Enhancing Adherence in Type 2 Diabetes: The ENHANCE Study (ENHANCE)
Enhancing Adherence in Type 2 Diabetics
This randomized study will test a behavioral intervention, based on social cognitive theory (SCT), to improve regimen adherence in three different groups of people with type 2 diabetes; (1) those with well controlled blood glucoses and no concurrent chronic renal insufficiency, (2) those with less well-controlled glucoses and no chronic renal insufficiency, and (3) those with chronic renal insufficiency regardless of glucose control. The primary aims of this study are to: (1)determine whether the intervention improves behavioral adherence to the diabetes self-management regimen including dietary adherence, physical activity, and capillary glucose self-monitoring; (2)determine whether the intervention improves clinical outcomes; (3) explore the extent to which self-efficacy is a mediator of adherence,(4) explore the extent to which the effectiveness of the intervention varies with respect to glycemic control and nephrovascular complications at baseline, and (5)explore the impact of a variety of covariates on the effectiveness of the intervention.
Hypothesis #1 is that intervention group participants will perform better than attention control group participants on various measures of adherence to the diabetes management regimen. Primary adherence variables will be dietary intake, and physical activity. Hypothesis #2 is that intervention group participants will have lower HbA1c levels than attention control group participants.
Обзор исследования
Статус
Вмешательство/лечение
Подробное описание
This randomized study, the ENHANCE Study (Enhancing Adherence to Diabetes Self-Management) will test a behavioral intervention, based on social cognitive theory (SCT), to improve regimen adherence in three different groups of people with type 2 diabetes; (1) HbA1c < 8% and no concurrent chronic renal insufficiency, (2) HbA1c>8% and no chronic renal insufficiency, and (3) those with evidence of chronic renal insufficiency regardless of glucose control.
The primary aims of this study are to:
- . Determine whether the intervention improves behavioral adherence to the diabetes self-management regimen including: 1.a. dietary adherence, as measured by self-report using dietary recalls and the Nutrient Data System, 1.b. physical activity as measured by the CHAMPS Physical Activity Questionnaire as well as pedometer readings, and 1.c. adherence to capillary glucose self-monitoring as assessed by the FreeStyle monitor.
- . Determine whether the intervention improves clinical outcome measures including: 2.a. glycosylated hemoglobin levels (HbA1c), 2.b. weight loss, 2.c. anthropometrics.
- . Explore the extent to which self-efficacy is a mediator of adherence.
- . Explore the extent to which the effectiveness of the intervention varies with respect to glycemic control and nephrovascular complications at baseline.
- . Explore the impact of a variety of covariates (medications, depression, social support, severity of disease, and general health and sociodemographic characteristics, clinic from which they were recruited, health literacy, and trust in research) on the effectiveness of the intervention.
Hypothesis #1 is that intervention group participants will perform better than attention control group participants on various measures of adherence to the diabetes management regimen. Primary behavioral adherence variables will be dietary intake, and physical activity. Hypothesis #2 is that intervention group participants will have lower HbA1c levels than attention control group participants.
The 6-month intervention includes group classes, held weekly during months 1&2, biweekly during months 3&4, and monthly during month 5&6. Classes focus on building a sense of mastery over the diabetes regimen and features the use of PDA-base dietary self-monitoring. Intervention group participants are compared to an attention care group, that receives monthly contacts. Measurements are made at baseline, 3, and 6 months.
Тип исследования
Регистрация (Ожидаемый)
Фаза
- Непригодный
Контакты и местонахождение
Места учебы
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, Соединенные Штаты, 15213
- University of Pittsburgh School of Medicine
-
-
Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
Inclusion Criteria: Study subjects will include those with: type 2 diabetes mellitus defined according to the 1997 ADA criteria and age of 18 years or greater. We will sample from three different patient populations: (1) 96 individuals who have HbA1c < 8%, and no evidence of chronic renal insufficiency (a serum creatinine <1.3mg/dl for women and <1.5mg/dl for men). (2) 96 individuals with HbA1c > 8%, and no evidence of chronic renal insufficiency, and (3) 96 individuals with evidence of chronic renal insufficiency (a serum creatinine >1.3mg/dl for women and >1.5mg/dl for men, but who have not yet progressed to dialysis), regardless of HbA1c level.
