A Task Analysis Study of DECIDE For African American Patients With Type 2 Diabetes (eDECIDE)

Web-Based Problem Solving Self-Management Program for African Americans With Type 2 Diabetes

The Decision-Making Education for Choices in Diabetes Every Day (DECIDE) program (copyrighted) was created by Dr. Felicia Hill-Briggs and is used by permission for the purpose of this pilot study. This problem-solving curriculum is used to help manage everyday problems when living with diabetes. The purpose of this project is to complete an in-depth review of the Decision-Making Education for Choices in Diabetes Every Day (DECIDE) curriculum, which is delivered in a group face-to-face setting. Using a task analysis process, the investigators will use the findings from the review to develop a web-site version that will be called eDECIDE for use with a community group in Kansas.

Phase 3: will be a pilot clinical trial (2 Arm Study) which examines the use of the eDECIDE curriculum compared to the traditional DECIDE curriculum delivered to participants individually.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus, Type 2
• Intervention / Treatment: Behavioral: eDECIDE Web-based Intervention Group

Detailed Description

The Task Analysis study of the DECIDE program is phase I (part 1) of a three-part study. Phase II (Part 2) is usability testing, and Phase 3 (Part 3) is the pilot clinical trial. For phase 1, a single group will receive the DECIDE intervention program as investigators conduct a task analysis of DECIDE in preparation for building the web-based version (eDECIDE). In Phase 1, participants will go through the curriculum and will be video recorded to help mimic what should be on the eventual eDECIDE website. One phase 1 is completed a usability testing study will be conducted, which is phase II and involves getting feedback from participants on the actual use of the eDECIDE wireframe prototype through recorded interviews. This web-based version will be used for Phase 3 of the study, which will be the pilot clinical trial (eDECIDE).

Self-management is important for persons with type 2 diabetes for glycemic control. When diabetes is uncontrolled, it is important to get back in control in order to decrease further health complications. New ways of delivering self-management that improve access to treatment are needed. This study will help provide background information on any potential problems and or benefit of using web-based and mobile phone applications (mHealth) for diabetes self-management. In addition, this study will help researchers at University of Kansas School of Medicine create a web-based version of the in-person DECIDE program, known as eDECIDE. Data gathered from the in-person DECIDE group sessions will be used to create a series of events for designing a web-based copy based on several task (current study). Therefore, this study is known as a task analysis.

Task Analysis: This entails documenting observations of an existing system, sequence of tasks, and information flows. High-level tasks are divided into subtasks and operations. Informational sources required in each subtask are also recorded. This technique is a critical step in any software development process to ensure a basic understanding of user needs and requirements necessary for optimal learning. It also provides a perspective on individual differences across patients. Understanding this workflow is critical and will serve as the basis for developing eDECIDE.

Phase II- For the task analysis up to 8 individuals will be recruited to take part in the in-person DECIDE problem-solving curriculum (task analysis), the information learned in the task analysis will help build and test (usability testing) the eDECIDE website, which are both integral to the pilot clinical trial (part 3) which will take place last.

PROCEDURES The current study will administer the DECIDE curriculum to a single group, examine responses, build the website, and then prepare for implementing the pilot clinical trial. The information gathered from this study will provide information about barriers to problem solving for diabetes self-management and perceptions of using a web-based diabetes problem-solving format.

Participants who meet eligibility criteria will take part in 9-weekly sessions on diabetes self-management and problem-solving techniques. The sessions will be recorded by audio and video tape. All audio and video taped recordings will be used to help create the web-based version of DECIDE, known as eDECIDE. All and any personal information that is recorded by audio tape will be removed when transcribing the audio recordings. All personal information such as name and face will be removed and blurred if video recording clips are used in an academic or conference meeting setting. Other personal identifiable information such as date of birth, address, or telephone number will be removed when transcribing and you will be identified by participant id number. The researcher will ask participants questions about their diabetes self-management behaviors; go over problem-solving techniques, and self-management skills. The recordings of the focus group sessions will be destroyed 12 months after publication of the research results.

Task Analysis and usability testing Procedures:

Using information gathered from the task analysis, the research team will develop a wire frame prototype of eDECIDE. A benefit of the prototype is to have a layout of the interface without the distraction of color or visual elements that would normally be a part of the actual webpages.

Once the prototype of the website design is complete, investigators will conduct usability testing (phase II/part 2) to assess the efficiency, ease-of-use, and user satisfaction based on participant feedback. Participant feedback is collected via web camera and online questionnaires. Objective data are collected via logging software designed for usability testing. Usability testing is a step-by-step process conducted several times throughout the design and development process. Results from each test are used to make design recommendations for the eDECIDE website. Once usability testing is complete, the pilot clinical trial (phase III/ part 3) of eDECIDE will begin.

Our long-term goal is to understand how problem-solving skills training (PSST), delivered using web-based and mobile phone technology, can improve diabetes self-management in community populations.

