Fidelity evaluation of the dialogue around respiratory illness treatment (DART) program communication training

Area of Science:

• Pediatric Medicine
• Health Communication
• Antibiotic Stewardship

Background:

• Antibiotic over-prescribing for pediatric acute respiratory tract infections (ARTIs) is a significant public health concern.
• Multifaceted interventions are being developed to address this issue, with communication training as a key component.

Purpose of the Study:

• To evaluate the receipt fidelity of communication training content within an intervention aimed at reducing antibiotic over-prescribing for pediatric ARTIs.
• To assess the extent to which clinicians implemented intended communication behavior changes post-training.

Main Methods:

• Parents of children aged 6 months to <11 years with ARTIs were surveyed post-visit (1026 visits, 53 clinicians, 18 practices).
• Communication outcomes measured clinician implementation of combined treatment recommendations and contingency plans (full, partial, or no implementation).
• Mixed effects multinomial logistic regression analyzed changes in communication outcomes from baseline across three training modules.

Main Results:

• Following communication training, the adjusted probability of clinicians fully implementing intended communication behaviors increased by 8.1% compared to baseline (p=0.005).
• The findings indicate strong receipt fidelity of the intervention's communication training component.

Conclusions:

• The study supports the effectiveness of the communication training in improving clinician behavior.
• Clinicians can be successfully trained to adopt communication strategies that contribute to reducing unnecessary antibiotic prescribing for pediatric ARTIs.