Cardiovascular Disease Education and Problem-Solving Training in People With Type 2 Diabetes (DECIDE)
2015年5月11日 更新者:Felicia Hill-Briggs、Johns Hopkins University
Randomized Trial of CVD Education and Problem-Solving Training in Urban Diabetics
The purpose of this study is to determine if patient education and problem-solving training, delivered in self-study, group, and individual intervention modalities, will produce substantial improvements in CVD risk profile via improved self management in urban African Americans with type 2 diabetes and a high CVD risk profile.
調査の概要
状態
完了
条件
詳細な説明
African Americans with type 2 diabetes suffer excess disease burden, but cardiovascular disease (CVD) risk factors such as hyperglycemia, hypertension, and dyslipidemia are modifiable with medical management and lifestyle modification.
Patient diabetes education and counseling for behavior change are recommended standards of practice to facilitate effective self-management of these risk factors.
However, for patients with low literacy or health literacy, accessibility and impact of educational and behavioral interventions are limited.
Pilot research suggests that: a) literacy demand and behavioral activation characteristics of patient education modules can be adapted to facilitate learning in urban patients with low literacy, and b) combining literacy-adapted education with problem-solving training facilitates understanding and use of health information for performing self-management in the context of daily life (functional health literacy).
Optimal modalities for delivery of a combined patient diabetes education and problem-solving training, and cost-effectiveness of this intervention model, however, are not known.
The proposed study will address these needs by testing effectiveness and cost-effectiveness of literacy-adapted diabetes and CVD education and problem-solving training interventions in urban African Americans with type 2 diabetes and high CVD risk profile (suboptimal blood sugar, blood pressure, and/or lipids).
The specific aims of the study are: a) to complete development of a package of literacy-adapted diabetes and CVD patient education materials by developing two video/DVDs addressing self-management recommendations appropriate to the needs, resources, and environment of the population; b) to randomize urban African-American adults with type 2 diabetes and a high CVD risk profile into one of four study arms: Usual Care (Arm 1), Literacy-Adapted Education and Problem-Solving Training Self-Study (Arm 2), Literacy-Adapted Education and Group Problem-Solving Training (Arm 3), and Literacy-Adapted Education and Individual Problem-Solving Training (Arm 4); c) to conduct baseline, 3-month post-intervention, and 6-month post-intervention assessment visits to analyze and compare effectiveness of the literacy-adapted education and problem-solving interventions, as compared to Usual Care, in improving the skills of knowledge, problem-solving and health literacy, behaviors of patient activation and diabetes self-management, and clinical outcomes of A1C, blood pressure and lipids; and d) to perform a cost-effectiveness analysis of each intervention arm as compared to Usual Care.
If proven effective, this research will yield low literacy diabetes and CVD patient education and self-management intervention tools for dissemination to high-risk urban minority populations.
Moreover, the cost-effectiveness analysis will provide evidence to support decision-making regarding implementation of the models to achieve cardiovascular disease patient self-management goals in clinical practice.
研究の種類
介入
入学 (実際)
382
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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Maryland
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Baltimore、Maryland、アメリカ、21205
- Johns Hopkins School of Medicine/General Clinical Research Center
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Baltimore、Maryland、アメリカ、21224
- Johns Hopkins Bayview Medical Center/General Clinical Research Center
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Baltimore、Maryland、アメリカ、21287
- Johns Hopkins School of Medicine/General Internal Medicine
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
25年歳以上 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
Age 25 years or older
- Type 2 diabetes determined by physician diagnosis or self-report of type 2 diabetes confirmed by medical documentation or medication review
- Black/African American by self-report
- currently receiving care and able to provide contact information for a treating physician
- residing in Baltimore, Maryland.
Exclusion Criteria:
- Mentally incompetent to give informed consent
- Severe cognitive impairment on the Telephone Interview for Cognitive Status
- Unable to complete assessment (interview, tests, venipuncture)
- Comorbid conditions likely to lead to death in the next 3-5 years (e.g. cancer, AIDS, end-stage renal disease, active tuberculosis, Alzheimer's disease)
- Planning to relocate from Baltimore region during the time period of the study or other reasons rendering person unable to attend visits to participate in intervention and follow-up assessments
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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アクティブコンパレータ:Usual Care
Packet of standard print patient education materials on CVD and diabetes from the American Heart Association (AHA) and the American Diabetes Association (ADA).
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他の名前:
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実験的:Self Study
One 90-minute educational session.
Print materials and DVDs for self-study
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他の名前:
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実験的:Group Problem-Solving Training
One 90-minute education session.
Group problem-solving training (eight, 90-minute sessions)
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他の名前:
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実験的:Individual Problem-Solving Training
One 90-minute education session.
