- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT04277117
Refeições para mim: controlando o diabetes em casa
Entrega em domicílio de refeições sob medida para melhorar o controle do diabetes
This is a three-arm, parallel randomized trial study that will assess the impact of home delivery of medically-tailored meals (MTM) to community-dwelling older adults living with diabetes mellitus type 2 on measurements of diabetes control, mental health, and other exploratory outcomes such as healthcare use.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
This study aims to:
- Assess the impact of medically-tailored meals program on diabetes management and mental health in comparison to usual care without such program.
- Assess the differential impact of two delivery models being considered for payment by the health system on diabetes management and mental health: once-a-week frozen drop shipment model versus daily warm meal delivery model that is more complex to implement but allows for human connection and easier meal preparation.
Implementation of program:
Meals on Wheels (MoW) of Central Texas (MOWCTX) in Austin, Texas, will provide the meals and delivery service in this study. Meals are all medically tailored (diabetes friendly) and design by MOWCT's team of Registered Dietitians.
Participants:
Older adults, 55 and over, living in the Austin city limits with poorly controlled diabetes; Inclusion criteria:
- Adult 55-90
- Hemoglobin A1C >=7.5 (as measured at baseline)
- Living in Austin city limits and within a MOWCTX daily delivery route
- Interested and available to receive meals during delivery window time
- Has access to a freezer and a microwave
- Pass a MOWCTX background check
Trial:
Eligible participants will be recruited from selected Federally Qualified Health Centers in the Austin area, MOWCTX clients on waitlist, and other (e.g. Medicaid recipients).
Participants will be randomized to one of three arms: 1) Waitlisted control; 2) Weekly frozen drop shipment of MTM 3) Daily Warm delivery of MTM with in-person check-ins during delivery.
Phase 1 (first 6 months) The intervention arms will receive their assigned method of meal delivery (weekly frozen or daily warm), for a total of 10 meals a week, including two main meals per day and snacks. The control arm will not receive any meals during this phase. All arms will receive printed educational materials at baseline.
Phase 2 (month 6 to 12) All arms will receive 2-4 meals a week (depending on participant's availability) delivered via the traditional meal services from MOWCTX, which includes one hot meal plus a snack delivered daily. Meal delivery can also include 1 or more frozen meals to account for a total of 5 meals per week.
Primary outcome is Hemoglobin A1C and secondary outcomes include depression as measured by PHQ-8 and other mental health measures.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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-
Texas
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Austin, Texas, Estados Unidos, 78702
- Meals on Wheels Central Texas
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Austin, Texas, Estados Unidos, 78741
- CommUnityCare Health Centers (all Austin clinics)
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-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Adult 55-90
- Hemoglobin A1c ≥7.5%
- Living in Austin city limits and within a MOWCTX daily delivery route
- Interested and available to receive meals during delivery window time
- Has access to a freezer and a microwave
- Pass a MOWCTX background check
Exclusion Criteria:
- Participated in MOW program in previous 3 months.
- Has any of the following: dementia or cognitive impairment, diagnosis of heart failure, cirrhosis, or active cancer
- Is receiving hospice care
- Does not pass a MOWCTX background check
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Pesquisa de serviços de saúde
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Dobro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Outro: Waitlisted control
Phase 1 (6 months, months 1-6):
Phase 2 (6 months, months 7-12): Standard MOWCTX home meal delivery: 5 meals a week, delivered daily 2 to 4X a week |
Phase 1 (6 months) • Educational materials on such topics as healthy eating for diabetes. Phase 2 (6 months)
|
|
Experimental: "Daily Warm" MTM in-person delivery
Phase 1 (6 months, months 1-6):
Phase 2 (6 months, months 7-12): Standard MOWCTX home meal delivery: 5 meals a week, delivered daily 2 to 4X a week |
Phase 2 (6 months)
Phase 1 (6 months)
|
|
Experimental: "Weekly Frozen" MTM drop shipment
Phase 1 (6 months, months 1-6):
Phase 2 (6 months, months 7-12): Standard MOWCTX home meal delivery: 5 meals a week, delivered daily 2 to 4X a week. |
Phase 2 (6 months)
Phase 1 (6 months)
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Change in Hemoglobin A1C (HbA1c)
Prazo: Baseline to 6 months
|
Finger stick point-of-care portable device. |
Baseline to 6 months
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Change in Hemoglobin A1C
Prazo: Baseline to 9 &12 months, 6 months to 12 months.
