- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05268250
Remedy to Diabetes Distress (R2D2): A Scalable Screen to Treat Program for School-age Families (R2D2)
February 28, 2024 updated by: Nemours Children's Clinic
This R01 is in response to RFA-DK-19-021, Treating Diabetes Distress to Improve Glycemic Outcomes in Type 1 Diabetes.
The objective is to test the feasibility and acceptability of a novel, practical, and potentially scalable screen to treat program for diabetes distress in families of school-age children with T1D (called Remedy to Diabetes Distress [R2D2]) and to test the initial efficacy of R2D2 to reduce diabetes distress to improve children's glycemic control.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Only 22% of school-age children with type 1 diabetes (T1D) achieve an HbA1c of <7.5% while the majority of school-age children who exceed this target are at higher risk for T1D-related complications.
Achieving optimal T1D self-care is the only direct pathway to better HbA1c and even with the addition of modern therapeutic modalities (e.g., hybrid closed loop), it is a complex, time-consuming, and relentless task.
School-age children cannot effectively manage T1D alone and require help from their parents to participate in daily T1D self-care.
The research suggests that both parents and youth with T1D are vulnerable to Diabetes Distress (DD) and the American Diabetes Association (ADA) Standards of Care recommend ongoing assessment of DD in youth (starting at 7-8-years-old) and their caregiver during routine diabetes clinic visits.
Unfortunately, while DD screening may be an ADA Care Standard, there are no practical treatment options for clinics to adopt to treat DD in school-age families in the case of positive screens.
The researchers submit this new R01 in response to RFA-DK-19-021, Treating Diabetes Distress to Improve Glycemic Outcomes in Type 1 Diabetes.
Our objective is to test the feasibility and acceptability of a novel, practical, and potentially scalable screen to treat program for DD in families of school-age children with T1D (called Remedy to Diabetes Distress [R2D2]) and to test the initial efficacy of R2D2 to reduce DD to improve children's glycemic control.
To enhance scientific rigor, the researchers plan to use the ORBIT model for behavioral intervention development to guide the study design.
The specific aims are: 1) Define feasibility and acceptability of our new screen to treat program (R2D2) for DD in school-age families, and 2) Establish initial efficacy of R2D2 to reduce parent and child DD to improve child glycemic control.
The researchers propose to address these Aims through an iterative process and multiple projects to complete the necessary formative research to design, build, and prepare to implement R2D2.
The researchers then propose to complete a Pilot randomized controlled trial of their R2D2 screen to treat program, testing for its initial efficacy based on child HbA1c and time in range (primary outcomes) and parent and child DD and resilience, and T1D self-care (secondary outcomes; Phase 2b: Pilot, n=180).
The impact of the proposed R01 is high because it addresses a critical need for practical and evidence-based solutions for screening and treating DD in families of school-age children, heretofore an understudied patient subgroup.
The researchers believe our study optimally responds to the FOA because the research team is multidisciplinary (anchored by a partnership between behavioral science and diabetology), and their R2D2 screen to treat program reflects a practical team approach that can realistically occur in clinic and scale to other centers.
Study Type
Interventional
Enrollment (Estimated)
180
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Amy Milkes
- Email: amy.milkes@nemours.org
Study Contact Backup
- Name: Susana R Patton, PhD
- Phone Number: 9046972000
- Email: susana.patton@nemours.org
Study Locations
-
-
Florida
-
Jacksonville, Florida, United States, 32207
- Recruiting
- Nemours Children's Health
-
Contact:
- Amy Milkes
- Email: amy.milkes@nemours.org
-
Contact:
- Susana R Patton, PhD
- Phone Number: 913-697-3595
- Email: sp0105@nemours.org
-
-
Missouri
-
Kansas City, Missouri, United States, 64108
- Recruiting
- Children's Mercy Kansas City
-
Contact:
- Mark Clements, MD PHD
- Phone Number: 816-234-3000
- Email: endoclinicaltrials@cmh.edu
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
8 years to 65 years (Child, Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- child age between 8-12 years, physician confirmed T1D diagnosis,
- either the child or the parent or both the child and parent report diabetes distress levels at or above clinical cut-points,
- child is on an intensive insulin regimen (pump or MDI).
Exclusion Criteria:
- children on a conventional insulin regimen, children and/or parents who do not report diabetes distress levels at or above the clinical cut-points,
- children who have an allergy or sensitivity to the adhesive and/or skin preparation used for CGM, children with a comorbid chronic condition (e.g., renal disease),
- children and parents who do not speak English.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: R2D2 mHealth treatment for diabetes distress
This is a mHealth supported, cognitive behavioral treatment for parents and school-age children who were identified with clinically relevant levels of diabetes distress as part of a clinic screening program
|
R2D2 mHealth treatment will use cognitive behavioral therapy, mindfulness, and behavioral activation strategies
|
No Intervention: Standard Care Control
Parents and school-age children who were identified with clinically relevant levels of diabetes distress as part of a clinic screening program will receive local resources (print or electronic).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
youth glycated hemoglobin (HbA1c)
Time Frame: week 0, week 13
|
proxy measure of average glycemic levels over 10-12 weeks
|
week 0, week 13
|
youth time in range
Time Frame: week 0, week 13
|
based on continuous glucose levels, the percentage of time spent between 70-180mg/dl
|
week 0, week 13
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Problem Areas in Diabetes-Child (PAID-C)
Time Frame: week 0, week 13
|
validated child report of diabetes distress; range: 11-66, higher scores reflect greater distress
|
week 0, week 13
|
Parent Problem Areas in Diabetes-Child (P-PAID-C)
Time Frame: week 0, week 13
|
validated parent report of diabetes distress; range 16-96, higher scores reflect greater distress
|
week 0, week 13
|
Diabetes Strengths and Resilience
Time Frame: week 0, week 13
|
validated child report of resilience; range: 12-60, higher scores reflect greater resilience
|
week 0, week 13
|
Brief Resilience Scale
Time Frame: week 0, week 13
|
validated adult report of resilience; range 1-5, higher scores reflect greater resilience
|
week 0, week 13
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Susana R Patton, PhD, Nemours Children's Health
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 23, 2024
Primary Completion (Estimated)
May 1, 2025
Study Completion (Estimated)
August 1, 2025
Study Registration Dates
First Submitted
February 16, 2022
First Submitted That Met QC Criteria
February 24, 2022
First Posted (Actual)
March 7, 2022
Study Record Updates
Last Update Posted (Estimated)
February 29, 2024
Last Update Submitted That Met QC Criteria
February 28, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1687888
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
The investigators may deposit de-identified data in appropriate public repositories in a timely manner once they have published the main findings from the final data set.
The investigators will not share data that may be linked back to individual research participants.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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