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.
研究概览
地位
完全的
条件
详细说明
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.
研究类型
介入性
注册 (实际的)
382
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
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Maryland
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Baltimore、Maryland、美国、21205
- Johns Hopkins School of Medicine/General Clinical Research Center
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Baltimore、Maryland、美国、21224
- Johns Hopkins Bayview Medical Center/General Clinical Research Center
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Baltimore、Maryland、美国、21287
- Johns Hopkins School of Medicine/General Internal Medicine
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-
参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
25年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
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
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
有源比较器: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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其他名称:
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实验性的:Self Study
One 90-minute educational session.
Print materials and DVDs for self-study
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其他名称:
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实验性的:Group Problem-Solving Training
One 90-minute education session.
Group problem-solving training (eight, 90-minute sessions)
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其他名称:
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实验性的:Individual Problem-Solving Training
One 90-minute education session.
Individual problem-solving training (eight, 60-minute sessions)
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其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
HbA1C
大体时间: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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次要结果测量
结果测量 |
大体时间 |
---|---|
Blood pressure
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员:Felicia Hill-Briggs, PhD, ABPP、Johns Hopkins School of Medicine
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- 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.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2010年8月1日
初级完成 (实际的)
2014年2月1日
研究完成 (实际的)
2014年2月1日
研究注册日期
首次提交
2009年8月24日
首先提交符合 QC 标准的
2009年8月24日
首次发布 (估计)
2009年8月25日
研究记录更新
最后更新发布 (估计)
2015年5月12日
上次提交的符合 QC 标准的更新
2015年5月11日
最后验证
2015年5月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
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