从诊所到社区研究 (C2C)
从诊所到社区:使用同伴支持作为改善长期糖尿病相关健康结果的过渡模型
研究概览
详细说明
这项两阶段研究是一项随机对照试验 (RCT),将常规护理与旨在改善长期糖尿病相关健康结果的为期 12 个月的同行主导的 DSMS 干预进行比较。
在第 1 阶段,研究团队将实施 30 小时的同伴领导培训 (PLT) 计划,招募患有 2 型糖尿病的成年人,并为他们提供糖尿病知识、促进策略和沟通技巧,以提供 DSMS 干预。 在第 2 阶段,研究人员将进行同伴支持干预,称为以同伴为主导、基于赋权的糖尿病自我管理方法 (PLEASED)。 随机分配到 PLEASED 组的患者将与同伴领导配对,并在头 3 个月内从他们的同伴领导 (PL) 那里获得 12 次每周一次的联系(面对面和电话支持),随后是 18 次每两周一次的电话支持联系最近 9 个月。
PLEASED 干预的目标是帮助患者改善血糖控制和糖尿病特异性 QOL,并长期维持这些健康益处。 为实现这一目标,PL 将解决同伴支持的 3 个关键功能,包括协助患者进行糖尿病的日常管理、提供社交和情感支持以及将患者与临床护理资源联系起来。
参与者的入选标准是:(1) 患有 2 型糖尿病,(2) 年满 21 岁,(3) 会说英语或越南语或他们的同行领导会说的任何语言,(4) 愿意与同行领导配对, (5) 拥有个人固定电话或手机。
同行领导的入选标准是:(1) 患有糖尿病,(2) 21 岁,(3) 会说英语,(4) 有交通工具参加培训,(5) 愿意参加 30 小时的培训计划, (6) 有固定电话或移动电话 (7) 自我报告的 HbA1c 为 8% 或更低。
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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British Columbia
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Vancouver、British Columbia、加拿大、V5Z 1M9
- Vancouver Coastal Health
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
描述
参与者的入选标准:
要符合研究资格,患者必须:
- 患有2型糖尿病,
- 21岁,
- 会说英语或越南语或他们的同行领导会说的任何语言,
- 愿意与同行领导相匹配,并且
- 有个人固定电话或移动电话。
参与者的排除标准:
- 如果他们有身体限制、严重的健康状况或酒精或药物成瘾,他们不应该参加研究,这会阻碍有意义地参与研究。
同行领导者的入选标准:
- 患有糖尿病,
- 21岁,
- 说英语,
- 有交通工具参加培训,
- 愿意参加 30 小时的培训计划,并且
- 有座机或手机
- 自我报告的 HbA1c 为 8% 或更低。
同行领导者的排除标准:
- 如果他们有身体限制、严重的健康状况或酒精或药物成瘾,他们不应该参加研究,这会阻碍有意义地参与研究。
学习计划
研究是如何设计的?
设计细节
- 主要用途:支持治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:高兴
PLEASED 干预组将接待接受过我们培训的糖尿病患者同行领导。
此外,他们将获得 3 次免费健康检查(基线、3 个月、12 个月)以及对他们所付出的时间和努力的金钱补偿。
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研究人员将对控制良好的 2 型糖尿病患者进行培训,并将他们与参与者配对。
同行领导者将帮助参与者克服他们的问题,并教他们如何通过 5 步目标设定策略做出改变。
同行领导从不就任何医疗状况提供建议。
所有医疗问题都将提交给研究团队。
其他名称:
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无干预:候补名单
候补名单将获得三项免费健康检查(基线、3 个月、12 个月),并为其付出的时间和努力提供金钱补偿。
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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 |
|---|---|
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HbA1c% 的变化
大体时间:0、3、12 个月
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0、3、12 个月
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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载脂蛋白B
大体时间:0、3、12 个月
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0、3、12 个月
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其他结果措施
结果测量 |
大体时间 |
|---|---|
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糖尿病特异性 QoL 的变化
大体时间:0、3、12 个月
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0、3、12 个月
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血压
大体时间:0、3、12 个月
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0、3、12 个月
|
|
高度
大体时间:0、3、12 个月
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0、3、12 个月
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重量
大体时间:0、3、12 个月
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0、3、12 个月
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合作者和调查者
调查人员
- 首席研究员:Tricia S Tang, PhD、University of British Columbia
出版物和有用的链接
一般刊物
- Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998 Sep 12;352(9131):837-53. Erratum In: Lancet 1999 Aug 14;354(9178):602.
- Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999 Nov 10;282(18):1737-44. doi: 10.1001/jama.282.18.1737.
- Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000 Jul;23(7):943-50. doi: 10.2337/diacare.23.7.943.
- Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26. doi: 10.1111/j.1475-6773.2004.00269.x.
- Glasgow RE, Boles SM, McKay HG, Feil EG, Barrera M Jr. The D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results. Prev Med. 2003 Apr;36(4):410-9. doi: 10.1016/s0091-7435(02)00056-7.
- Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, Jackson RA. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005 Mar;28(3):626-31. doi: 10.2337/diacare.28.3.626.
- Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group. J Pediatr. 1994 Aug;125(2):177-88. doi: 10.1016/s0022-3476(94)70190-3.
- Philis-Tsimikas A, Fortmann A, Lleva-Ocana L, Walker C, Gallo LC. Peer-led diabetes education programs in high-risk Mexican Americans improve glycemic control compared with standard approaches: a Project Dulce promotora randomized trial. Diabetes Care. 2011 Sep;34(9):1926-31. doi: 10.2337/dc10-2081. Epub 2011 Jul 20.
- Lorig K, Ritter PL, Laurent DD, Plant K, Green M, Jernigan VB, Case S. Online diabetes self-management program: a randomized study. Diabetes Care. 2010 Jun;33(6):1275-81. doi: 10.2337/dc09-2153. Epub 2010 Mar 18.
- Lorig K, Ritter PL, Villa FJ, Armas J. Community-based peer-led diabetes self-management: a randomized trial. Diabetes Educ. 2009 Jul-Aug;35(4):641-51. doi: 10.1177/0145721709335006. Epub 2009 Apr 30.
- Norris SL, Nichols PJ, Caspersen CJ, Glasgow RE, Engelgau MM, Jack L, Snyder SR, Carande-Kulis VG, Isham G, Garfield S, Briss P, McCulloch D. Increasing diabetes self-management education in community settings. A systematic review. Am J Prev Med. 2002 May;22(4 Suppl):39-66. doi: 10.1016/s0749-3797(02)00424-5.
- Padgett D, Mumford E, Hynes M, Carter R. Meta-analysis of the effects of educational and psychosocial interventions on management of diabetes mellitus. J Clin Epidemiol. 1988;41(10):1007-30. doi: 10.1016/0895-4356(88)90040-6.
- Deakin T, McShane CE, Cade JE, Williams RD. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003417. doi: 10.1002/14651858.CD003417.pub2.
- Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, Fisher EB, Hanson L, Kent D, Kolb L, McLaughlin S, Orzeck E, Piette JD, Rhinehart AS, Rothman R, Sklaroff S, Tomky D, Youssef G; 2012 Standards Revision Task Force. National standards for diabetes self-management education and support. Diabetes Care. 2013 Jan;36 Suppl 1(Suppl 1):S100-8. doi: 10.2337/dc13-S100. No abstract available.
- Anderson G, Horvath J. The growing burden of chronic disease in America. Public Health Rep. 2004 May-Jun;119(3):263-70. doi: 10.1016/j.phr.2004.04.005. No abstract available.
- Fischman J. Who will take care of you? US News World Rep. 2005 Jan 31-Feb 7;138(4):44-6. No abstract available.
- Institute of Medicine of the National Academies (report). Crossing the quality chasm: A new heart system for the 21st century/Committee on Quality Health Care in America. Washington, DC. National Academy Press, 2001.
- Reported by Joanne Currie, Executive Director of Canadian Diabetes Educators Certification Board.
- Lewin S, Munabi-Babigumira S, Glenton C, Daniels K, Bosch-Capblanch X, van Wyk BE, Odgaard-Jensen J, Johansen M, Aja GN, Zwarenstein M, Scheel IB. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database Syst Rev. 2010 Mar 17;2010(3):CD004015. doi: 10.1002/14651858.CD004015.pub3.
- Dennis CL. Peer support within a health care context: a concept analysis. Int J Nurs Stud. 2003 Mar;40(3):321-32. doi: 10.1016/s0020-7489(02)00092-5.
