Faculty Collaboration Database

Rationale and design: telephone-delivered behavioral skills interventions for Blacks with Type 2 diabetes. Trials 2010 Mar 29;11:35

Date

03/31/2010

Pubmed ID

20350322

Pubmed Central ID

PMC2855561

DOI

10.1186/1745-6215-11-35

Scopus ID

2-s2.0-77952906350 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

BACKGROUND: African Americans with Type 2 diabetes (T2DM) have higher prevalence of diabetes, poorer metabolic control, and greater risk for complications and death compared to American Whites. Poor outcomes in African Americans with T2DM can be attributed to patient, provider, and health systems level factors. Provider and health system factors account for <10% of variance in major diabetes outcomes including hemoglobin A1c (HbA1c), lipid control, and resource use. Key differences appear to be at the patient level. Of the patient level factors, consistent differences between African Americans and American Whites with T2DM have been found in diabetes knowledge, self-management skills, empowerment, and perceived control. A variety of interventions to improve diabetes self-management have been tested including: 1) knowledge interventions; 2) lifestyle interventions; 3) skills training interventions; and 4) patient activation and empowerment interventions. Most of these interventions have been tested individually, but rarely have they been tested in combination, especially among African Americans who have the greatest burden of diabetes related complications. This study provides a unique opportunity to address this gap in the literature.

METHODS/DESIGN: We describe an ongoing four-year randomized clinical trial, using a 2 x 2 factorial design, which will test the efficacy of separate and combined telephone-delivered, diabetes knowledge/information and motivation/behavioral skills training interventions in high risk African Americans with poorly controlled T2DM (HbA1c >or= 9%). Two-hundred thirty-two (232) male and female African-American participants, 18 years of age or older and with an HbA1c >or= 9%, will be randomized into one of four groups for 12-weeks of phone interventions: (1) an education group, (2) a motivation/skills group, (3) a combined group or (4) a usual care/general health education group. Participants will be followed for 12-months to ascertain the effect of the interventions on glycemic control. Our primary hypothesis is that among African Americans with poorly controlled T2DM, patients randomized to the combined diabetes knowledge/information and motivation/behavioral skills training intervention will have significantly greater reduction in HbA1c at 12 months of follow-up compared to the usual care/general health education group.

DISCUSSION: Results from this study will provide important insight into how best to deliver diabetes education and skills training in ethnic minorities and whether combined knowledge/information and motivation/behavioral skills training is superior to the usual method of delivering diabetes education for African Americans with poorly controlled T2DM.

TRIAL REGISTRATION: National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00929838).

Author List

Egede LE, Strom JL, Durkalski VL, Mauldin PD, Moran WP

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Biomarkers
Counseling
Diabetes Mellitus, Type 2
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Humans
Hypoglycemic Agents
Male
Motivation
Pamphlets
Patient Education as Topic
Research Design
Telephone
Time Factors
Treatment Outcome