The goal of the eREACH3 Study is to evaluate the implementation of digital tools into remote genetic
services, evaluating uptake and use of digital tools and outcomes in representative clinical populations. Our primary endpoints will include uptake of services and digital alternatives (future amendments).
We will use proportions and 95% confidence intervals to estimate uptake among participants. We will use proportions, means, and standard deviations, as appropriate, to estimate the use and acceptability of digital delivery alternatives in remote genetic services. The primary purpose of the study is to obtain point estimates that will enable the investigators to design larger studies. Secondary outcomes will include PROs, differences in PROs by patient characteristics, use of digital interventions and test result. Other secondary outcomes include provider time and patient costs, which will inform future broader clinical implementation.
In secondary analyses, we will create variables that define groups based on digital delivery alternatives used. We will compare unadjusted differences among groups using T-tests and Fisher's Exact tests as appropriate. We will examine multivariable associations among groups using Generalized Linear Models (GLMs) with appropriate link and family functions (e.g., logistic, linear, or Poisson regressions). We will account for repeated measures over study wave (e.g., T0, T1, T2) by estimating regressions using Generalized Estimating Equations (GEE). The analyses will be considered exploratory and hypothesis testing. We will also compare longitudinal change scores between study waves.