- Report of a World Health Organization consultation. Peer support programmes in diabetes November 5-7, 2007.
- Dale JR, Williams SM, Bowyer V. What is the effect of peer support on diabetes outcomes in adults? A systematic review. Diabet Med. 2012 Nov;29(11):1361-77. doi: 10.1111/j.1464-5491.2012.03749.x.
- Smith SM, Paul G, Kelly A, Whitford DL, O'Shea E, O'Dowd T. Peer support for patients with type 2 diabetes: cluster randomised controlled trial. BMJ. 2011 Feb 15;342:d715. doi: 10.1136/bmj.d715.
- Dale J, Caramlau I, Sturt J, Friede T, Walker R. Telephone peer-delivered intervention for diabetes motivation and support: the telecare exploratory RCT. Patient Educ Couns. 2009 Apr;75(1):91-8. doi: 10.1016/j.pec.2008.09.014. Epub 2008 Nov 14.
- Cade JE, Kirk SF, Nelson P, Hollins L, Deakin T, Greenwood DC, Harvey EL. Can peer educators influence healthy eating in people with diabetes? Results of a randomized controlled trial. Diabet Med. 2009 Oct;26(10):1048-54. doi: 10.1111/j.1464-5491.2009.02808.x.
- Murrock CJ, Higgins PA, Killion C. Dance and peer support to improve diabetes outcomes in African American women. Diabetes Educ. 2009 Nov-Dec;35(6):995-1003. doi: 10.1177/0145721709343322. Epub 2009 Sep 23.
- Lorig K, Ritter PL, Villa F, Piette JD. Spanish diabetes self-management with and without automated telephone reinforcement: two randomized trials. Diabetes Care. 2008 Mar;31(3):408-14. doi: 10.2337/dc07-1313. Epub 2007 Dec 20.
- Anderson-Loftin W, Barnett S, Bunn P, Sullivan P, Hussey J, Tavakoli A. Soul food light: culturally competent diabetes education. Diabetes Educ. 2005 Jul-Aug;31(4):555-63. doi: 10.1177/0145721705278948.
- Keyserling TC, Samuel-Hodge CD, Ammerman AS, Ainsworth BE, Henriquez-Roldan CF, Elasy TA, Skelly AH, Johnston LF, Bangdiwala SI. A randomized trial of an intervention to improve self-care behaviors of African-American women with type 2 diabetes: impact on physical activity. Diabetes Care. 2002 Sep;25(9):1576-83. doi: 10.2337/diacare.25.9.1576.
- Pratt C, Wilson W, Leklem J, Kingsley L. Peer support and nutrition education for older adults with diabetes. J Nutr Elder. 1987 Summer;6(4):31-43. doi: 10.1300/J052v06n04_04. No abstract available.
- Heisler M, Vijan S, Makki F, Piette JD. Diabetes control with reciprocal peer support versus nurse care management: a randomized trial. Ann Intern Med. 2010 Oct 19;153(8):507-15. doi: 10.7326/0003-4819-153-8-201010190-00007.
- Baksi AK, Al-Mrayat M, Hogan D, Whittingstall E, Wilson P, Wex J. Peer advisers compared with specialist health professionals in delivering a training programme on self-management to people with diabetes: a randomized controlled trial. Diabet Med. 2008 Sep;25(9):1076-82. doi: 10.1111/j.1464-5491.2008.02542.x.
- McKay HG, Glasgow RE, Feil EG, Boles SM, Barrera M. Internet-based diabetes self-management and support: Initial outcomes from the Diabetes Network project, Rehabil Psychol 2002;47:31-48.
- Thom DH, Ghorob A, Hessler D, De Vore D, Chen E, Bodenheimer TA. Impact of peer health coaching on glycemic control in low-income patients with diabetes: a randomized controlled trial. Ann Fam Med. 2013 Mar-Apr;11(2):137-44. doi: 10.1370/afm.1443.
- Siminerio L, Ruppert KM, Gabbay RA. Who can provide diabetes self-management support in primary care? Findings from a randomized controlled trial. Diabetes Educ. 2013 Sep-Oct;39(5):705-13. doi: 10.1177/0145721713492570. Epub 2013 Jun 19.