Individual problem-solving training (eight, 60-minute sessions)
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他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
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HbA1C
時間枠:Screening, 3 months post intervention, 6 months post-intervention
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Screening, 3 months post intervention, 6 months post-intervention
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二次結果の測定
結果測定 |
時間枠 |
---|---|
Blood pressure
時間枠:Screening, 3 months post-intervention, 6 months post-intervention
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Screening, 3 months post-intervention, 6 months post-intervention
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Lipid Panel
時間枠:Screening, 3 months post-intervention, 6 months post-intervention
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Screening, 3 months post-intervention, 6 months post-intervention
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Body Mass Index
時間枠:Screening, 3 months post-intervention, 6 months post-intervention
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Screening, 3 months post-intervention, 6 months post-intervention
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Health Problem Solving Scale
時間枠:Screening, 1 week post-intervention, 3 months post-intervention, 6 months post-intervention
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Screening, 1 week post-intervention, 3 months post-intervention, 6 months post-intervention
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Diabetes and CVD Knowledge Test
時間枠:Screening, 3 months post-intervention, 6 months post-intervention
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Screening, 3 months post-intervention, 6 months post-intervention
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Patient Activation Measure
時間枠:Baseline, 3 months post-intervention, 6 months post-intervention
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Baseline, 3 months post-intervention, 6 months post-intervention
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Summary of Diabetes Self-Care Activities Scale
時間枠:Baseline, 3 months post-intervention, 6 months post-intervention
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Baseline, 3 months post-intervention, 6 months post-intervention
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Barriers to Self-Management
時間枠:Baseline, 1 week post-intervention, 3 months post-intervention, 6 months post-intervention
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Baseline, 1 week post-intervention, 3 months post-intervention, 6 months post-intervention
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
捜査官
- 主任研究者:Felicia Hill-Briggs, PhD, ABPP、Johns Hopkins School of Medicine
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Hill-Briggs F. Problem solving in diabetes self-management: a model of chronic illness self-management behavior. Ann Behav Med. 2003 Summer;25(3):182-93. doi: 10.1207/S15324796ABM2503_04.
- Hill-Briggs F, Gemmell L. Problem solving in diabetes self-management and control: a systematic review of the literature. Diabetes Educ. 2007 Nov-Dec;33(6):1032-50; discussion 1051-2. doi: 10.1177/0145721707308412.
- Hill-Briggs F, Smith AS. Evaluation of diabetes and cardiovascular disease print patient education materials for use with low-health literate populations. Diabetes Care. 2008 Apr;31(4):667-71. doi: 10.2337/dc07-1365. Epub 2008 Jan 17.
- Hill-Briggs F, Gemmell L, Kulkarni B, Klick B, Brancati FL. Associations of patient health-related problem solving with disease control, emergency department visits, and hospitalizations in HIV and diabetes clinic samples. J Gen Intern Med. 2007 May;22(5):649-54. doi: 10.1007/s11606-006-0091-2.
- Hill-Briggs F, Renosky R, Lazo M, Bone L, Hill M, Levine D, Brancati FL, Peyrot M. Development and pilot evaluation of literacy-adapted diabetes and CVD education in urban, diabetic African Americans. J Gen Intern Med. 2008 Sep;23(9):1491-4. doi: 10.1007/s11606-008-0679-9. Epub 2008 Jun 3.
- Majid HM, Schumann KP, Doswell A, Sutherland J, Hill Golden S, Stewart KJ, Hill-Briggs F. Development and evaluation of the DECIDE to move! Physical activity educational video. Diabetes Educ. 2012 Nov-Dec;38(6):855-9. doi: 10.1177/0145721712462748. Epub 2012 Oct 4. Erratum In: Diabetes Educ. 2013 Jul-Aug;39(4):586.
- Hill-Briggs F, Schumann KP, Dike O. Five-step methodology for evaluation and adaptation of print patient health information to meet the < 5th grade readability criterion. Med Care. 2012 Apr;50(4):294-301. doi: 10.1097/MLR.0b013e318249d6c8.
- Fitzpatrick SL, Schumann KP, Hill-Briggs F. Problem solving interventions for diabetes self-management and control: a systematic review of the literature. Diabetes Res Clin Pract. 2013 May;100(2):145-61. doi: 10.1016/j.diabres.2012.12.016. Epub 2013 Jan 9.
- Fitzpatrick SL, Golden SH, Stewart K, Sutherland J, DeGross S, Brown T, Wang NY, Allen J, Cooper LA, Hill-Briggs F. Effect of DECIDE (Decision-making Education for Choices In Diabetes Everyday) Program Delivery Modalities on Clinical and Behavioral Outcomes in Urban African Americans With Type 2 Diabetes: A Randomized Trial. Diabetes Care. 2016 Dec;39(12):2149-2157. doi: 10.2337/dc16-0941.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2010年8月1日
一次修了 (実際)
2014年2月1日
研究の完了 (実際)
2014年2月1日
試験登録日
最初に提出
2009年8月24日
QC基準を満たした最初の提出物
2009年8月24日
最初の投稿 (見積もり)
2009年8月25日
学習記録の更新
投稿された最後の更新 (見積もり)
2015年5月12日
QC基準を満たした最後の更新が送信されました
2015年5月11日
最終確認日
2015年5月1日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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