OASIS: Peer Support for T2DM in Appalachia (Peer Coaches) (OASIS)

Older Adults Using Social Support to Improve Self-Care: Adaptation, Implementation, and Feasibility of Peer Support for Older Adults With T2DM in Appalachia.

The goal of this clinical trial is to compare the effects of peer coaching models in older adults with unmanaged type two diabetes. The main questions it aims to answer are:

  • Are peer coaching models effective at promoting Type 2 Diabetes Mellitus self-management?
  • If effective, which facets of the peer model are most effective? Peer coaches will undergo peer coach training.
  • Reach out to peer participants on a weekly/biweekly time frame to discuss self-management and goal setting.
  • Retain records of contact, topics discussed, and general notes on interactions. Researchers will compare differences in the frequency of contact, as well as how peer coaches were matched to peer participants to see if efficacy of the intervention is altered between groups.

Study Overview

Detailed Description

The Older Adults using Social Support to Improve Self-Care (OASIS) intervention is an asset-based approach, utilizing the unique social structure existing in Kentucky's rural Appalachian communities to address self-care behaviors as they relate to Type 2 Diabetes Mellitus (T2DM) management. The intervention will be composed of two groups: peer coaches who have managed T2DM (HbA1c < 7.5%), and peer participants who have unmanaged T2DM (HbA1c ≥ 7.5%). Peer coaches will undergo training prior to intervention initiation to develop coaching skills. Peer participants will be linked to a peer coach in one of four ways: (1) self-select coach with contact once a week (2) self-selected coach with contact every 2 weeks (3) matched with peer coach with contact once a week (4) matched with peer coach with contact every 2 weeks. In addition to evaluating the effectiveness of a peer coaching model, the four groups will be evaluated allowing for a more detailed understanding of factors that influence self-care behaviors. Stakeholders will also be engaged at three time points: prior to the intervention, study mid-point, and at study conclusion. At study conclusion, a small cohort of both peer participants and peer coaches will be invited to contribute to stakeholder group interviews. Information exchange with stakeholders will aid in developing a robust understanding of influential factors and how to effectively promulgate the intervention.

Study Type

Interventional

Enrollment (Estimated)

25

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

Study Contact Backup

Study Locations

    • Kentucky
      • Bowling Green, Kentucky, United States, 42101
        • Recruiting
        • Barren River Area Development District
        • Contact:
      • Hazard, Kentucky, United States, 41701
        • Recruiting
        • UK HealthCare
        • Contact:

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Study Population

  • Age greater than or equal to 55 years
  • Resident in Rural Kentucky
  • Positive diagnosis of Type 2 Diabetes Mellitus
  • HbA1c less than 7.5 for peer coaches
  • Passing score on cognitive assessment administered by study personnel
  • English Speaking

Description

Inclusion Criteria:

  • Age greater than or equal to 55 years
  • Resident in Rural Kentucky
  • Positive diagnosis of Type 2 Diabetes Mellitus
  • HbA1c less than 7.5 for peer coaches
  • Passing score on cognitive assessment administered by study personnel
  • English Speaking

Exclusion Criteria:

  • Age less than 55 years
  • Not a resident of a Rural Kentucky County
  • No Type 2 Diabetes Mellitus Diagnosis
  • Cognitive Impairment
  • Non-English Speaking

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: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Peer Participants (A)
Peer participants in group A will self select a peer coach using peer coach profile sheets, and will be contacted weekly during the intervention period.
Peer participants in group A will be contacted by peer coaches on a weekly basis.
Experimental: Peer Participants (B)
Peer participants in group B will self select a peer coach using peer coach profile sheets, and will be contacted every 2 weeks during the intervention period.
Peer participants in group B will be contacted by peer coaches on a bi-weekly basis.
Experimental: Peer Participants (C)
Peer participants in group C will be matched with a peer coach and will be contacted weekly during the intervention period.
Peer participants in group C will be contacted by peer coaches on a weekly basis.
Experimental: Peer Participants (D)
Peer participants in group D will be matched with a peer coach and will be contacted every 2 weeks during the intervention period.
Peer participants in group D will be contacted by peer coaches on a bi-weekly basis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants with Change in A1c
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Obtained using point of care assessment
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diabetes Empowerment
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Attitudes Towards Diabetes - DES". 5 point scale ranging from 1 "Strongly Agree" to 5 "Strongly Disagree", where lower scores indicate greater feelings of empowerment.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Quality of Life Index
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"EuroQofL-5D" measures acts of daily living (ADL) on a five point scale ranging from 0 "no" problems to 5 "extreme" problems, where higher scores indicate lower ability to engage in ADL.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Social Support
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"MOS Social Support Survey" a five point scale ranging from 1 "none of the time" to 5 "all of the time" where higher scores indicate better social support.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Depression Scale
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Geriatric Depression Scale: Short Form" is a binary survey where participants can select "yes" or "no". Each "yes" is a singular point, if a score >5 points it is suggestive about depression and warrant a follow-up comprehensive assessment. A score of greater than or equal to 10 is almost always indicative of depression.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Problem Areas in Diabetes
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Problem Areas In Diabetes (PAID) Scale" a five point scale ranging from 0 "not a problem" to 4 "serious problem", where a higher score indicates more problems in diabetes management.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Diabetes Self-Management
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Diabetes Self-Management Questionnaire (DSMQ) is a four point scale ranging from 0 "does not apply to me" to 3 "applies to me very much". Higher scores indicate better diabetes management.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Social Network Scale
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Lubbens Social Network Scale - 6 (LSNS-6) is a five point scale ranging from "0" none to "5" nine or more. Higher scores indicate greater amount of social support.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Diabetes Knowledge Questionnaire
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Diabetes Knowledge Questionnaire (DKQ)" is a 24-item survey that has shown sensitivity to a diabetes knowledge intervention; additionally, it targets knowledge deficits which can be related to measurable outcomes, false statements, or common and/or serious misconceptions. Participants can select "yes", "no", or "don't know".
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Problem Solving Skills
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Diabetes Problem-Solving Inventory (DPSI)" includes 9 items that assess how individuals living with diabetes cope with challenges of T2D-related self-care. The inventory measures three components: healthy eating, physical activity, and stress management. Overall problem-solving rating is provided on a 5-point scale from 1 "(very poor strategy)" to 5 "(excellent strategy)".
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Brooks Medication Adherence
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Brooks Medication Adherence Scale" is a 6-item scale and is sensitive to changes in adherence due to intervention.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Frailty
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Pictorial Fit-Frail Scale" measures frailty phenotype using a validated assessment that characterizes frailty by exhaustion, low physical activity, weakness, and low body mass index. Individuals are characterized as frail if they have affirmative responses to 3 or 4 of the items. By identifying frailty phenotype, individuals at increased risk for adverse health outcomes can be identified, which serves as an indicator for complex patient management.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Acts of Daily Living
Time Frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
"Lawton-Brody Instrumental Activities of Daily Living Scale (I.A.D.L.) is a binary where "0" is low functioning and "1" is high functioning. Higher scores indicate higher functioning.
Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Brittany L. Smalls, PhD, University of Texas Medial Branch

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

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)

November 20, 2023

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

March 31, 2027

Study Registration Dates

First Submitted

July 31, 2023

First Submitted That Met QC Criteria

August 14, 2023

First Posted (Actual)

August 22, 2023

Study Record Updates

Last Update Posted (Actual)

June 17, 2026

Last Update Submitted That Met QC Criteria

June 15, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

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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