Understanding and Improving Diabetes Care for Ethnic Minorities (R2D2C2)
Reducing Racial Disparities in Diabetes Care - The Coached Care Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Newport Beach, California, United States, 92663
- Mary and Dick Allen Diabetes Center at Hoag Hospital
-
Orange, California, United States, 92868
- University of California Irvine Medical Center
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Westminster, California, United States, 92683
- Westminster Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- diagnosis of type 2 diabetes
- At least one Hemoglobin A1c value greater than 7.5% in the year prior to recruitment.
Exclusion Criteria:
- Age above 80 years
- patients with dementia or other serious mental health problems that would prevent them from participating in the intervention.
- patients with other serious medical problems that would prevent them from participating in the intervention.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Coached Care
Coached Care pairs patients with linguistically and ethnically matched peer "coaches" who have been trained to promote patient participation in the medical visit.
The coaches, who themselves have diabetes, meet with patients immediately before each of their regularly scheduled medical visits to encourage active involvement in information seeking and decision-making.
|
Coached Care pairs patients with linguistically and ethnically matched peer "coaches", who themselves have diabetes, and have been trained to meet with patients immediately before each of their regularly scheduled medical visits to encourage active involvement in information seeking and decision-making.
Using a decision tree algorithm, they help patients identify relevant questions about symptoms, barriers to self-management and treatment options to discuss with doctor.
They encourage mutual decision-making about tailoring the patient's medication regimen, diet and physical activities and work with the patients to overcome barriers to communication with their doctor.
After the medical visit, the coach and patient review any treatment decisions and goals for self-care.
|
|
Active Comparator: Standard Diabetes Education
Patients receive one-on-one diabetes education sessions before each medical visit.
These sessions are purely informational, and do not include the specific patient activation components of the coached care intervention.
|
Patients randomized to the control group will receive 20 minutes of standardized diabetes education delivered by staff research assistants.
Education materials have been adapted from materials developed by the American Diabetes Association.
The content of these materials includes information about the causes and complications of diabetes, as well as ways to reduce complication risks.
Patients in the control arm will receive 20 minutes of standardized diabetes education before each visit
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hemoglobin A1c
Time Frame: 1 year and 2 year follow-up
|
A laboratory measure of blood sugar control
|
1 year and 2 year follow-up
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Health-related quality of life
Time Frame: 1 year and 2 year follow-up
|
Patient reported general and diabetes-specific measures of quality of life, including SF-36, diabetes burden and others.
|
1 year and 2 year follow-up
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Malik S, Billimek J, Greenfield S, Sorkin DH, Ngo-Metzger Q, Kaplan SH. Patient complexity and risk factor control among multimorbid patients with type 2 diabetes: results from the R2D2C2 study. Med Care. 2013 Feb;51(2):180-5. doi: 10.1097/MLR.0b013e318273119b.
- Sorkin DH, Ngo-Metzger Q, Billimek J, August KJ, Greenfield S, Kaplan SH. Underdiagnosed and undertreated depression among racially/ethnically diverse patients with type 2 diabetes. Diabetes Care. 2011 Mar;34(3):598-600. doi: 10.2337/dc10-1825. Epub 2011 Jan 27.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- HS# 2004-4025
- R18DK069846 (U.S. NIH Grant/Contract)
- K01DK078939 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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