Currently Recruiting: Clinical Trial Phase of eDECIDE: Plot 2-Arm Study:

Intervention arm: eDECIDE Online Curriculum Comparison arm: DECIDE Traditional Curriculum delivered one/on/one (Self-Study).

Will recruit at total of 40-70 participants Primary outcome A1c Secondary outcomes: goal setting, problem-solving, feasibility of use for eDECIDE online, satisfaction with eDECIDE online.

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Kansas
    • Wichita, Kansas, United States, 67214
      • University of Kansas Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 65 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• African American
• English speaking
• Access to the Internet daily
• Reading level of at least 5th grade

• Diagnosis of Type 2 Diabetes per one of the following

  1. Fasting blood glucose ≥ to 126 mg/dL
  2. 2 hr plasma glucose ≥ 200 mg/dL
  3. Glycosylated hemoglobin HbA1c ≥ to 6.5%
  4. Random plasma glucose ≥ 200 mg/dL

Exclusion Criteria:

• Glycosylated hemoglobin HbA1c ≤ 7.0
• Pregnancy
• Severe visual or hearing impairment or any existing condition that would limit or hinder one's ability to use the Internet
• Dementia
• Use of supplemental oxygen
• Chest pain or angina
• Prior lower extremity amputation
• A diagnosis of a life threatening malignancy within the past year

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: eDECIDE Web-based Intervention Group; Participants randomized to the eDECIDE arm will use the online version of the program through the eDECIDE study portal. Participants in this group will receive bi-weekly calls from their health coach to mark their progress with the program.	Behavioral: eDECIDE Web-based Intervention Group; Will conduct 18 week in-person group sessions of the DECIDE curriculum with recruited volunteers. This is part 1 or phase I of the eventual pilot clinical trial. Participants will attend weekly group sessions to learn problem-solving skills and management of their diabetes. After the completion of the task analysis participants will be recruited for the eDECIDE web-based intervention
Active Comparator: DECIDE Traditional Group; Participants randomized to the DECIDE group will receive a copy of the curriculum via mail and will be a self-study group where they go through the curriculum on their own with 4 calls from their health coach.	Behavioral: eDECIDE Web-based Intervention Group; Will conduct 18 week in-person group sessions of the DECIDE curriculum with recruited volunteers. This is part 1 or phase I of the eventual pilot clinical trial. Participants will attend weekly group sessions to learn problem-solving skills and management of their diabetes. After the completion of the task analysis participants will be recruited for the eDECIDE web-based intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Glycated Hemoglobin Among Participants at Baseline and 18-week Follow-up	The primary outcome of interest is HbA1c (glycated hemoglobin) measurement in the traditional DECIDE (control) group and eDECIDE (intervention) group. A .5% change in HbA1c has been considered clinically meaningful.	Change in glycated hemoglobin (A1c) over time at baseline and 18-week post-intervention follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health Problem Solving Scores Outcomes	Secondary outcomes on scores on the health problem-solving scale which looks at applying the process of recognizing and identifying problems, generating solutions, and making decisions to surmount specific barriers to completing self-management tasks and diabetes self-care behaviors (measuring) frequency and of self -management behaviors. The HPSS scale scores range from 4 (possible minimum score) to 28 (possible max score). Health Problem-Solving Scale (HPSS), higher scores indicate more effective problem-solving skill. There are seven subscales (Likert-scale is from zero to four and the mean scores from each subscale were summed and then an average was derived for the total score. Outcome measure data reflects the total problem solving score by arm at baseline and follow-up.	18 weeks
Diabetes Self -Care Behaviors-monitoring Blood Glucose Levels	Secondary outcomes on scores on diabetes self-care behaviors specifically checking blood glucose level (blood sugar) away from clinic office. Count of participants who checked blood sugar levels daily (at least 5 or more days a week). Scale used, Diabetes Self-care behaviors- scale ask frequency of days.	18 weeks

Collaborators and Investigators

• Sponsor: University of Kansas Medical Center
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI); Wichita State University
• Investigators: Principal Investigator: Michelle L Redmond, PhD, University of Kansas Medican Center Research Institute, Inc

Study record dates

Study Major Dates

• Study Start (Actual): June 5, 2019
• Primary Completion (Actual): October 30, 2024
• Study Completion (Actual): October 30, 2024

Study Registration Dates

• First Submitted: February 20, 2019
• First Submitted That Met QC Criteria: February 25, 2019
• First Posted (Actual): February 26, 2019

Study Record Updates

• Last Update Posted (Actual): March 20, 2026
• Last Update Submitted That Met QC Criteria: March 18, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Education; Self-management; Problem solving
• Additional Relevant MeSH Terms: Endocrine System Diseases; Metabolic Diseases; Glucose Metabolism Disorders; Diabetes Mellitus; Nutritional and Metabolic Diseases; Diabetes Mellitus, Type 2
• Other Study ID Numbers: STUDY00141460; 1K01HL135472-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No