- Gillespie P, O'Shea E, Paul G, O'Dowd T, Smith SM. Cost effectiveness of peer support for type 2 diabetes. Int J Technol Assess Health Care. 2012 Jan;28(1):3-11. doi: 10.1017/S0266462311000663.
- Tang TS, Funnell M, Sinco B, Piatt G, Palmisano G, Spencer MS, Kieffer EC, Heisler M. Comparative effectiveness of peer leaders and community health workers in diabetes self-management support: results of a randomized controlled trial. Diabetes Care. 2014 Jun;37(6):1525-34. doi: 10.2337/dc13-2161. Epub 2014 Apr 10.
- Tang TS, Funnell MM, Gillard M, Nwankwo R, Heisler M. The development of a pilot training program for peer leaders in diabetes: process and content. Diabetes Educ. 2011 Jan-Feb;37(1):67-77. doi: 10.1177/0145721710387308. Epub 2011 Jan 10.
- Tang TS, Funnell MM, Gillard M, Nwankwo R, Heisler M. Training peers to provide ongoing diabetes self-management support (DSMS): results from a pilot study. Patient Educ Couns. 2011 Nov;85(2):160-8. doi: 10.1016/j.pec.2010.12.013. Epub 2011 Feb 2.
- Tang TS, Sohal PS, Garg AK. Evaluating a diabetes self-management support peer leader training programme for the English- and Punjabi-speaking South-Asian community in Vancouver. Diabet Med. 2013 Jun;30(6):746-52. doi: 10.1111/dme.12179. Epub 2013 Apr 17.
- Esliger DW, Tremblay MS. Technical reliability assessment of three accelerometer models in a mechanical setup. Med Sci Sports Exerc. 2006 Dec;38(12):2173-81. doi: 10.1249/01.mss.0000239394.55461.08.
- Block G, Gillespie C, Rosenbaum EH, Jenson C. A rapid food screener to assess fat and fruit and vegetable intake. Am J Prev Med. 2000 May;18(4):284-8. doi: 10.1016/s0749-3797(00)00119-7.
- Sarason I, Sarason B, Brock D, Pierce G. Social support: current status, current issues. Spielberger CE. Stress and Emotion: Anxiety, Anger, and Curiously. Washington DC: Taylor and Francis; 1998
- Resnicow K, Campbell M, Carr C, McCarty F, Wang T, Periasamy S, Rahotep S, Doyle C, Williams A, Stables G. Body and soul. A dietary intervention conducted through African-American churches. Am J Prev Med. 2004 Aug;27(2):97-105. doi: 10.1016/j.amepre.2004.04.009.
- Abbey A, Abramis D, Caplan R. Effects of different sources of social support and social conflict on emotional well-being. Soc Sci Med 1985;6:2:111-129.
- Kulzer B, Hermanns N, Reinecker H, Haak T. Effects of self-management training in Type 2 diabetes: a randomized, prospective trial. Diabet Med. 2007 Apr;24(4):415-23. doi: 10.1111/j.1464-5491.2007.02089.x. Epub 2007 Feb 12.
- Canadian Diabetes Association. The prevalence and costs of diabetes. Diabetes.ca (accessed December 1, 2013).
- Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM. Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care. 2002 Jul;25(7):1159-71. doi: 10.2337/diacare.25.7.1159.
- Norris SL, Engelgau MM, Narayan KM. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 2001 Mar;24(3):561-87. doi: 10.2337/diacare.24.3.561.
- Afshar R, Askari AS, Sidhu R, Cox S, Sherifali D, Camp PG, Tang TS. Out of the mouths of Peer Leaders: Perspectives on how to improve a telephone-based peer support intervention in type 2 diabetes. Diabet Med. 2022 Sep;39(9):e14853. doi: 10.1111/dme.14853. Epub 2022 Apr 30.
- Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care; Smedley BD, Stith AY, Nelson AR, editors. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington (DC): National Academies Press (US); 2003. Available from http://www.ncbi.nlm.nih.gov/books/NBK220358/
- Seddigh S, Tang TS. Social support and diabetes distress: Does the messenger matter as much as the message? Chronic Illn. 2023 Sep;19(3):681-685. doi: 10.1177/17423953221102622. Epub 2022 May 26.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- H14-02419
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
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