Technologically Enhanced Coaching: A Program to Improve Diabetes Outcomes
VA-TEC
1 other identifier
interventional
290
1 country
2
Brief Summary
Peer support programs have been demonstrated to improve glycemic control among Veterans with poor control. This program will expand on this success by putting innovative tools in the hands of Veteran diabetes patients. Veteran coaches who have demonstrated effective control of their own diabetes will be trained to use communication skills to guide their peers through a diabetes education and decision aid. This tool, which is an iPad application, draws the patient in by showing them their personal risk and medication information derived from baseline labs and self-reported survey data. The tool encourages interaction by providing choices of materials to view, using audio-visual elements and incorporating a goal-setting process for developing self-management action steps and questions to discuss with their doctor at their next clinic visit. Ongoing weekly contact between the Veterans is supported by a confidential phone system.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable diabetes
Started Sep 2014
Typical duration for not_applicable diabetes
2 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
May 13, 2013
CompletedFirst Posted
Study publicly available on registry
May 16, 2013
CompletedStudy Start
First participant enrolled
September 9, 2014
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 20, 2017
CompletedStudy Completion
Last participant's last visit for all outcomes
September 29, 2017
CompletedResults Posted
Study results publicly available
July 12, 2019
CompletedJuly 12, 2019
April 1, 2019
3 years
May 13, 2013
June 28, 2018
April 30, 2019
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Percent Glycosylated Hemoglobin
Percent glycosylated hemoglobin is measured at baseline, 6 months, and 12 months to test the effectiveness of a technology-enhanced peer coaching (TEC) program in improving glucose control relative to peer support alone.
6 Month
Study Arms (2)
Peer Coaching + Decision Aid
EXPERIMENTALAll participants will be assigned to one of up to 87 peer coaches, who also are Detroit VA diabetes patients who previously had poor glycemic control but are currently in good control. After their baseline assessment, participants in both arms will receive information on their lab and blood pressure values and will be randomized to one of the two study arms. Participants in the TEC arm will be scheduled for an initial visit with their coach to review the decision aid, which has incorporated their personal baseline data.
Peer Coaching Alone
ACTIVE COMPARATORParticipants randomized to the 'print materials' group will be scheduled for an initial visit with their coach. The coach will then help them list questions and concerns they wish to discuss with their health care provider, practice raising their questions and concerns and develop an action plan to address barriers to self-management they have identified. During the next six months coaches in both arms will call their assigned peers once a week to provide support for their action steps.
Interventions
All participants will be assigned to a peer coach, who is a Detroit VA diabetes patient who previously had poor glycemic control but is currently in good control. Participants will receive information on their lab and blood pressure values and will be scheduled for an initial visit with their coach. The coach will then help them list questions and concerns they wish to discuss with their health care provider, practice raising their questions and concerns, and develop an action plan to address barriers to self-management they have identified. During the next six months, coaches will call their assigned peers once a week to provide support for their action steps.
The iDecide tool is designed to present key tailored, evidence-based information on diabetes and diabetes treatments. Importantly for a peer support intervention, all content information will be provided through the tool, with the role of the peer mentor being to assist the participant to go through the program and participate in helping the patient formulate questions and concerns to discuss with their health care provider, to set their own behavioral goals and action steps, and to help the participant practice raising the issues they plan to discuss with their health care provider.
Eligibility Criteria
You may qualify if:
- one hospitalization with a diabetes-related ICD-9 code
- two outpatient visits with a diabetes-related ICD-9 code
- at least one prescription for a glucose control medication (insulin or oral agents) or monitoring supplies.
- \[70\] Potential participants must also have their most recent A1c in the prior 6 months be at least 8.0% if age \< 70 or at least 8.5% if age 70+).
You may not qualify if:
- Using ICD-9 diagnostic codes, the investigators will exclude patients if they have an active substance abuse disorder or serious psychiatric illness:
- PTSD
- bipolar disorder
- dementia
- schizophrenia
- or personality disorders
- We will then send names of the patients to their primary care providers to identify any patients who they do not recommend inviting to participate in the program.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (2)
VA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, Michigan, 48105, United States
John D. Dingell VA Medical Center, Detroit, MI
Detroit, Michigan, 48201, United States
Related Publications (1)
Turner CD, Lindsay R, Heisler M. Peer Coaching to Improve Diabetes Self-Management Among Low-Income Black Veteran Men: A Mixed Methods Assessment of Enrollment and Engagement. Ann Fam Med. 2021 Nov-Dec;19(6):532-539. doi: 10.1370/afm.2742.
PMID: 34750128DERIVED
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Results Point of Contact
- Title
- Dr. Michele Heisler
- Organization
- VA HSRD: CCMR Ann Arbor and University of Michigan Medical School
Study Officials
- PRINCIPAL INVESTIGATOR
M. E. Michele Heisler, MD MPA
VA Ann Arbor Healthcare System, Ann Arbor, MI
Publication Agreements
- PI is Sponsor Employee
- Yes
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- INVESTIGATOR
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- FED
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
May 13, 2013
First Posted
May 16, 2013
Study Start
September 9, 2014
Primary Completion
September 20, 2017
Study Completion
September 29, 2017
Last Updated
July 12, 2019
Results First Posted
July 12, 2019
Record last verified: 2019-04