- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06000813
REACH-Es: Adapting a Digital Health Tool to Improve Diabetes Medication Adherence Among Latino Adults
Study Overview
Status
Intervention / Treatment
Detailed Description
Latino adults have a disproportionate burden of type 2 diabetes and diabetes-related complications. Diabetes medication non-adherence is an important modifiable contributor to suboptimal glycemic management among Latino adults, who are nearly twice as likely to report non-adherence to diabetes medications as non-Hispanic White individuals. Besides language barriers, additional commonly reported barriers that contribute to non-adherence in this population include negative perceptions about insulin use and misunderstanding ongoing need for diabetes medications once HbA1c has improved. Mobile health (mHealth) technology can reduce medication adherence barriers and improve adherence behavior, but mHealth tools that address commonly reported barriers to diabetes medication adherence among Latino adults are lacking. One such mHealth platform is REACH (Rapid Encouragement/Education And Communications for Health), a text message-based tool that improved diabetes medication adherence and glycemic control among English-speaking adults with type 2 diabetes.
This study will evaluate REACH-Español (hereafter "REACH-Es), an mHealth platform adapted from the original REACH intervention that will incorporate qualitative input from Latino adults with type 2 diabetes on barriers to diabetes medication adherence relevant to this population. Specifically, the investigators will conduct a pilot RCT (n=70) to assess feasibility, acceptability, and usability of REACH-Es, as well as intervention targets (diabetes medication adherence and barriers to adherence) comparing REACH-Es to enhanced treatment as usual; secondary outcomes are HbA1c and diabetes self- efficacy. The project will generate preliminary data for an R01 hybrid-effectiveness implementation trial of REACH-Es.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Jacqueline Seiglie
- Phone Number: 714-588-4791
- Email: jseiglie@mgh.harvard.edu
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital Diabetes Research Center
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Principal Investigator:
- Jacqueline Seiglie, MD
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Sub-Investigator:
- Deborah Wexler, MD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Type 2 diabetes mellitus
- Have current or prior (since 2018) HbA1c ≥8.0%
- Take at least one diabetes medication
- Receive care at MGH- affiliated primary care practices (≥2 visits in the past 3 years)
- ≥18 yrs
- Identify as Latino and/or Hispanic
- Speak and read in Spanish as preferred language
- Willing and able to provide informed consent
- Access to a mobile telephone with text messaging capability
- Suboptimal diabetes medication adherence, assessed using the first 2 items in the Adherence to Refill and Medication Scale (ARMS-d) questionnaire combined: "How frequently do you forget or decide to not take your diabetes medications?" Participants who answer sometimes, almost always, and/or always will be considered eligible for the study.
Exclusion Criteria:
- Auditory limitations and/or inability to communicate orally
- Inability to receive, read, or send a text message (assessed by a trained research assistant)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: REACH-Es
Participants in the REACH-Es arm will receive REACH-Es short message service (SMS), as follows: 1) Daily SMS (information related to diet, exercise, self-monitoring of blood glucose, their specific diabetes medication(s), and top 4 medication adherence barriers); 2) Daily two-way SMS (diabetes medication adherence question); 3) Weekly one-way SMS (participants receive weekly feedback on Sunday regarding how many of the last 7 days they took their medicine); 4) A SMS each time an HbA1c is collected with a link to a secure website that displays the result.
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REACH-Español is a mobile health platform adapted from the original REACH intervention to a Latino population with type 2 diabetes.
The goal of REACH-Español is to improve diabetes medication adherence and glycemic management in this population.
Other Names:
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Active Comparator: Enhanced treatment as usual (ETAU)
Participants will maintain care as usual (medication treatment and physician monitoring) in addition to a welcome SMS following enrollment, a SMS each time an HbA1c is collected with a link to a secure website that displays the result, and bi-monthly information on diabetes self-care education.
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Participants will maintain care as usual (medication treatment and physician monitoring) in addition to a welcome SMS following enrollment, a SMS each time an HbA1c is collected with a link to a secure website that displays the result, and bi-monthly information on diabetes self-care education.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility (recruitment rate)
Time Frame: Collected at 0 months
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Number of eligible participants who enroll/ Number of eligible participants who are contacted and reached by phone
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Collected at 0 months
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Feasibility (response rate to 2-way text messages)
Time Frame: Collected at 3 and 6 months
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Number of 2-way text messages answered/ Number of 2-way text messages received
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Collected at 3 and 6 months
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Feasibility (retention rate)
Time Frame: Collected at 3 and 6 months
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Number of participants enrolled in the study at follow-up/ Number of participants enrolled at the start of the study
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Collected at 3 and 6 months
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Acceptability
Time Frame: Collected at 3 and 6 months
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Assessed quantitatively based on utility of REACH-Es on a 0-10 Likert scale and qualitatively through exit interviews.
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Collected at 3 and 6 months
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Usability
Time Frame: Collected at 3 and 6 months
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Assessed quantitatively by administering the 10-item Spanish version of the System Usability Scale (SUS) questionnaire, scored on a 0-5 Likert-type scale.
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Collected at 3 and 6 months
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Diabetes Medication adherence
Time Frame: Collected at 0, 3, and 6 months
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Assessed using the 11-item Adherence to Refill and Medication Scale (ARMS-d) questionnaire scored on a 0-4 Likert scale (range 12-48).
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Collected at 0, 3, and 6 months
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IMB barrier sum score
Time Frame: Collected at 0, 3, and 6 months
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Calculated by rating each barrier item on a 0-10 scale (1=never to 10=a lot) and identifying each participant's 4 highest- scored barriers (range 4-40).
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Collected at 0, 3, and 6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
HbA1c
Time Frame: Collected at 0, 3, and 6 months
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The HbA1c collection will be done through: 1) EHR review if available <3 weeks from the enrollment visit, 2) point-of-care testing; or) clinical lab draw.
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Collected at 0, 3, and 6 months
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Diabetes self-efficacy
Time Frame: Collected at 0, 3, and 6 months
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Assessed by administering the 8-item Spanish Diabetes Self-Efficacy questionnaire (0-10 Likert scale).
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Collected at 0, 3, and 6 months
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jacqueline Seiglie, Massachusetts General Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2023p001968
- 1K23DK135798-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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