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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

Author

Listed:
  • Derjung M Tarn
  • Wilson D Pace
  • Kurt C Stange
  • Chi-hong Tseng
  • Neil S Wenger

Abstract

Background: 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. Objectives: 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. Methods: 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). Results: 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. Conclusions: 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.

Suggested Citation

  • Derjung M Tarn & Wilson D Pace & Kurt C Stange & Chi-hong Tseng & Neil S Wenger, 2025. "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," PLOS ONE, Public Library of Science, vol. 20(8), pages 1-12, August.
    • Handle: RePEc:plo:pone00:0329004
    DOI: 10.1371/journal.pone.0329004
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    References listed on IDEAS

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    2. Gaglio, B. & Shoup, J.A. & Glasgow, R.E., 2013. "The RE-AIM framework: A systematic review of use over time," American Journal of Public Health, American Public Health Association, vol. 103(6), pages 38-46.
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