iDecide.Decido: Diabetes Medication Decision Support Study
Technologically Enhanced Community Health Worker (CHW) Delivery of Personalized Diabetes Information
Lead Sponsor: University of Michigan
Collaborator: Agency for Healthcare Research and Quality (AHRQ)
|Source||University of Michigan|
Two of AHRQ 's consumer-focused guides, "Pills for Type 2 Diabetes" and "Premixed Insulin for Type 2 Diabetes" could be of great use to underserved ethnic and racial minority adults. The presentation of content and delivery mechanisms of these Guides, however, needs to be modified to increase their use and impact among these difficult-to-reach populations.
To achieve this goal, a long-standing collaboration among African American and Latino community organizations, health care centers and systems, public health organizations, and academics (the REACH Detroit Partnership) is joining with leading experts in the development of personally and culturally tailored health decision aids (University of Michigan's Center for Health Communications Research [CHCR] and Center for Behavioral and Decision Sciences in Medicine [CBDSM]).
The investigators will develop and evaluate a computer tailored online diabetes medication decision aid that will enable community health workers (CHWs) to provide personalized patient education materials to underserved diabetic African American and Latino adults in Detroit, Michigan.
The Specific Aims of this study are:
Aim 1: To use the information in the two diabetes medications consumer CERSGs to build an interactive, computer tailored diabetes medication guide that will enable patients to assess their treatment goals, personal preferences, and side-effect concerns and generate a personally tailored assessment of their current diabetes treatments with, as appropriate, options for improving their diabetes care;
Aim 2: To determine the extent to which this personally tailored diabetes medication guide compared with the print consumer guides reduces Latino and African American diabetes patients' decisional conflict, through improved knowledge of anti-hyperglycemic medications and satisfaction with information received.
Aim 3: To examine the computer tailored program's effects on participants' changes in medications (medication intensification), self-reported medication adherence and beliefs and A1C levels between baseline and follow-up compared to participants receiving the print consumer guides.
|Start Date||September 2011|
|Completion Date||October 2013|
|Primary Completion Date||September 2013|
Intervention Type: Behavioral
Intervention Name: Community Health Worker Diabetes Education: Print media
Description: Providing information to patients about potential benefits, harms, costs, and burdens of medications and discussing patients' treatment preferences.
Arm Group Label: Traditional CERSG Arm
Other Name: Print Materials Arm
Intervention Type: Behavioral
Intervention Name: CHW Diabetes Education: tailored web site
Description: Providing tailored and interactive information to patients about potential benefits, harms, costs, and burdens of medications and discussing patients' treatment preferences.
Arm Group Label: Web-Based Materials Arm
Other Name: Tailored web based decision aid
Inclusion Criteria: - type 2 diabetes - stated concern about diabetes and diabetes treatment - poor glycemic control - over 21 years of age Exclusion Criteria: - blind, deaf, otherwise unable to use the telephone or visual resources - pregnant - currently enrolled in other REACH Detroit research study - in hospice care - current radiation or chemotherapy
- type 2 diabetes
- stated concern about diabetes and diabetes treatment
- poor glycemic control
- over 21 years of age
- blind, deaf, otherwise unable to use the telephone or visual resources
- currently enrolled in other REACH Detroit research study
- in hospice care
- current radiation or chemotherapy
Minimum Age: 21 Years
Maximum Age: N/A
Healthy Volunteers: No
Type: Principal Investigator
Investigator Affiliation: University of Michigan
Investigator Full Name: Rebecca Mase
Investigator Title: Project Manager
|Has Expanded Access||No|
|Number Of Arms||2|
Label: Traditional CERSG Arm
Type: Active Comparator
Description: CHWs will provide and review with patients language-appropriate versions of the AHRQ consumer guides. CHWs will highlight key points on each page, review information on each medication and elicit and address questions. They will use the autonomy enhancing, motivational-interviewing based skills. As with the first arm, CHWs will schedule follow-up clinic appointments for participants who note a specific treatment change they would consider and will call participants two times after the session at three and six weeks to address additional questions and to follow up on any goals the participant set.
Label: Web-Based Materials Arm
Description: Participants randomized to this arm will be scheduled within 3 weeks of enrollment to have a one-hour face-to-face session with a CHW who will deliver the ipad platform personally tailored diabetes medication decision aid. Participants will receive a printed tailored preference summary at the completion of this visit. If participants note a specific treatment change they would like to discuss with their providers, the CHW will facilitate scheduling a clinic visit within the next month. Finally, CHWs will call participants two times after the session at 3 and 6 weeks to assess if the participant has additional questions and to follow up on any treatment or other goals the participant set during their session.
|Study Design Info||
Intervention Model: Parallel Assignment
Primary Purpose: Health Services Research
Masking: Single (Outcomes Assessor)