© For Behavior Change and Collaborative Goal Setting in Primary Care: A Pilot Randomized Controlled Trial.

Our team developed Conversation Cards for Adolescents© (CCAs), a tool to help adolescents and health care providers (HCPs) communicate and collaboratively set behavior change goals. The objectives of this pilot randomized controlled trial were to test the feasibility, user experience, and preliminary effect of using CCAs with adolescents in primary care, focusing on behavior change and collaborative goal setting among adolescents. From March 2019 to September 2022, adolescents were recruited from the Northeast Community Health Centre (Edmonton, AB). Adolescents were randomized (1:1) to one of two groups: CCA + goal setting (experimental group) or goal setting alone (control group). Data were collected from both groups at baseline and at 3-weeks post-baseline. In total, 31 adolescents completed the trial (terminated early due to COVID-19). The study demonstrated high practicality. Adolescents reported positive user experiences with CCAs, citing attractiveness, clarity, efficiency, and dependability. No group differences were detected for behavior changes at 3-weeks post-baseline (p > .05), although adolescents in the experimental group qualitatively described improved rapport and communication with HCPs. CCAs can be used practically in a primary health care setting to facilitate communication and rapport with adolescents; however, their effect in enabling behavior change should be investigated in a multi-site, larger-scale trial.

Feasibility, user experiences, and preliminary effect of Conversation Cards for Adolescents© on collaborative goal-setting and behavior change: protocol for a pilot randomized controlled trial.

BACKGROUND: Adolescents and providers can benefit from practical tools targeting lifestyle modification for obesity prevention and management. We created Conversation Cards for Adolescents© (CCAs), a patient-centered communication and behavior change tool for adolescents and providers to use in clinical practice. The purpose of our study is to (i) assess the feasibility of CCAs in a real-world, practice setting to inform full-scale trial procedures, (ii) assess user experiences of CCAs, and (iii) determine the preliminary effect of CCAs on changing behavioral and affective-cognitive outcomes among adolescents. METHODS: Starting in early 2019, this prospective study is a nested mixed-methods, theory-driven, and pragmatic pilot randomized controlled trial with a goal to enroll 50 adolescents (13-17 years old) and 9 physicians practicing at the Northeast Community Health Centre in Edmonton, Alberta, Canada. Adolescents will collaboratively set one S.M.A.R.T. (specific, measurable, attainable, realistic, timely) goal with their physician to implement over a 3-week period; however, only those randomized to the experimental group will use CCAs to inform their goal. Outcome assessments at baseline and follow-up (3 weeks post-baseline) will include behavioral, affective-cognitive, and process-related outcomes. DISCUSSION: In examining the feasibility, user experiences, and preliminary effect of CCAs, our study will add contributions to the obesity literature on lifestyle modifications among adolescents in a real-world, practice setting as well as inform the scalability of our approach for a full-scale effectiveness randomized controlled trial on behavior change. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03821896.