Diabetes Outcomes and Unmet Resources

Sponsor
University of Michigan (Other)
Overall Status
Enrolling by invitation
CT.gov ID
NCT03950973
Collaborator
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (NIH)
600
1
2
44.2
13.6

Study Details

Study Description

Brief Summary

This study will refine and test the effectiveness of CareAvenue, an automated e-health tool that informs and activates patients with uncontrolled diabetes to take steps in accessing resources and engaging in self-care. Our central hypothesis is that activating patients with uncontrolled diabetes and linking them to resources to address financial burden and unmet social risk factors will improve both intermediate outcomes and measures of disease control above and beyond existing services, especially for high need patients.

Condition or Disease Intervention/Treatment Phase
  • Behavioral: CareAvenue
  • Behavioral: Guest Assistance Program
N/A

Study Design

Study Type:
Interventional
Anticipated Enrollment :
600 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose:
Supportive Care
Official Title:
Improving Diabetes Outcomes and Health Disparities Through a Patient Activation Intervention Addressing Unmet Resource Needs
Actual Study Start Date :
Jun 26, 2019
Anticipated Primary Completion Date :
Mar 1, 2023
Anticipated Study Completion Date :
Mar 1, 2023

Arms and Interventions

Arm Intervention/Treatment
Experimental: CareAvenue

Participants receive access to CareAvenue, an e-health tool, and receive one weekly automated telephone call and 4-5 text messages per week for 52 weeks.

Behavioral: CareAvenue
CareAvenue is an e-health tool providing information about diabetes management and low-cost resources. Participants in this group have access to CareAvenue and receive a weekly automated phone call and text messages related to CareAvenue and its resources as well as diabetes management.

Active Comparator: Guest Assistance Program

Participants receive information about the Guest Assistance Program (GAP) and receive 3-4 text messages per week related to diabetes management and resources for 52 weeks.

Behavioral: Guest Assistance Program
The Guest Assistance Program (GAP) is a resource, which provides assistance with medical and non-medical needs and resources to patients receiving medical care at University of Michigan health system. Participants in this group are provided with GAP information and receive text messages related to diabetes management.

Outcome Measures

Primary Outcome Measures

  1. Change in HbA1c as measured by an HbA1c machine [Baseline, 6 months, 12 months]

    Change in HbA1c will be measured at baseline, 6 months, and 12 months using HbA1c machine. HbA1c is a measure of the average level of glucose in blood over the past 3 months measured as a percentage.

Secondary Outcome Measures

  1. Change in blood pressure as measured an automated blood pressure machine [Baseline, 6 months, 12 months]

    Change in blood pressure will be measured at baseline, 6 months, and 12 months using an automated blood pressure machine. Blood pressure is measured as systolic blood pressure/diastolic blood pressure in millimeters of mercury (e.g., 120/80 mm Hg).

  2. Change in Cost-Related Non-Adherence Behaviors with prescribed treatment regimens related to diabetes as measured by participant questionnaire [Baseline, 6 months, 12 months]

    Cost-Related Non-Adherence (CRN) Behaviors related to diabetes will be measured at baseline, 6 months, and 12 months by 4-items adapted from the Medicare Current Beneficiary Survey and 2 items adapted from the National Health Interview Survey that look at diabetes. The items are measured with a 4-point Likert scale. Participants answering "often" or "sometimes" to any of the items are indicated as exhibiting CRN.

  3. Change in Cost-Related Non-Adherence Behaviors with prescribed treatment regimens related to other conditions being managed as measured by participant questionnaire [Baseline, 6 months, 12 months]

    Cost-Related Non-Adherence (CRN) Behaviors related to other conditions being managed will be measured at baseline, 6 months, and 12 months by 4-items adapted from the Medicare Current Beneficiary Survey and 2 items adapted from the National Health Interview Survey that look at other health conditions being managed. The items are measured with a 4-point Likert scale. Participants answering "often" or "sometimes" to any of the items are indicated as exhibiting CRN.

  4. Change in Perceived Financial Burden as measured by the Comprehensive Score for Financial Toxicity (COST) - Functional Assessment of Chronic Illness Therapy (FACIT) [Baseline, 6 months, 12 months]

    Perceived Financial Burden will be measured at baseline, 6 months, and 12 months by the 12-item measure Comprehensive Score for Financial Toxicity (COST) - Functional Assessment of Chronic Illness Therapy (FACIT). The items are measured with a 5-point Likert scale. The higher the score the better the Financial well-being.

  5. Change in Unmet Social Risk Factors as measured by participant questionnaire [Baseline, 6 months, 12 months]

    Change in Unmet Social Risk Factors will be measured at baseline, 6 months, and 12 months by 20 items adapted from the Accountable Health Communities Health-Related Social Needs Screening Tool, the Health Leads Social Needs Screening Toolkit, and the Kaiser Permanente Your Current Life Situation Questionnaire. The item values are binary (yes/no). Number of "yes" responses indicates number of unmet social risk factors.

  6. Change in Unmet Social Risk Factors as measured by participant questionnaire [Baseline, 6 months, 12 months]

    Change in Unmet Social Risk Factors will be measured at baseline, 6 months, and 12 months by 3 items from the Accountable Health Communities Health-Related Social Needs Screening Tool and 1 item adapted from the National Health Interview Survey. The items each have three response options, in which a positive response indicates an unmet social risk factor.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 75 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Be 18-75 years of age

  • Be diagnosed with type 1 or type 2 diabetes with prescribed anti-hyperglycemic medication

  • Have a most recent hemoglobin A1c(HbA1c) level within the past 6 months of ≥7.5% for individuals ≤70 years and >8.0% for individuals between 70-75 years in age

  • Have access to a telephone that can receive and send text messages

  • Not participating in another diabetes intervention research study

Exclusion Criteria:
  • Significant cognitive impairment precluding individuals from completing the study as evidenced by ability to complete study intake procedures.

Contacts and Locations

Locations

Site City State Country Postal Code
1 University of Michigan Ann Arbor Michigan United States 48109

Sponsors and Collaborators

  • University of Michigan
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Investigators

  • Principal Investigator: Minal R Patel, PhD, MPH, University of Michigan

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Minal Patel, Associate Professor, University of Michigan
ClinicalTrials.gov Identifier:
NCT03950973
Other Study ID Numbers:
  • HUM00149794
  • R01DK116715
First Posted:
May 15, 2019
Last Update Posted:
Apr 21, 2022
Last Verified:
Apr 1, 2022
Individual Participant Data (IPD) Sharing Statement:
Yes
Plan to Share IPD:
Yes
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Minal Patel, Associate Professor, University of Michigan
Additional relevant MeSH terms:

Study Results

No Results Posted as of Apr 21, 2022