AzTrials
AzTrials

Type 2 DiabetesDECIDENCT00964587

Cardiovascular Disease Education and Problem-Solving Training in People With Type 2 Diabetes

A study testing Education + Problem-Solving Training Self-Study, Education + Group Problem-Solving Training and Education + Individual Problem-Solving Training in people with Type 2 Diabetes, run by Johns Hopkins University at 3 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

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… Read more about this study

Who is it for?
Ages 25 years and older
Conditions the study is for
Type 2 Diabetes
What is being tested?
Education + Problem-Solving Training Self-Study, Education + Group Problem-Solving Training and Education + Individual Problem-Solving Training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
382 participants
Where
3 sitesUnited States
Study dates
Aug 2010to Feb 2014
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 25 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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.

Who cannot join

  • 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

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Johns Hopkins School of Medicine/General Clinical Research Center

    Baltimore, Maryland, 21205

  • Johns Hopkins Bayview Medical Center/General Clinical Research Center

    Baltimore, Maryland, 21224

  • Johns Hopkins School of Medicine/General Internal Medicine

    Baltimore, Maryland, 21287

Other trials in United States

About this study

Official title: 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.

Read the detailed description

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.

Conditions
Type 2 Diabetes
Being tested
Education + Problem-Solving Training Self-Study, Education + Group Problem-Solving Training, Education + Individual Problem-Solving Training, Usual Care
Keywords
diabetes self management education, problem-solving training, health behavior change, health literacy
Medical subject headings
Diabetes Mellitus, Type 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Education + Problem-Solving Training Self-StudyBehavioural

    Also called Self-Management Training Self-Study, Project DECIDE Self-Study

    • Education + Problem-Solving Training Self-Study
    • One session of Literacy-Adapted Diabetes and CVD Risk Education
    • Instructions and a schedule for use of the Literacy-Adapted Problem-Solving Workbook for self-study will be given to each participant.
  • Education + Group Problem-Solving TrainingBehavioural

    Also called Group Self-Management Training, Project DECIDE Group Training

    • Education + Group Problem-Solving Training
    • One session of the Literacy-Adapted Diabetes and CVD Risk Education
    • Group problem-solving training eight, 90-minute sessions
  • Education + Individual Problem-Solving TrainingBehavioural

    Also called Individual Self-Management Training, Project DECIDE Individual Training

    • Education + Individual Problem-Solving Training
    • One session of the Literacy-Adapted Diabetes and CVD Risk Education
    • Individual problem-solving training (eight, 60-minute sessions)
  • Usual CareBehavioural

    Also called Standard Print Education Materials, Project DECIDE Usual Care

    • Packet of print patient education materials about CVD and diabetes from the American Heart Association (AHA) and the American Diabetes Association (ADA)given at baseline following randomization to Arm 1
    • Scripted set of instructions will be given along with a verbal description of the materials and the content provided.
Study groups in NCT00964587
Study groupRoleWhat they receive
Usual CareActive comparatorPacket of standard print patient education materials on CVD and diabetes from the American Heart Association (AHA) and the American Diabetes Association (ADA).
Receives: Behavioral: Usual Care
Self StudyExperimentalOne 90-minute educational session. Print materials and DVDs for self-study
Receives: Behavioral: Education + Problem-Solving Training Self-Study
Group Problem-Solving TrainingExperimentalOne 90-minute education session. Group problem-solving training (eight, 90-minute sessions)
Receives: Behavioral: Education + Group Problem-Solving Training
Individual Problem-Solving TrainingExperimentalOne 90-minute education session. Individual problem-solving training (eight, 60-minute sessions)
Receives: Behavioral: Education + Individual Problem-Solving Training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. HbA1C

    Measured: Screening, 3 months post intervention, 6 months post-intervention

Secondary outcomes (8)
  1. Blood pressure

    Measured: Screening, 3 months post-intervention, 6 months post-intervention

  2. Lipid Panel

    Measured: Screening, 3 months post-intervention, 6 months post-intervention

  3. Body Mass Index

    Measured: Screening, 3 months post-intervention, 6 months post-intervention

  4. Health Problem Solving Scale

    Measured: Screening, 1 week post-intervention, 3 months post-intervention, 6 months post-intervention

  5. Diabetes and CVD Knowledge Test

    Measured: Screening, 3 months post-intervention, 6 months post-intervention

  6. Patient Activation Measure

    Measured: Baseline, 3 months post-intervention, 6 months post-intervention

  7. Summary of Diabetes Self-Care Activities Scale

    Measured: Baseline, 3 months post-intervention, 6 months post-intervention

  8. Barriers to Self-Management

    Measured: Baseline, 1 week post-intervention, 3 months post-intervention, 6 months post-intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Aug 2009 (estimated)
  2. Study startAug 2010
  3. Primary completionFeb 2014
  4. Study completionFeb 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
382 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00964587
Sponsor's protocol ID
R01HL089751-01A1
Other IDs
R01HL089751-01A1
Acronym
DECIDE
Status last verified
May 2015
First submitted
24 Aug 2009
Last updated
12 May 2015
Results posted
No
Data monitoring committee
Yes

Publications

  • 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.

    PubMed 18057272
  • 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.

    PubMed 18202245
  • 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.

    PubMed 17443373
  • 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.

    PubMed 12763713
  • 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.

    PubMed 18521688
  • 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.

    PubMed 23042504
  • 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.

    PubMed 22354210
  • 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.

    PubMed 23312614
  • 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.

    PubMed 27879359

Questions about this trial

What is this clinical trial studying?

A study testing Education + Problem-Solving Training Self-Study, Education + Group Problem-Solving Training and Education + Individual Problem-Solving Training in people with Type 2 Diabetes, run by Johns Hopkins University at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 May 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

HbA1C (time frame: Screening, 3 months post intervention, 6 months post-intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00964587, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 May 2015.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in