-
Exclusion Criteria: Exclusion criteria were selected to enhance safety and ability to complete the study protocol. They include: (1) history of hypoglycemic coma/seizure within the last 12 months, (2) hypoglycemia requiring 3rd party assistance within the last 3 months, (3) history consistent with type 1 diabetes, (4) unwillingness to do capillary blood testing using the FreeStyle monitor, (5) unwillingness or inability to participate in scheduled group classes or individual counseling sessions, (7) subjects currently on renal dialysis, (8) any factors likely to preclude adherence to the study protocol including dementia, alcohol or substance abuse, plan to move within the next 8 months, lack of support from the subject's primary health care provider (i.e. PCP is aware of significant risks such as extreme variation in blood glucoses and/or comorbidities that would make participation in the study unsafe), failure to obtain informed consent from the participant, current participation in another clinical trial, and (9) subjects who are not available by telephone during the hours of 8am to 6pm.
-
Учебный план
Как устроено исследование?
Детали дизайна
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Нет (открытая этикетка)
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
|---|---|
|
Активный компаратор: A
Attention control
|
Participants attend 3 educational seminars, receive a lay diabetes journal, pedometer, and glucose monitoring supplies.
|
|
Экспериментальный: B
Intervention
|
Behavioral intervention of diabetes self-management paired with PDA-based monitoring of dietary intake and physical activity.
Participants also receive a pedometer and glucose self-monitoring supplies.
|
Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Временное ограничение |
|---|---|
|
Physical activity CHAMPS
Временное ограничение: Baseline, 3 and 6 months
|
Baseline, 3 and 6 months
|
|
Glycemic control - HbA1c
Временное ограничение: Baseline, 3 and 6 months
|
Baseline, 3 and 6 months
|
|
Dietary adherence
Временное ограничение: Baseline, 3 and 6 months
|
Baseline, 3 and 6 months
|
Вторичные показатели результатов
Мера результата |
Временное ограничение |
|---|---|
|
Adherence to capillary glucose checks - glucometer uploads
Временное ограничение: Baseline, 3 and 6 months
|
Baseline, 3 and 6 months
|
|
Weight loss
Временное ограничение: Baseline, 3 and 6 months
|
Baseline, 3 and 6 months
|
|
BMI
Временное ограничение: Baseline, 3 and 6 months
|
Baseline, 3 and 6 months
|
|
Waist circumference
Временное ограничение: Baseline, 3 and 6 months
|
Baseline, 3 and 6 months
|
Соавторы и исследователи
Спонсор
Следователи
- Главный следователь: Mary A Sevick, ScD, RN, University of PIttsburgh & Veterans Health Administration
Публикации и полезные ссылки
Даты записи исследования
Изучение основных дат
Начало исследования
Первичное завершение (Действительный)
Завершение исследования (Действительный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Оценивать)
Обновления учебных записей
Последнее опубликованное обновление (Оценивать)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
Другие идентификационные номера исследования
- NIH-R01-NR008792
Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .
Клинические исследования Attention control
-
Butler HospitalNational Institute of Mental Health (NIMH)ЗавершенныйСильное депрессивное расстройствоСоединенные Штаты
-
Arizona State UniversityFoundation for Professional DevelopmentРекрутинг
-
St. Jude Children's Research HospitalАктивный, не рекрутирующийОстрый лимфобластный лейкоз | Исполнительная дисфункция | Транскраниальная стимуляция постоянным токомСоединенные Штаты
-
Aristotle University Of ThessalonikiРекрутингДислексия | Проблемы старенияГреция
-
University of Southern MississippiMilitary Suicide Research ConsortiumЗапись по приглашениюСуицидальные мысли | Чувствительность к тревогеСоединенные Штаты
-
Rethink Medical SLРекрутингКачество жизни | Осложнение, связанное с катетером | Катетер-ассоциированная инфекция мочевыводящих путейИспания
-
University of North Texas Health Science CenterNational Institute on Aging (NIA); University of Texas Southwestern Medical CenterРекрутингЛегкое когнитивное нарушение | Нарушение памятиСоединенные Штаты
-
Rethink Medical SLОтозванЗадержка мочи | Катетерные осложнения | Катетер-ассоциированная инфекция мочевыводящих путейИспания
-
Johns Hopkins UniversityЗавершенный
-
University of Colorado, DenverЗавершенныйСердечно-сосудистые заболевания | Диабет | Преждевременные роды | Избыточный вес и ожирение | Преэклампсия | Сахарный диабет при беременности | Маленький для гестационного возраста при родах | Гестационная гипертензияСоединенные Штаты