|
Finger stick point-of-care portable device. |
Baseline to 9 &12 months, 6 months to 12 months.
|
|
Program meal consumption
Prazo: 6 months, 12 months
|
For frozen and warm meals, self-report on what was actually consumed (customized survey) |
6 months, 12 months
|
|
Diet quality as assessed by NHANES DSQ
Prazo: 6 months, 12 months
|
Self-report of food consumption patterns |
6 months, 12 months
|
|
Loneliness as assessed by scores on the 3-item UCLA Loneliness Scale
Prazo: 6 months, 12 months
|
Respondents rate each item as 'Never' , 'Rarely', 'Sometimes' or 'Often'. Scores range from 3 to 9. Higher numbers imply greater loneliness. |
6 months, 12 months
|
|
Depressive symptoms as assessed by scores on the the 8-item Depression Health Questionnaire (PHQ-8)
Prazo: 6 months, 12 months
|
Respondents answer to eight questions that reflect the DSM-IV diagnosis criteria of depressive disorders. These questions ask how often in the past 2 weeks the respondent had experienced a particular depressive symptom. Each answer is scored from 0 to 3 and then summed. Total scores go from 0 and 24 points, with higher scores indicating greater depressive symptoms. |
6 months, 12 months
|
|
Anxiety symptoms as assessed by the 7-item Generalized Anxiety Disorder Scale (GAD-7)
Prazo: 6 months
|
Investigators will use the Generalized Anxiety Disorder Scale (GAD-7) to measure anxiety. Scored from 0-3, and a score of 0 indicates lower levels of anxiety while a score of 3 indicates higher levels of anxiety. |
6 months
|
|
Diabetes Self-Efficacy as assessed by scores on the Stanford Self-Efficacy for Diabetes Scale 8-item
Prazo: 6 months, 12 months
|
Respondents are asked to score their level of confidence (scale from 1, not at all confident, to 10, totally confident) at the present time in doing tasks related to diabetes management (e.g., diet behavior, physical activity, measuring blood glycemia and others). Higher scores indicate higher self-efficacy. |
6 months, 12 months
|
|
Food security status as assessed by the USDA Food Security Survey Module: Six-Item Short Form
Prazo: 6 months, 12 months
|
Self-reported with a 30-day lookback period. The sum of affirmative responses to the six questions in the module is the household's raw score on the scale. Higher scores indicate greater food insecurity. |
6 months, 12 months
|
|
Health Status and Quality of Life as assessed by scores on Short-form 12-item (SF-12)
Prazo: 6 months, 12 months
|
Measures physical and mental health status. Summary scores range from 0-100, with higher scores indicating a better self-reported level of health. |
6 months, 12 months
|
|
Healthcare delay due to cost
Prazo: 6 months, 12 months
|
Self-report of delaying healthcare due to cost. 1 item. |
6 months, 12 months
|
|
Emergency room visits
Prazo: 6 months, 12 months
|
Self-report of going to a hospital emergency room. |
6 months, 12 months
|
|
Food-basic needs trade-offs (3 items)
Prazo: 6 months, 12 months
|
Self-report of trading off paying for food vs. paying for medicine or medical care, for utilities, and for housing |
6 months, 12 months
|
|
Medication underuse due to cost (2 items)
Prazo: 6 months, 12 months
|
Self-report of not acquiring a prescribed medication or took reduce dosage due to cost. |
6 months, 12 months
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Maninder K Kahlon, PhD, University of Texas at Austin
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças do Sistema Endócrino
- Processos Patológicos
- Atributos da doença
- Doenças Metabólicas
- Distúrbios do Metabolismo da Glicose
- Condições Patológicas, Sinais e Sintomas
- Doenças Nutricionais e Metabólicas
- Diabetes Mellitus
- Doença crônica
- Organização e administração
- Administração de Serviços de Saúde
- Compromissos e cronogramas
- Listas de espera
Outros números de identificação do estudo
- STUDY00002808-2022
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