Recruiting

Telephonic Navigation vs. Virtual Outreach

Sponsor:

Kaiser Permanente

Code:

NCT06941519

Conditions

Multiple Chronic Conditions

Social Needs

Care Gaps

Navigation

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Telephonic Outreach

Virtual Outreach

Study Details

Brief summary:

The investigators will conduct a comparative effectiveness randomized clinical trial with two "active comparator" arms. The investigators will evaluate the two current, usual care strategies (higher intensity "telephonic navigation" vs. lower intensity "virtual outreach") for addressing social needs among patients with multiple chronic conditions.

Conditions

Multiple Chronic Conditions

Social Needs

Care Gaps

Navigation

Study ID

NCT06941519

Start date

Sep 1, 2025

Status verified date

Jun, 2026

Completion date

Dec 1, 2029

Anticipated

Primary completion date

Sep 15, 2029

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Two or more chronic medical conditions from a defined list of 24 chronic conditions
  • One or more gaps in evidence-based care (related to condition-specific risk factor management, evidence-based screening and preventive care, missed appointments, and medication non-adherence),
  • At least one self-reported social-related barrier to care or "social need" (e.g., transportation, food, housing, utilities, and/or financial insecurity).

Exclusion Criteria:

  • major cognitive barriers (dementia, psychosis).
  • multiple prior year hospitalizations ("extremely high utilizers")

Study Design

Enrollment

800 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Health Services Research

Interventions and Outcome Measures

Arms

experimental: Telephonic Navigation

Higher Intensity (active telephonic outreach from a health navigator with follow-up contacts for up to 3 months)

active comparator: Virtual Outreach

Lower Intensity (outreach via text, email, and/or letter with materials that contain information about available local, state, and federal governmental benefits and services)

Interventions

Telephonic Outreach

Higher Intensity (active telephonic outreach from a health navigator with follow-up contacts for up to 3 months)

Virtual Outreach

Lower Intensity (outreach via text, email, and/or letter with materials that contain information about available local, state, and federal governmental benefits and services)

Primary outcome measure

  • Receipt of social services [ Time Frame: approximately 6 months after enrollment ]
  • Reduction in number of social needs [ Time Frame: approximately 6 months after enrollment ]
  • Clinical care gap closure [ Time Frame: approximately 12 months after enrollment ]

Central Contacts and Locations

Central contacts

Karen R Estacio, MHA

510.891.5960karen.r.estacio@kp.org

Locations

Division of Research

Recruiting

Pleasanton, California, United States, 94588

Contacts

Karen R Estacio, MHA

510.891.5960karen.r.estacio@kp.org

Principal Investigator:

Richard W Grant, MD MPH

More Information

Sponsor

Kaiser Permanente

Last update posted

Jun 5, 2026

Last verified

Jun, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Kaiser Permanente on 2026-06-05.